A Controlled Before-and-after Evaluation of a Mobile Crisis Partnership between Mental Health and Police Services in Nova Scotia

• Published in: Canadian journal of psychiatry Vol. 55; no. 10; pp. 662 - 668
• Main Authors: Kisely, Stephen, Campbell, Leslie Anne, Peddle, Sarah, Hare, Susan, Pyche, Mary, Spicer, Don, Moore, Bill
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-10-2010; Canadian Psychiatric Association; SAGE PUBLICATIONS, INC
• Subjects: Biological and medical sciences; Cooperative Behavior; Crisis intervention; Crisis Intervention - organization & administration; Efficiency; Emergency Services, Psychiatric - organization & administration; Focus groups; Forensic Psychiatry - methods; Hospitals; Humans; Interviews as Topic; Medical research; Medical sciences; Mental disorders; Mobile Health Units - manpower; Nova Scotia - epidemiology; Police; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality Improvement - statistics & numerical data; Social Welfare - psychology; Studies; Canada; Nova Scotia; North America; America; mixed-methods; integrated service; police; mental health; mobile crisis unit; Evaluation; Partnership; Mental health; Health service; Police; Mixed method; Public health
• ISSN: 0706-7437; 1497-0015
• DOI: 10.1177/070674371005501005

Objectives:
Police are often the front-line response to people experiencing mental health crises. This study examined the impact of an integrated mobile crisis team formed in partnership between mental health services, municipal police, and emergency health services. The service offered short-term crisis management, with mobile interventions being attended by a plainclothes police officer and a mental health professional.
Methods:
We used a mixed-methods design encompassing: a controlled before-and-after quantitative comparison of the intervention area with a control area without access to such a service, for 1 year before and 2 years after program implementation; and qualitative assessments of the views of service recipients, families, police officers, and health staff at baseline and 2 years afterward.
Results:
The integrated service resulted in increased use by people in crisis, families, and service partners (for example, from 464 to 1666 service recipients per year). Despite increased service use, time spent on-scene and call-to-door time were reduced. At year 2, the time spent on-scene by police (136 minutes) was significantly lower than in the control area (165 minutes) (Student t test = 3.4, df = 1649, P < 0.001). After adjusting for confounders, people seen by the integrated team (n = 295) showed greater engagement than control subjects as measured by outpatient contacts (b = 1.3, χ2 = 92.7, df=1,P< 0.001). The service data findings were supported by the qualitative results of focus groups and interviews.
Conclusions:
Partnerships between the police department and mental health system can improve collaboration, efficiency, and the treatment of people with mental illness.