Decision analytic model exploring the cost and cost-offset implications of street triage
Open accessAbstract
Objectives: To determine if street triage is effective at reducing the total number of people with mental health needs detained under section 136, and is associated with cost savings compared to usual police response. Design: Routine data from a 6-month period in the year before and after the implementation of a street triage scheme were used to explore detentions under section 136, and to populate a decision analytic model to explore the impact of street triage on the cost to the NHS and the criminal justice sector of supporting people with a mental health need. Setting: A predefined area of Sussex, South East England, UK. Participants: All people who were detained under section 136 within the predefined area or had contact with the street triage team. Interventions: The street triage model used here was based on a psychiatric nurse attending incidents with a police constable. Primary and secondary outcome measures: The primary outcome was change in the total number of detentions under section 136 between the before and after periods assessed. Secondary analysis focused on whether the additional costs of street triage were offset by cost savings as a result of changes in detentions under section 136. Results: Detentions under section 136 in the street triage period were significantly lower than in the usual response period (118 vs 194 incidents, respectively; χ 2(1df) 18.542, p<0.001). Total NHS and criminal justice costs were estimated to be £1043 in the street triage period compared to £1077 in the usual response period. Conclusions: Investment in street triage was offset by savings as a result of reduced detentions under section 136, particularly detentions in custody. Data available did not include assessment of patient outcomes, so a full economic evaluation was not possible.
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Street Triage is a UK-based coresponse model where a dedicated police officer and psychiatric nurse together attend the scene of incidents requiring support for mental health needs.
“An example of this model is the UK-based ‘Street Triage’,68 70 89 where a dedicated police officer and psychiatric nurse together attend the scene of incidents requiring support for mental health needs.”
From Interagency collaboration models for people with mental ill health in contact with the police: a systematic scoping review (2018) · cites this paper as [68]
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- Authors
- Heslin, M., Callaghan, L., Packwood, M., Badu, V., & Byford, S.
- Affiliations
- King's College London (GB)
- Peninsula College of Medicine and Dentistry (GB)
- Sussex Partnership NHS Foundation Trust (GB)
- Corresponding author
- Heslin, Margaret
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2016-02
- Volume
- 6
- Issue
- 2
- Pages
- e009670
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4762102
- OpenAlex
- W2263551488
- Cited by
- 26
- References
- 4
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 2
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- PEARL (University of Plymouth) (submittedVersion, cc-by-nc)
- Research Portal (King's College London) (submittedVersion, cc-by-nc)
- HighWire Press Open Archive (submittedVersion)
- PEARL (University of Plymouth) (submittedVersion)
- Funders
- Sussex Partnership NHS Foundation Trust
- National Institute for Health and Care Research
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Keywords
- psychiatric detention, cost reduction, criminal justice costs, NHS costs, decision-analytic model, mental health crisis response
- MeSH terms
- Cost-Benefit Analysis, Decision Support Techniques, United Kingdom, Humans, Patient Care Team, Psychiatric Nursing, Triage, Police
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