Police, ambulance and psychiatric co-response versus usual care for mental health and suicide emergency callouts: A quasi-experimental study

Objective: Mental health–related calls to emergency services made via 111 (New Zealand) or 000 (Australia) often represent critical junctures for the person in crisis. Traditionally, police, ambulance and mental health services work separately to manage such emergencies. Sequential agency responses...

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Bibliographic Details
Published in:Australian and New Zealand journal of psychiatry 2023-04, Vol.57 (4), p.572-582
Main Authors: Every-Palmer, Susanna, Kim, Alice Hyun Min, Cloutman, Lauren, Kuehl, Silke
Format: Article
Language:English
Subjects:
Ambulances
Emergencies
Humans
Mental Disorders - therapy
Mental Health
Police
Suicide
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Summary:Objective: Mental health–related calls to emergency services made via 111 (New Zealand) or 000 (Australia) often represent critical junctures for the person in crisis. Traditionally, police, ambulance and mental health services work separately to manage such emergencies. Sequential agency responses may be protracted and cause escalation. This study tests multi-agency co-response aiming for more integrated, faster, safer and less coercive management of mental health crises. Methods: Immediate and 1-month outcomes of mental health emergency calls made to police and ambulance were compared according to whether they occurred on days with co-response availability. Outcomes measured included emergency department admission and waiting times, psychiatric admissions, compulsory treatment, use of force, detention in police cells and the time to resolution of the event. Relative risk estimates were constructed. Results: A total 1273 eligible mental health emergency callouts occurred between March 2020 and March 2021 (38% coded ‘mental health’ emergencies, 48% suicide risk and 14% as ‘other’), 881 on days with co-response availability and 392 on days without. Co-response interventions were resolved faster and were more likely to be community-based. Fewer than one-third (32%) led to emergency department admissions, compared with close to half (45%) on days without co-response (risk ratio: 0.7 [0.6, 0.8]). In the following month, the number of emergency department and mental health admissions reduced (p 
ISSN:0004-8674
1440-1614
DOI:10.1177/00048674221109131