Street Triage in Brighton and Hove - Thoughts on the Sustainability Angle?

As part of my role as Psychiatry Sustainability Scholar for 2016/17, I have been attached to Brighton and Hove CCG and had the opportunity to gain experience of mental health commissioning on a number of different projects.

Over the next couple of months I will be working with the CCG, MIND and Sussex Police to produce a service evaluation of a Street Triage pilot that is currently running in Brighton and Hove.

The service model involves a community psychiatric nurse teaming up with a police officer in a designated street triage car, to attend and assess in person any incidents where there is concern about the individual’s mental health.

Over the past 12 months, between 40-80% of all detentions under Section 136 in Brighton and Hove do not lead to detention under the Mental Health Act or informal hospital admission, suggesting that there is scope to reduce the number of Section 136 detentions if specialist mental health input could be accessed by police and service user at the point of first contact. This was clearly demonstrated in the national evaluation of street triage pilots published in 2016, which found an average 12% reduction in use of Section 136 across the participating services - https://www.ucl.ac.uk/pals/research/cehp/research-groups/core/pdfs/street-triage

The service evaluation design for Brighton and Hove will broadly follow that of the national evaluation, but I am keen to include a sustainable angle to fully map the impact of this service on the overall pathway and service provision for mental health crisis care.

One part of this will include attempting to quantify any impact on the carbon footprint of services if the total number of Section 136 detentions is reduced. A single detention under Section 136 generates significant travel for police and mental health staff – the supervising nurse, the clerking SHO and those involved in the Mental Health Act Assessment. There is also the impact of building use, and any travel required after the conclusion of the assessment. In some months of 2016, up to 70% of all admissions to the Brighton and Hove place of safety suite were out of area detentions, involving a round trip of anywhere between ten to seventy miles for the service user.

Any thoughts on other sustainable angles to this project would be warmly welcomed. I will post updates as and when available!