Mental Health Pilot in Hertfordshire Reduces Strain on A&E Services
Further work to support those in mental health crisis in Hertfordshire through the Street Triage Scheme has reported a significant drop in the number of people in mental health crisis being detained under the Mental Health Act.

The Police and Crime Commissioner, David Lloyd is now funding a full cost-benefit analysis of the scheme to see what the best model of Street Triage is for Hertfordshire and whether on that basis, it should be extended and made permanent.  

Commissioner Lloyd said: “This is a brilliant example of partnership working in action.  It is reducing the demand on our public services, but far more importantly it is providing a much better and more appropriate service for people who find themselves in mental health crisis.”

The service is a joint partnership between Hertfordshire Constabulary and the Hertfordshire University Partnership NHS Foundation Trust (HPFT). Under the scheme, health professionals make an on-street assessment to ensure an individual gets the best care possible when concerns about their mental state are reported to the police. It is primarily designed to help avoid preventable detentions under Section 136 of the Mental Health Act.

Under Section 136 a police officer can take a person in mental health distress to a ‘place of safety,’ to assess their needs.

The triage scheme is the latest result of Hertfordshire’s Mental Health Crisis Care Concordat, originally set up by the Police and Crime Commissioner and designed to bring a wide variety of agencies together to commit to providing a better service to people facing mental health crisis.

The service is based on the provision of two cars with a police officer and a mental health crisis team clinician who attend incidents concerning people reported to be in mental health crisis countywide. Two shifts operate between 5pm to 2am and 7pm to 4am.

In a temporary expansion of the scheme in December 2016, one of the cars was replaced by an unmarked ambulance supplied by the East of England Ambulance Services Trust (EEAST) and the deployment of a paramedic working alongside the mental health clinician and police officer. The aim was to provide more specialist medical care and to ease the pressure on A&E services.

This prevented 43 people in mental health crisis from having to go to A&E. As a result of its success, the ambulance pilot service also ran throughout the month of March.

A/DCI Matt Phillips, from Hertfordshire Constabulary’s Safeguarding Command, said: “The initial results of this trial have been very encouraging with a significant reduction in the number of people in mental health crisis being detained under the MHA, compared to the months prior to the most recent changes. We will continue to monitor the figures and will be working with the Herts Partnership Foundation Trust and the East of England Ambulance Service to learn where we can and improve the service further.

Not only is this scheme providing quality of care and speed of services to people who often need urgent help, but it has the secondary benefit of keeping more police resources out on the street preventing crime and keeping people safe.”

Background and Key Dates

October 2014: The PCC and Hertfordshire’s Partners publish a Mental Health Crisis Care Concordat and Action Plan.
April 2015: Hertfordshire Constabulary and HPFT launch a pilot Mental Health Triage Scheme in the Police Force Control Room. A mental health clinician gives advice and information to frontline police officers around proposed detentions under S.136 and in doing so assists in supporting a reduction in the number of S.136 detentions.
Early 2016: Pilot expands to providing resources on the street with the mental health clinician attending calls in a street triage vehicle alongside a police officer.
August 2016: Street Triage pilot provides two vehicles to cover the whole county between the hours of 5pm to 4am (5pm to 2am and 7pm and 4am). The mental health clinician from the Force Control Room is redeployed to one of the vehicles and access enabled to service users’ care plans through HPFT’s electronic patient record - PARIS.
Dec 2016 – Jan 2017: Paramedic pilot runs for a month’s trial which replaced one of the police cars with an ambulance, supplied by the East of England Ambulance Services Trust (EEAST) and includes a paramedic with the mental health clinician and police officer from 5pm to 2am.This avoided 43 people from going to A&E.
March 2017: Following the positive results from December’s trial, the paramedic pilot is put in place for the month of March.

Picture: The Chief Constable and Commissioner visit the Street Triage team on duty in the Force Control Room, January 2017