Costs of the police service and mental healthcare pathways experienced by individuals with enduring mental health needs

BackgroundSubstantial policy, communication and operational gaps exist between mental health services and the police for individuals with enduring mental health needs.AimsTo map and cost pathways through mental health and police services, and to model the cost impact of implementing key policy recommendations.MethodWithin a case-linkage study, we estimated 1-year individual-level healthcare and policing costs. Using decision modelling, we then estimated the potential impact on costs of three recommended service enhancements: street triage, Mental Health Act assessments for all Section 136 detainees and outreach custody link workers.ResultsUnder current care, average 1-year mental health and police costs were £10 812 and £4552 per individual respectively (n = 55). The cost per police incident was £522. Models suggested that each service enhancement would alter per incident costs by between −8% and +6%.ConclusionsRecommended enhancements to care pathways only marginally increase individual-level costs.

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Supporting people in mental health crisis in 21st-century Britain

BJPsych Bulletin ◽

10.1192/bjb.2019.93 ◽

2020 ◽

Vol 44 (6) ◽

pp. 231-232 ◽

Cited By ~ 1

Author(s):

Andrew Molodynski ◽

Stephen Puntis ◽

Em Mcallister ◽

Hannah Wheeler ◽

Keith Cooper

Keyword(s):

Mental Health ◽

Law Enforcement ◽

21St Century ◽

Current System ◽

Mental Healthcare ◽

Evidence Base ◽

Health Needs ◽

Mental Health Crisis ◽

Mental Health Needs ◽

Health Crisis

Recent years have seen a surge in interest in mental healthcare and some reduction in stigma. Partly as a result of this, alongside a growing population and higher levels of societal distress, many more people are presenting with mental health needs, often in crisis. Systems that date back to the beginning of the National Health Service still form the basis for much care, and the current system is complex, hard to navigate and often fails people. Law enforcement services are increasingly being drawn into providing mental healthcare in the community, which most believe is inappropriate. We propose that it is now time for a fundamental root and branch review of mental health emergency care, taking into account the views of patients and the international evidence base, to ‘reset’ the balance and commission services that are humane and responsive – services that are fit for the 21st century.

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The global impact on mental health almost 2 years into the COVID-19 pandemic

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2021.75 ◽

2021 ◽

Vol 38 (4) ◽

pp. 243-246

Author(s):

Blanaid Gavin ◽

John Lyne ◽

Fiona McNicholas

Keyword(s):

Mental Health ◽

Health Research ◽

Mental Healthcare ◽

Mental Health Research ◽

Health Needs ◽

Mental Health Needs ◽

Global Impact ◽

Global Pandemic ◽

Population Mental Health ◽

Global Population

AbstractApproaching 2 years into a global pandemic, it is timely to reflect on how COVID-19 has impacted the mental health of the global population. With research continuing apace, a clearer picture should crystallise in time. COVID-19 has undoubtedly had some impact on population mental health, although the severity and duration of this impact remain less clear. The exceptional period of COVID-19 has provided a unique prism through which we can observe and consider societal mental health. This is a momentous time to be involved in mental health research as we strive to understand the mental health needs of the population and advocate for adequate resourcing to deliver quality mental healthcare in the post-pandemic period.

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The mental health needs of asylum seekers and refugees – challenges and solutions

BJPsych International ◽

10.1192/s2056474000001069 ◽

2016 ◽

Vol 13 (2) ◽

pp. 30-32 ◽

Cited By ~ 6

Author(s):

Piyal Sen

Keyword(s):

Mental Health ◽

Asylum Seekers ◽

Mental Healthcare ◽

Leadership Role ◽

Health Needs ◽

Mental Health Needs ◽

Cultural Brokers ◽

Competency Training ◽

Second World ◽

Asylum Seekers And Refugees

Global events like wars and natural disasters have led to the refugee population reaching numbers not seen since the Second World War. Attitudes to asylum have hardened, with the potential to compromise the mental health needs of asylum seekers and refugees. The challenges in providing mental healthcare for asylum seekers and refugees include working with the uncertainties of immigration status and cultural differences. Ways to meet the challenges include cultural competency training, availability of interpreters and cultural brokers as well as appropriately adapting modes of therapy. Service delivery should support adjustment to life in a foreign country. Never has the need been greater for psychiatrists to play a leadership role in the area.

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Multiculturalism and Compassion: Responding to Mental Health Needs Among Refugees and Asylum Seekers Comment on "A Crisis of Humanitarianism: Refugees at the Gates of Europe"

International Journal of Health Policy and Management ◽

10.15171/ijhpm.2019.77 ◽

2019 ◽

Vol 8 (12) ◽

pp. 734-736 ◽

Cited By ~ 2

Author(s):

Emily Satinsky ◽

Theodoros A. Filippou ◽

Antonis A. Kousoulis

Keyword(s):

Mental Health ◽

Asylum Seekers ◽

Culturally Relevant ◽

Mental Healthcare ◽

Service Design ◽

Health Needs ◽

Political Climate ◽

Mental Health Needs ◽

Refugees And Asylum Seekers

As Fotaki (2019) argues, the current political climate in Europe is threatening principles of humanitarianism, particularly among refugees and asylum seekers. This commentary builds on that argument, with a spotlight on mental health and culturally relevant service design. By addressing some of the barriers faced by refugees and asylum seekers in accessing mental healthcare, we can address inequalities and develop compassionate societies.

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Sociodemographic profile and mental health needs of referrals to an Irish psychiatric service: a transcultural perspective

Irish Journal of Psychological Medicine ◽

10.1017/s079096670001212x ◽

2011 ◽

Vol 28 (3) ◽

pp. 141-144 ◽

Cited By ~ 1

Author(s):

Mohamed Ahmed ◽

Brendan Dineen ◽

Sinead O'Brien ◽

Philip A Carney

Keyword(s):

Mental Health ◽

Service Utilization ◽

Psychiatric Care ◽

Psychiatric Service ◽

Mental Healthcare ◽

Alcohol Problems ◽

Health Needs ◽

Service Utilisation ◽

Service Users ◽

Mental Health Needs

AbstractObjectives: This study describes the social, demographic and clinical characteristics of all the new referrals in a mental health catchment area. This study aims to compare Irish and non-Irish service users in terms of their mental health needs and service utilization.Method: Case notes were reviewed retrospectively to investigate demographic, clinical and service utilization parameters among new referrals to the psychiatric services in Galway, Ireland over a six-month period.Results: One hundred and fifty-four new referrals, of whom 41 were non-Irish, presented over a six-month period. Results showed no difference between Irish and non-Irish service users in terms of socio-demographic variables. Alcohol problems and subsequent need for detoxification and counselling were significantly higher among service users from the new EU accession states with a significant impact on the duration of their hospital stay and the need for intensive psychiatric care.Conclusions: There is an urgent need for enhanced resources for the delivery of mental healthcare to immigrants. Service utilisation and mental health needs are not explained merely by illness-related aspects in immigrant service users. Social and cultural factors have to be recognised in order to prevent disadvantages in psychiatric care.

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Integration of mental healthcare into primary healthcare in Lagos, Nigeria: the way forward

Healthcare in Low-resource Settings ◽

10.4081/hls.2015.3786 ◽

2015 ◽

Vol 3 (2) ◽

Cited By ~ 3

Author(s):

Ayodele O. Coker ◽

Olufemi B. Olugbile ◽

Olufemi Oluwatayo

Keyword(s):

Mental Health ◽

Primary Healthcare ◽

Mental Health Policy ◽

Mental Healthcare ◽

Healthcare Services ◽

The State ◽

Health Needs ◽

Treatment Gap ◽

Mental Health Needs ◽

Lagos State

The Lagos State Ministry of Health recently launched its Mental Health Policy aimed at addressing the mental health needs the residents of the State. The policy also aimed at reducing the mental disorders treatment gap in the state by integrating mental healthcare into the primary healthcare in order to make mental healthcare services closer and accessible for residents of the State. This paper therefore critically reviews the rationale for the integration, magnitude of problems in Lagos State with regards to mental healthcare services, available resources, challenges in providing mental healthcare services, recommendations for successful integration, the necessary advocacy needed to implement the integration and benefits of the integration.

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The management of individuals with enduring moderate to severe mental health needs: a participatory evaluation of client journeys and the interface of mental health services with the criminal justice system in Cornwall

Health Services and Delivery Research ◽

10.3310/hsdr03150 ◽

2015 ◽

Vol 3 (15) ◽

pp. 1-232 ◽

Cited By ~ 4

Author(s):

Susan Lea ◽

Lynne Callaghan ◽

Susan Eick ◽

Margaret Heslin ◽

John Morgan ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Economics ◽

Health Services ◽

Justice System ◽

Clinical Audit ◽

Linkage Study ◽

Health Needs ◽

Mental Health Needs ◽

Stakeholder Consultation

BackgroundExisting research identified substantial gaps between NHS mental health services and the criminal justice system for individuals with enduring moderate to severe mental health needs (EMHN). A pilot study in Cornwall echoed these findings, identifying deficiencies in provision at the interface of police and mental health services.AimTo explore the interagency management of individuals with EMHN as they come into contact with the police.DesignA mixed-methods approach within a community psychology framework to enhance the implementation of findings. Stage 1: policy review and clinical audit to identify a sample of mental health service users who were in contact with the police. Stage 2: case-linkage study of 80 service user journeys through services at the time of three types of police contact (Section 136 detention; arrest for criminal offence and contact that did not result in detention); and a health economics component including analysis of the actual cost of 55 service user journeys and enhanced service scenarios. Stage 3: local stakeholder consultation to validate and contextualise case-linkage findings, including a national event.SettingThe research site was the county of Cornwall within the organisational contexts of Cornwall Partnership NHS Foundation Trust and Devon & Cornwall Police.SampleProportionate stratified random sampling identified a sample of 80 cases examined in the case-linkage study from the 538 linked cases identified by the clinical audit.Data sourcesCase-linkage and health economics data involved individuals’ police and mental health records; stakeholder consultation data involved focus groups and interviews.ResultsOf the sample of 80 cases examined, 23 individuals had been detained under Section 136 of the Mental Health Act (1983: Great Britain.Mental Health Act 1983.Chapter 20. London: The Stationery Office; 1983) (accounting for 32 detentions), 52 had been detained in custody on suspicion of an offence (accounting for 126 arrests) and 15 had non-detention contact with the police. Findings showed that where police were aware of mental health needs and individuals were on caseload of a Mental Health Team, there was increased interaction and enhanced outcomes for service users and organisations. The health economics scenario modelling suggests that enhancing services has minimal effects on individual level costs compared with current practice.ConclusionsThe research revealed discrepancy in police and mental health professionals’ assessment of risk and interpretation of protocol and highlighted the need for joint interagency protocols and training to improve information sharing between agencies to enhance the management of individuals with enduring moderate to severe mental health needs.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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