Mental health street triage: Comparing experiences of delivery across three sites

Abstract

Introduction:The limited evidence on MHST is largely focused on service development and is overly police-centric dominated by narratives of risk. This article considers the interplay between officers and CPNs in practice situated within strategic and operational contexts, illustrating the importance of place to service developments and trust within practice.Aim: This study was conducted to compare the processes, experiences, and perceptions of MHST in 3 sites in England.Method: Semi-structured interviews were completed with 27 police and health service staff in strategic and operational roles over a three-month period in three sites in England. Results: Four themes were identified: 'Reducing and improving the use of mental health detainments'; 'Importance of local contexts and partnerships', 'Enhancing officer confidence'; and 'Developing street triage'. Discussion: MHST decision-making and outcomes were influenced by issues of trust, belonging and legitimacy within the interplay between officers and nurses. Continuity and staff turnover influenced strategic and operational development. However, MHST was perceived to be an effective and costsaving model. Implications for practice: Mental health nurses are well positioned to lead awareness and education of officers in relation to mental health crisis response. Staff need to develop communication strategies that extend beyond those immediately involved in MHST.

Subjective experiences of the first response to mental health crises in the community: a qualitative systematic review

“…They described pressure from colleagues to detain PMI when they did not meet the requirements of S136,36 and said that they often prioritised the safety of the PMI over the law in order to take them to hospital30 31 36 54: “I'd rather get into trouble ethically for taking somebody against their will than somebody die, and I left them there to die ” (paramedic) 30. During MHC, FRs worried about being blamed, scrutiny, losing their job and pension, and felt they had to cover themselves17 30 31 35 47 56 57: “ It’s just not worth losing my job over people who don’t care about themselves” (paramedic) 56. Police officers shared their anxiety and sense of responsibility for suicide victims and their families 57…”

“…Issues of stigmatisation and disregarding mental illness as a legitimate health condition were also revealed in the studies. 17 77 81 This demonstrates the difficulty of eliminating stigma, unconscious bias and the unintended consequences of attitudes. New studies 82 continue to find stigmatising views among officers.…”

“…Factors that impact on the interactions between FRs and PMI need to be understood better and integrated into training to improve response 16. Significant research focuses on service development, however there is a need for research on lived experiences and interactions as they unfold in real time, exploring the perspectives of all stakeholders, including companions (family/carers/friends) 17 18. With rises in mental distress and illness worldwide, identifying experiences of the responses to MHC from all people involved is critical.…”

Perceiving Agency in Sustainability Transitions: A Case Study of a Police-Hospital Collaboration

“…The closure of mental health hospitals [54] and the reduction of social service funding [55] has increased the number of PMIs that the police and health care providers have to manage within a given year, and increased the financial and reputational costs of managing the PMI process for both organizations. Police services are responding to more calls for service involving PMIs now than in the past [56]. This has, in turn, increased the PMI patient load at the hospital to the extent that health care providers are now less able to treat PMIs in a timely manner.…”

Service evaluation of the South Wales police control room mental health triage model: outcomes achieved, lessons learned and next steps

“…Increases in police demand has been attributed, in part, to the impact of funding pressures on local authority and NHS services and the limited operating hours of MH services (House of Commons, 2018). For example, police might receive “concern for safety” requests or calls from the public who are unsure who to contact for help when community MH service are closed (Callender et al , 2019; Horspool et al , 2016; Lepresle et al , 2013). Indeed, a Home Affairs inquiry found a growing demand in police work relating to safeguarding vulnerable people, including: being the first responders to MH-related incidents, repeat missing person incidents, child protection work and the need to protect marginalised individuals from harm (House of Commons, 2018).…”