Effectiveness of a training program for police officers who come into contact with people with mental health problems: A pragmatic randomised controlled trial

Abstract

IntroductionPolice officers frequently come into contact with individuals with mental health problems. Specialist training in this area for police officers may improve how they respond to individuals with mental health problems; however, evidence to support this is sparse. This study evaluated the effectiveness of one bespoke mental health training package for frontline police officers relative to routine training.DesignPragmatic, two-armed cluster randomised controlled trial in one police force in England. Police stations in North Yorkshire were randomised with frontline police officers receiving either a bespoke mental health training package or routine training. The primary outcome was the number of incidents which resulted in a police response reported to the North Yorkshire Police control room up to six months after delivery of training. Secondary outcomes included: likelihood of incidents using Section 136 of the Mental Health Act; likelihood of incidents having a mental health tag applied; and number of individuals with a mental health warning marker involved in incidents. The appropriateness of mental health tags applied to a random sample of incidents was checked by an independent mental health professional. Routinely collected data were used.ResultsTwelve police stations were recruited and randomised (Intervention group n = 6; Control group n = 6), and 249 officers received the bespoke mental health training intervention. At follow-up, a median of 397 incidents were assigned to trial stations in the intervention group, and 498 in the control group. There was no evidence of a difference in the number of incidents with a police response (adjusted incidence rate ratio (IRR) 0.92, 95% CI 0.61 to 1.38, p = 0.69), or in the number of people with mental health warning markers involved in incidents (adjusted IRR 1.39, 95% CI 0.91 to 2.10, p = 0.13) between the intervention and control groups up to six months following the intervention; however, incidents assigned to stations in the intervention group were more likely to have a mental health tag applied to them than incidents assigned to control stations (adjusted odds ratio 1.41, 95% CI 1.16 to 1.71, p = 0.001). The review of 100 incidents suggests that there may be incidents involving individuals with mental health issues that are not being recorded as such (Kappa coefficient 0.65). There was no statistically significant difference in the likelihood of Section 136 of the Mental Health Act being applied to an incident.ConclusionsThe bespoke one day mental health training delivered to frontline officers by mental health professionals did not reduce the number of incidents reported to the police control room up to six months after its delivery; however training may have a positive effect on how the police record incidents involving individuals with mental health problems. Our trial has shown that conducting pragmatic trials within the police setting is feasible and acceptable. There is a wealth of routinely collected police data that can be utilised for research ...

Investigating police officers' perceptions of their role in pathways to mental healthcare

“…Another possible solution is ‘Street Triage’ (Horspool et al, )—a collaborative model of care that has been piloted in various police forces in England, which involves mental health nurses accompanying police officers to mental health‐based incidents (Scantlebury et. al, ). However, more research into the effectiveness of Street Triage is necessary, including resourcing and effect on inter‐agency working (Horspool et al, ).…”

“…Officers suggested that joint training would help services understand each other better, creating less potential for conflict. Another possible solution is 'Street Triage' (Horspool et al, 2016)-a collaborative model of care that has been piloted in various police forces in England, which involves mental health nurses accompanying police officers to mental health-based incidents (Scantlebury et. al, 2017).…”

“…Study participants also suggested amendments to mental health training to improve its effectiveness and acceptability. Suggestions for police officers was unable to conclude the best approach due to huge variations and poor quality of evidence (Booth et. al, 2017).…”

“…Police officers' mental health training should assist decision-making in these situations (Booth et. al, 2017).…”

Police-related triage interventions for mental health-related incidents: a rapid evidence synthesis

“…The included studies were of varying designs. One RCT evaluated a training programme for front-line officers, 47,48 although the remaining studies were largely descriptive, reporting little comparative data. Single studies used the following designs: a comparison of two different models of PRMHT interventions, 44 a largely single-group evaluation during a PRMHT intervention with some comparison data from a cost-benefit analysis, 46 an evaluation across multiple areas of PRMHT pilot interventions that reported comparative data only for some outcomes (e.g.…”