Costs of the police service and mental healthcare pathways experienced by individuals with enduring mental health needs
Substantial policy, communication and operational gaps exist between mental health services and the police for individuals with enduring mental health needs.
To map and cost pathways through mental health and police services, and to model the cost impact of implementing key policy recommendations.
Within a case-linkage study, we estimated 1-year individual-level healthcare and policing costs. Using decision modelling, we then estimated the potential impact on costs of three recommended service enhancements: street triage, Mental Health Act assessments for all Section 136 detainees and outreach custody link workers.
Under current care, average 1-year mental health and police costs were £10 812 and £4552 per individual respectively (n = 55). The cost per police incident was £522. Models suggested that each service enhancement would alter per incident costs by between −8% and +6%.
Recommended enhancements to care pathways only marginally increase individual-level costs.
In the UK, the importance of investment in the interface between National Health Service (NHS) mental health services and the criminal justice system has been highlighted, and research has identified substantial gaps between the sectors for individuals with enduring moderate to severe mental health needs. Mental health disorders are costly to society, with estimates of healthcare costs in England at around £22.5 billion per year, exclusive of indirect costs such as costs to the criminal justice system. In light of recommendations from key policy documents in recent years, this study aimed to map current care pathways between mental health services and the police, to estimate the costs to each sector and to explore, by decision modelling, the potential cost impacts of implementing enhanced care pathways based on key policy recommendations in recent years. To date, no investigation of the potential cost impacts of implementing enhanced care pathways has been conducted. The modelling approach used here is helpful in the absence of ‘harder’ evidence on the cost impacts and can prove informative for service/policy evaluation and appraisal.