Policing and street triage

Cummins, ID; Edmondson, David

doi:10.1108/jap-03-2015-0009

Cited by 23 publications

(35 citation statements)

References 41 publications

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“…This also identifies that a number of different collaborative operational models may be labelled as ‘Street Triage’ [10], but could also be argued as standalone collaborative interventions for example mental health training for police offers. Our findings also support those of Irvine, Allen and Webber [29] in that Street Triage services in the UK demonstrate some crossover between crisis response typologies [26], which may suggest that further assessment of existing Street Triage operating models should be taken to develop new terminology applicable to UK services.…”

Section: Discussionmentioning

confidence: 99%

Implementing street triage: a qualitative study of collaboration between police and mental health services

2016

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BackgroundStreet Triage is a collaborative service between mental health workers and police which aims to improve the emergency response to individuals experiencing crisis, but peer reviewed evidence of the effectiveness of these services is limited. We examined the design and potential impact of two services, along with factors that hindered and facilitated the implementation of the services.MethodsWe conducted 14 semi-structured interviews with mental health and police stakeholders with experience of a Street Triage service in two locations of the UK. Framework analysis identified themes related to key aspects of the Street Triage service, perceived benefits of Street Triage, and ways in which the service could be developed in the future.ResultsStakeholders endorsed the Street Triage services which utilised different operating models. These models had several components including a joint response vehicle or a mental health worker in a police control room. Operating models were developed with consideration of the local geographical and population density. The ability to make referrals to the existing mental health service was perceived as key to the success of the service yet there was evidence to suggest Street Triage had the potential to increase pressure on already stretched mental health and police services. Identifying staff with skills and experience for Street Triage work was important, and their joint response resulted in shared decision making which was less risk averse for the police and regarded as in the interest of patient care by mental health professionals. Collaboration during Street Triage improved the understanding of roles and responsibilities in the ‘other’ agency and led to the development of local information sharing agreements. Views about the future direction of the service focused on expansion of Street Triage to address other shared priorities such as frequent users of police and mental health services, and a reduction in the police involvement in crisis response.ConclusionThe Street Triage service received strong support from stakeholders involved in it. Referral to existing health services is a key function of Street Triage, and its impact on referral behaviour requires rigorous evaluation. Street Triage may result in improvement to collaborative working but competing demands for resources within mental health and police services presented challenges for implementation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-1026-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Implementing street triage: a qualitative study of collaboration between police and mental health services

2016

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“…The participants felt that this way of working would enhance the quality of the experience for detainees accessing mental healthcare. 10,19 Training This study has shown that ambulance and paramedic workers play a pivotal role in dealing with individuals experiencing mental health problems in a community setting. Yet, training for this group of professionals is somewhat limited.…”

Section: Accessing the 136 Suitementioning

confidence: 99%

Emergency workers’ experiences of the use of section 136 of the Mental Health Act 1983: interpretative phenomenological investigation

et al. 2020

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Aims and method To explore the experiences of emergency workers dealing with incidents in which section 136 of the Mental Health Act 1983 is invoked by the police. Data from interviews with police officers and ambulance workers in a London locality were subject to interpretative phenomenological analysis. Results Participants felt they were the first port of call and that training should be improved to help them deal with those experiencing mental health crises in the community. Police participants noted time pressures trying to gain individuals’ trust and described section 136 detention as sometimes feeling like a betrayal of the individual. Most participants had negative experiences of admissions to the 136 suite; several suggested ways of improving the admissions system. Several went beyond their expected duties to ensure that distressed individuals were supported before accessing mental healthcare services. Clinical implications Improving training of emergency workers in dealing with mental health crises would also help with aftercare decision-making. Learning identified from the participants’ experiences lends support to collaboration between emergency and mental health services, an important step towards improving the section 136 process so that detainees can access help without unnecessary delay.

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“…11,[15][16][17][18] In addition, a number of non-systematic literature reviews also described relevant intervention models. [19][20][21][22] The existing reviews incorporated overlapping literature searches, the most recent of which was completed in June 2016. Although these reviews provided a useful overview of the existing evidence, the reviews also highlighted the methodological inadequacy of many existing evaluations for drawing firm conclusions about the effects of PRMHT interventions.…”

Section: Results Of Scoping Workmentioning

confidence: 99%

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

Rodgers

Thomas

Dalton

et al. 2019

Health Serv Deliv Res

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Background Police officers are often the first responders to mental health-related incidents and, consequently, can become a common gateway to care. The volume of such calls is an increasing challenge. Objective What is the evidence base for models of police-related mental health triage (often referred to as ‘street triage’) interventions? Design Rapid evidence synthesis. Participants Individuals perceived to be experiencing mental ill health or in a mental health crisis. Interventions Police officers responding to calls involving individuals experiencing perceived mental ill health or a mental health crisis, in the absence of suspected criminality or a criminal charge. Main outcome measures Inclusion was not restricted by outcome. Data sources Eleven bibliographic databases (i.e. Applied Social Sciences Index and Abstracts, Criminal Justice Abstracts, EMBASE, MEDLINE, PAIS® Index, PsycINFO, Scopus, Social Care Online, Social Policy & Practice, Social Sciences Citation Index and Social Services Abstracts) and multiple online sources were searched for relevant systematic reviews and qualitative studies from inception to November 2017. Additional primary studies reporting quantitative data published from January 2016 were also sought. Review methods The three-part rapid evidence synthesis incorporated metasynthesis of the effects of street triage-type intervention models, rapid synthesis of UK-relevant qualitative evidence on implementation and the overall synthesis. Results Five systematic reviews, eight primary studies reporting quantitative data and eight primary studies reporting qualitative data were included. Most interventions involved police officers working in partnership with mental health professionals. These interventions were generally valued by staff and showed some positive effects on procedures (such as rates of detention) and resources, although these results were not entirely consistent and not all important outcomes were measured. Most of the evidence was at risk of multiple biases caused by design flaws and/or a lack of reporting of methods, which might affect the results. Limitations All primary research was conducted in England, so may not be generalisable to the whole of the UK. Discussion of health equity issues was largely absent from the evidence. Conclusions Most published evidence that aims to describe and evaluate various models of street triage interventions is limited in scope and methodologically weak. Several systematic reviews and recent studies have called for a prospective, comprehensive and streamlined collection of a wider variety of data to evaluate the impact of these interventions. This rapid evidence synthesis expands on these recommendations to outline detailed implications for research, which includes clearer articulation of the intervention’s objectives, measurement of quantitative outcomes beyond section 136 of the Mental Health Act 1983 [Great Britain. Mental Health Act 1983. Section 136. London: The Stationery Office; 1983 URL: www.legislation.gov.uk/ukpga/1983/20/section/136 (accessed October 2017)] (i.e. rates, places of safety and processing data) and outcomes that are most important to the police, mental health and social care services and service users. Evaluations should take into consideration shorter-, medium- and longer-term effects. Whenever possible, study designs should have an appropriate concurrent comparator, for example by comparing the pragmatic implementation of collaborative street triage models with models that emphasise specialist training of police officers. The collection of qualitative data should capture dissenting views as well as the views of advocates. Any future cost-effectiveness analysis of these interventions should evaluate the impact across police, health and social services. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Policing and street triage

Cited by 23 publications

References 41 publications

Implementing street triage: a qualitative study of collaboration between police and mental health services

Implementing street triage: a qualitative study of collaboration between police and mental health services

Emergency workers’ experiences of the use of section 136 of the Mental Health Act 1983: interpretative phenomenological investigation

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

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