Police community mental health triage in the UK

Andrew Molodynski is working with police and social services on a project to understand better the use of mental health workers alongside police officers in the community to reduce the number of detentions and removals to places of safety (hospitals or police cells):


How can we reduce the use of compulsion of people with severe mental illness? A cross-sectoral, multi-methods study in Norway
PI: Prof Jorun Rugkåsa, Health Services Research Unit, Akershus Univeristy Hospital, Norway
Research team: Dr Tonje Husum, Centre for Medical Ethics, Universirty of Oslo; Olav Nyttingnes, Health Services Research Unit, Akershus Univeristy Hospital, Norway, Dr Ellen Hoxmark, NAPHA; Solveig Ose, SINTEF- Health
This project addresses the policy ambition of reducing compulsion of people with severe mental illness. Compulsion remains controversial, and it is not clear how public policy match the concerns of those subjected to compulsion and those who carry it out. As referrals for compulsion often comes from GPs or municipal services, an understanding of both primary and specialist levels of health and social care is needed to identify potential for reduction. There is significant variation in the use of compulsion across services and regions of Norway, which might indicate scope for reduction where prevalence is high. However, as the extent of service variation has not been fully established, and no analysis of how current compulsion levels correlate to population profiles exist, this remains unknown. Implementation of interventions aimed to reduce compulsion in hospital and in specialists out-patient services have shown positive outcomes. No such intervention has been developed or tested for the municipal setting nor tailored for the Norwegian service context.
In this study we aim to address these knowledge gaps. Five work packages seek to answer the following questions:
• WP 1: How is the ‘problem’ of coercion represented in public policy, among service users and health professionals and how are the identified solutions aligned with current efforts to reduce it?
• WP2: What is the level of service variation in compulsion and what characterises services with high and low compulsion rates?
• WP 3: What are population predictors for and effects of service variation in compulsion?
• WP 4: Can a tailored intervention at the municipal level reduce the rate of compulsion?
• WP5: What are the implications of findings in WP1-4 for the delivery of good quality, ethical services and how can this be implemented into services and education?

The project, which is funded by the Norwegian Research Council (€1.5 mill), will run from 1 September 2018- 31 August 2022.