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

  • Margaret Heslin (a1), Lynne Callaghan (a2), Barbara Barrett (a1), Susan Lea (a3), Susan Eick (a4), John Morgan (a5), Mark Bolt (a6), Graham Thornicroft (a7), Diana Rose (a7), Andrew Healey (a7) and Anita Patel (a7)...
Abstract
Background

Substantial policy, communication and operational gaps exist between mental health services and the police for individuals with enduring mental health needs.

Aims

To map and cost pathways through mental health and police services, and to model the cost impact of implementing key policy recommendations.

Method

Within 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.

Results

Under 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%.

Conclusions

Recommended enhancements to care pathways only marginally increase individual-level costs.

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Copyright
This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence.
Corresponding author
Margaret Heslin, Institute of Psychiatry, Psychology & Neuroscience at King's College London, Box 024, The David Goldberg Centre, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. Email: margaret.heslin@kcl.ac.uk
Footnotes
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These authors are joint first authors.

∗∗

These authors are joint senior authors.

Declaration of interest

None.

Footnotes
References
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1 Royal College of Psychiatrists. Mental Health and the Economic Downturn: National Priorities and NHS Solutions (Occasional Paper OP70). Royal College of Psychiatrists, 2009.
2 Adebowale, V. Independent Commission on Mental Health and Policing Report. Independent Commission on Mental Health and Policing, 2013.
3 Bradley, K. The Bradley Report: Lord Bradley's Review of People with Mental Health Problems or Learning Disabilities in the Criminal Justice System. Department of Health, 2009.
4 Rutherford, M. Blurring the Boundaries: The Convergence of Mental and Criminal Justice Policy: Legislation Systems and Practice. Sainsbury Centre for Mental Health, 2010.
5 McCrone, P, Dhanasiri, S, Patel, A, Knapp, M, Lawton-Smith, S. Paying the Price: The Cost of Mental Health Care in England to 2026. King's Fund, 2008.
6 Lea, S, Callaghan, L, Eick, S, Heslin, M, Morgan, J, Bolt, M, et al 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 Serv Deliv Res 2015; 3(15).
7 Phillips, Z, Ginnelly, L, Schulpher, M, Claxton, K, Golder, S, Riemsma, R, et al Review of guidelines for good practice in decision-analytic modelling in health technology assessment. Health Technol Assess 2004; 8: 1158.
8 McCrone, P, Thornicroft, G, Phelan, M, Holloway, F, Wykes, T, Johnson, S. Utilisation and costs of community mental health services: PRiSM Psychosis Study 5. Br J Psychiatry 1998; 173: 391–8.
9 Department of Health. Extending the street triage scheme: new patrols with nurses and the police (https://www.gov.uk/government/news/extending-the-street-triage-scheme-new-patrols-with-nurses-and-the-police). Department of Health, 2013
10 James, D. Police station diversion schemes: role and efficacy in central London. J Forens Psychiatry 2000; 11: 532–55.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Costs of the police service and mental healthcare pathways experienced by individuals with enduring mental health needs

  • Margaret Heslin (a1), Lynne Callaghan (a2), Barbara Barrett (a1), Susan Lea (a3), Susan Eick (a4), John Morgan (a5), Mark Bolt (a6), Graham Thornicroft (a7), Diana Rose (a7), Andrew Healey (a7) and Anita Patel (a7)...
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