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Police and clinician diversion of people in mental health crisis from the Emergency Department: a trend analysis and cross comparison study

Overview

This study evaluated NPACER, a combined police and mental health clinician response team in Victoria, Australia. The team diverted people in mental health crisis from emergency departments to community care or direct inpatient admission. Results showed a 50% reduction in ED presentations during operational hours.

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Individual authors

Primary Authors:

  • Brian McKenna (School of Nursing, Midwifery and Paramedicine, Australian Catholic University & NorthWestern Mental Health)
  • Trentham Furness (Australian Catholic University & NorthWestern Mental Health)
  • Steve Brown (Northern Area Mental Health Service, NorthWestern Mental Health)
  • Mark Tacey (Melbourne EpiCentre, The Royal Melbourne Hospital & University of Melbourne)
  • Andrew Hiam (Epping Police Station, Victoria Police)
  • Morgan Wise (Australian Catholic University)

Key insights

Key Insights:

  1. NPACER reduced ED mental health presentations by approximately 50% when operational

  2. Only 16% of crisis cases went to ED during NPACER hours vs 100% otherwise

  3. Joint police-clinician teams enabled direct community assessment and hospital admission pathways

  4. Most people (73%) assessed in community remained there rather than hospitalization

  5. Team operated 15:00-23:30 daily across two police divisions covering 600,000 people

  6. Direct inpatient access was provided for 51 people bypassing ED processing

  7. Model reduced restrictive interventions while maintaining safety through police partnership

  8. Some people were still transported to police stations raising criminalization concerns

Did this resource draw on transformative evidence?

<p>This document was based on limited experiential evidence. While it evaluated a real-world police-clinician program (NPACER) using operational data, it relied primarily on retrospective electronic records analysis rather than direct experiential accounts from stakeholders (clinicians, police, patients, families) who actually participated in the program.</p>
<p>This document incorporated some practice wisdom through the development and implementation of the NPACER model by experienced police officers and senior mental health clinicians. However, it primarily used quantitative data analysis rather than systematically capturing the accumulated knowledge, insights, and lessons learned from practitioners in the field.</p>
<p>This document was heavily based on research and evaluation insights. It employed rigorous research methodology including interrupted time series analysis, retrospective data collection over 27 months (N=1776), chi-squared statistical tests, and comparative analysis to systematically evaluate the NPACER program&#39;s effectiveness in reducing emergency department presentations.</p>

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Categories

Resource type

Evidence Summary

Translational research priority theme

Alternatives to compulsory treatment, seclusion and restraint

Hybrid models of care

Community-based models of care

Workforce capability

Supporting system navigation, partnerships and collaborative care