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Inter-agency collaboration models for people with mental health problems in contact with the police: a systematic scoping review
ForJournal: peerBMJ Open review only Manuscript ID bmjopen-2017-019312
Article Type: Research
Date Submitted by the Author: 24-Aug-2017
Complete List of Authors: Parker, Adwoa; University of York, York Trials Unit, Department of Health Sciences Scantlebury, Arabella; University of York, Centre for Reviews & Dissemination Booth, Alison; York University, CRD Macbryde, Jillian; University of York, York Management School Scott, William; North Yorkshire Police Wright, Kath; University of York, Centre for Reviews & Dissemination McDaid, Catriona; University of York, York Trials Unit
Primary Subject Mental health Heading:
Health services research, Legal and forensic medicine, Mental health, Public http://bmjopen.bmj.com/ Secondary Subject Heading: health
police, MENTAL HEALTH, systematic scoping review, inter-agency Keywords: collaboration
on September 26, 2021 by guest. Protected copyright.
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1 2 3 4 5 INTER-AGENCY COLLABORATION MODELS FOR PEOPLE WITH MENTAL 6 7 HEALTH PROBLEMS IN CONTACT WITH THE POLICE: A SYSTEMATIC 8 9 SCOPING REVIEW 10
11 12 1* 1 1 2 3 13 Adwoa Parker , Arabella Scantlebury , Alison Booth , Jillian Catherine MacBryde , William J Scott , 14 4 1 Kath Wright , Catriona McDaid 15 16 For peer review only 17 18 AUTHOR AFFILIATIONS 19 1 20 York Trials Unit, Department of Health Sciences, University of York, YO10 5DD, United Kingdom, 21 22 2The York Management School, University of York, YO10 5DD 23 24 3North Yorkshire Police, Newby Wiske Hall, Northallerton, North Yorkshire, DL7 9HA 25 26 27 4Centre for Reviews and Dissemination, University of York, YO10 5DD 28 29 30 31 CORRESPONDING AUTHOR 32 *Adwoa Parker, Email: [email protected] http://bmjopen.bmj.com/ 33 34 35 36 37 38 WORD COUNT: 3794 39 40
on September 26, 2021 by guest. Protected copyright. 41 42 43 Key Words: Police, mental health, systematic scoping review, inter-agency-collaboration 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 1 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 2 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 ABSTRACT 4 5 6 Objective: To identify existing evidence on inter-agency collaboration between law enforcement, 7 emergency services, statutory services and third sector agencies regarding people with mental health 8 9 problems. 10 11 Design: Systematic scoping review. 12 13 Data sources and eligibility: ASSIA, CENTRAL, the Cochrane Library databases, Criminal Justice 14 15 Abstracts, ERIC, Embase, MEDLINE, PsycINFO, PROSPERO and Social Care Online and Social Sciences 16 Citation Index, wereFor searched peer up to 2017, reviewas were grey literature only and hand searches. Eligible articles 17 18 were empirical evaluations or descriptions of models of inter-agency collaboration between the police 19 20 and other agencies. 21 22 Study appraisal and synthesis: Screening and data extraction were undertaken 23 24 independently by two researchers. Arksey’s framework was used to collate and map included studies. 25 26 Results: One hundred and twenty-six studies were included. The majority of articles were of single 27 28 service evaluations (38%) descriptions of models (28%) and mixed methods evaluations of models 29 (18%). The most frequently reported outcomes (52%) were ‘organisational or service level outcomes’ 30 31 (e.g. arrest rates). Most articles (53%) focused on adults with mental health problems, whilst others 32 http://bmjopen.bmj.com/ 33 focused on adult offenders with mental health problems (17.4%). Fourteen models of inter-agency 34 collaboration were described, each involving between 2-13 agencies. Frequently reported models were 35 36 ‘pre-arrest diversion’ of people with mental health problems (34%), ‘co-response’ involving joint 37 response by police officers paired with mental health professionals (28.6%) and ‘jail diversion’ 38 39 following arrest (23.8%). 40 on September 26, 2021 by guest. Protected copyright. 41 We identified 14 different inter-agency collaboration models catering for a range of 42 Conclusions: 43 mental health related interactions. All but one of these models involved the police and mental health 44 45 services or professionals. Several models have sufficient literature to warrant full systematic reviews of 46 their effectiveness, while others need robust evaluation, by RCT where appropriate. Future evaluations 47 48 should focus on health related outcomes and the impact on key stakeholders. 49
50 51 52 53 54
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1 2 3 Strengths and limitations of this study 4 5 • This is the first, broad scoping review to map the evidence available for interagency 6 collaboration models between the police and other agencies, for people with apparent mental 7 8 health problems. 9 • We undertook rigorous searches for the available literature, including grey literature, led by an 10 11 information specialist with input from the team, including a police officer. 12 13 • Two reviewers independently undertook study selection and the data extraction and study 14 coding was checked by a second researcher to ensure robustness in these processes. 15 16 • The lack ofFor an assessment peer of study qualityreview and synthesis onlyof the findings means we were unable 17 to make conclusions about the effectiveness of individual models. 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 3 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 4 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 BACKGROUND 4 5 Globally, there has been increasing policy and legislative focus on inter-agency collaboration for people 6 with mental health problems coming into contact with the police and other statutory agencies such as 7 8 healthcare providers.[1-7] In recent decades in the UK and elsewhere, mental health legislation has 9 required health departments to establish jointly agreed policies with other statutory agencies to 10 11 manage people with a range of mental health problems.[3,4,8,9] 12 13 Inter-agency collaboration, also known as ‘integrated’, ‘multi-agency’ or ‘inter-professional’ 14 15 collaboration,[10,11] takes many forms [12] ranging from a low level of joint decision-making with 16 For peer review only 17 limited shared resources to multifaceted, fully-integrated services.[13,14] Regardless of the form, 18 inter-agency collaboration generally involves three core principles of information sharing, joint 19 20 decision-making and coordinated intervention.[2,15] Inter-agency collaborations involving the police 21 aim to improve health and social care outcomes for individuals with mental health problems and the 22 23 cost and effectiveness of services.[16,17] 24 25 A disproportionate number of people with mental health problems come into contact with police, who 26 27 are often the first public service to interact with such individuals. Between 20-45% of police time is 28 spent engaging with people experiencing mental health problems, as victims, witnesses or 29 30 offenders.[18] However, mental health problems are often unrecognised and poorly handled by the 31 police, meaning that many people end up incarcerated rather than receiving appropriate 32 http://bmjopen.bmj.com/ 33 treatment.[19] 34 35 There have been few systematic reviews of inter-agency collaboration models involving the police, 36 37 with no current registered ongoing review; so the impacts, particularly health-related, of such models 38 39 remain unclear. One review focused on guidance and research in the UK related to information-sharing 40
practices within mental health services and the organisations they work in partnership with.[20] Other on September 26, 2021 by guest. Protected copyright. 41 42 reviews have focused on inter-agency working in general rather than law enforcement 43 agencies.[11,12,21,22] The extent, range and nature of the available literature on inter-agency 44 45 collaboration between the police and other agencies are unclear. 46 47 We therefore undertook a systematic scoping review of inter-agency collaboration models involving 48 49 the police or other law enforcement organisations and emergency services, health and social care and 50 third sector organisations, aimed at supporting people with mental health problems. Scoping reviews 51 52 are used in complex areas or where there is no existing systematic review. They provide a map of ‘the 53 54 key concepts underpinning a research area and the main sources and types of evidence available’.[23] 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 4 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 5 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 It is then possible to identify areas where a full systematic review would be feasible and worthwhile, 4 such as to capture the effectiveness of certain interventions on health outcomes. 5 6 7 8 AIMS AND OBJECTIVES 9 10 We aimed to identify and map the existing research evidence evaluating and describing inter-agency 11 collaboration between the police or law enforcement and emergency services, health service, social 12 13 care, education and third sector agencies for people who appear to be suffering from mental health 14 disorder. 15 16 For peer review only 17 Our specific objectives were to identify and map the evidence available on: 18 19 1. Models or mechanisms for inter-agency collaboration that have been described and/or 20 21 evaluated 22 2. The broad areas and issues covered 23 24 3. Views and experiences of the collaborative models 25 26 27 28 METHODS 29 We undertook a systematic scoping review of the published evidence. This followed systematic review 30 31 methodology, except for quality assessment of studies and the evidence identified is mapped rather 32 than the findings synthesised.[24] The protocol was made publicly available a priori via our project http://bmjopen.bmj.com/ 33 34 website.[25] 35 36 37 Inclusion and exclusion criteria 38 Eligible studies were empirical evaluations or descriptions of models of inter-agency collaboration 39 40 between the police and other organisations dealing with members of the public of any age appearing on September 26, 2021 by guest. Protected copyright. 41 to suffer from mental disorder, mental vulnerability or learning disability. Evidence and international 42 43 literature from Organisation for Economic Co-operation and Development (OECD) countries were 44 included. Studies with any or no comparator were included. All outcomes measured were eligible for 45 46 inclusion. 47 48 We excluded: studies undertaken in the prison setting since separate arrangements exist for prisons; 49 50 non-English language studies; studies where the interagency collaboration was focused solely on 51 52 substance abuse; and Inter-agency collaboration without the involvement of the police. Appendix 1 53 lists the full inclusion and exclusion criteria. 54 55 56 Search strategy 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 5 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 6 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 The following electronic databases were searched from inception to March 2017 by an information 4 specialist: ASSIA, CENTRAL, Cochrane Database of Systematic Reviews, Database of Abstracts of 5 6 Reviews of Effects (DARE), Criminal Justice Abstracts, ERIC, MEDLINE, Embase, PsycINFO, Social Care 7 Online and Social Sciences Citation Index. The search strategy for ASSIA is provided in Appendix 2; the 8 9 complete search strategies are available from the authors on request. The Cochrane Effective Practice 10 11 and Organisation of Care and PROSPERO were searched for relevant reviews. 12 13 ‘Google Advanced Search’ was used to identify documents and the websites of organisations such as 14 15 the Centre for Mental Health, Crisis Care Concordat, NHS England and the Society for Evidence Based 16 Policing. SearchesFor combined peer domain terms review and their associations only for ‘interagency’ and ‘police’ and 17 18 ‘mental health’. We contacted the UK College of Policing for relevant evaluations. The reference lists of 19 eligible studies were hand searched. 20 21 22 Study selection and data extraction 23 Search results were downloaded into Endnote and duplicate references removed before titles and 24 25 abstracts were screened. Study selection was undertaken independently by two researchers. 26 27 Discrepancies were resolved by discussion or by recourse to a third researcher. Data extraction forms 28 were developed and piloted. One researcher extracted data and classified the included studies and this 29 30 was checked by a second researcher. Discrepancies were resolved by discussion or by recourse to a 31 third researcher. Data extraction forms were developed for primary/descriptive studies and for 32 http://bmjopen.bmj.com/ 33 reviews. Information extracted included: type of study; model of inter-agency collaboration; target 34 35 audience; agencies involved; study setting and context; purpose of inter-agency collaboration; 36 outcomes evaluated; and whether stakeholder perspectives were evaluated. 37 38 39 Strategy for collating, summarising and reporting the data 40 We mapped the literature, following Arksey’s [26] framework. We firstly present basic numerical on September 26, 2021 by guest. Protected copyright. 41 42 analysis of the extent, nature and distribution of the studies. We collated: the geographic and 43 chronological distribution of studies, agencies involved and the care recipient groups; research 44 45 methods adopted; outcome measures reported; and inter-agency models. We grouped studies 46 47 according to the name of the interagency collaboration model and the definition of the model, as 48 provided by the authors. We then used the terminology reported in the primary papers to code and 49 50 categorise the different models. We present the studies grouped by the different models of inter- 51 agency collaboration. 52 53 54 55 RESULTS 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 6 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 7 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Overview of included studies 4 5 After deduplication there were 2802 records; 340 full text articles were reviewed independently by 6 two authors and 126 were included (Figure 1). 7 8 [Figure 1 about here] 9 10 11 Figure 1: Flowchart of study selection process, adapted from PRISMA [27] 12 13 Records identified through database Additional records identified through 14 15 searching: (n = 3701) other sources: (n = 172) 16 For peer review only 17 18 19 20 21 Records after duplicates removed: (n = 2802) 22 23 24 25 26 27
28 Records screened: (n = 2802) Records excluded: (n = 2462) 29 30 31 32
http://bmjopen.bmj.com/ 33 Full-text articles assessed for Full-text articles excluded, with 34 eligibility: (n = 340) 35 reasons: (n = 214) 36 37 • Not research, n = 87 38 39 • Not inter-agency, n = 45 40 Studies included in review: on September 26, 2021 by guest. Protected copyright. 41 • Unobtainable, n = 28 (n = 126) 42 • Police not involved, n = 16 43 44 • Not mental health, n = 14 45 • Published <1995, n = 8 46 47 • Not English language, n = 4 48 49 • Duplicate, n = 4 50 • Not OECD, n = 1 51 52 • Non-systematic review, n = 7 53 54 55 56 The studies were from 8 countries: Australia,[28-42] Canada,[43-51] Denmark 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 7 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 8 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 ,[52] France,[53] Ireland,[54] Netherlands,[55] UK,[56-92] and USA;[93-149] two multinational studies 4 were undertaken in Australia, Canada and the USA.[111,150] The majority of studies were from the 5 6 USA (45%) and the UK (29%). 7 8 Study Design 9 10 The study designs of the 126 included articles are given in Table 1. Definitions for our classification of 11 12 study designs are in Appendix 2. 13 14 [Table 1 about here] 15 16 Table 1: ResearchFor methods adoptedpeer review only 17 18 19 Study Design Number of Reference number 20 studies (%) 21 Audit 3 (5.3%) [41,42,84] 22 Case study 6 (4.8%) [58,70,76,97,137,141] 23 Scoping review 1 (0.8%) [43] 24 25 Qualitative 11 (8.7%) [29,35,48,49,60,82,83,91,133,150,151] 26 27 Mixed methods 23 (18.3%) [28,30-32,37,50,52-54,57,62,66- 28 68,71,90,105,110,119,142,143,147,148] 29 Controlled before and 15 (11.9%) [40,55,64,65,69,74,80,89,115,121,131,132,135,145,149] 30 after study 31 Service evaluation 18 (38.1%) [36,39,44,73,75,81,86- 32 88,92,94,95,113,117,120,122,125,138] http://bmjopen.bmj.com/ 33 Survey 13 (10.3%) [32,59,61,77,85,101,106,109,111,124,136,144,152] 34 Description of model 35 (27.8%) [33,34,38,45-47,51,56,63,78,79,93,96,98-100,102- 35 36 104,107,108,112,114,116,118,123,126- 37 130,134,139,140,146] 38 Prospective 1 (0.8%) [72] 39 observational study 40 on September 26, 2021 by guest. Protected copyright. 41 42 Outcomes assessed 43 44 There was a wide range of outcomes assessed, with some studies reporting multiple outcomes. Where 45 46 this occurred we report outcomes in all relevant categories (Table 2); therefore some studies are 47 presented in multiple categories. The most frequently occurring outcomes (66 studies) were 48 49 ‘organisational or service level outcomes’. The views and experiences of agency staff were investigated 50 in 28 studies. 51 52 53 [Table 2 about here] 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 8 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 9 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Table 2: Outcomes assessed 4 5 Outcomes assessed Number of Reference number 6 7 studies (%) 8 Organisational/service level 66 (52%) [30-33,36,39,40,42,44,47,50,51,54,55,59,62-65,69,71- 9 10 outcomes (e.g. arrest rates, 77,81,84-89,93,94,96,97,101,106,108-111,113,115,117,119- 11 12 diversion rates, mental health 122,124,125,128,131,132,134-138,140,141,144,145,147,148] 13 referrals, court referrals and 14 15 numbers of people under 16 emergency protectiveFor custody) peer review only 17 18 Views and experiences of agency 28 (22%) [29-32,35,37,48- 19 staff (e.g. police officers) 50,52,53,57,66,67,71,83,90,95,105,110,119,124,133,142,143,1 20 21 47,151] 22 23 Views and experiences of people 18 (14.2%) [30,31,44,48-50,53,54,57,59,60,66,67,90,91,110,119,152] 24 in community (e.g. service users, 25 26 families and carers) 27 Service user mental health 7 (5.5%) [59,61,63,81,102,119,140] 28 29 outcomes (e.g. improvement in 30 31 mood) 32
Cost effectiveness or wider 3 (2.4%) [28,61,65] http://bmjopen.bmj.com/ 33 34 economic costs 35 Staff learning outcomes (e.g. staff 3 (2.4%) [58,80,92] 36 37 knowledge about mental health 38 39 following mental health training) 40
No outcomes reported 28 (22%) [34,38,43,45,46,56,70,78,79,98- on September 26, 2021 by guest. Protected copyright. 41 42 100,103,104,107,112,114,116,118,123,126,127,129,130,139,1 43 46,150] 44 45 46 47 Study population 48 49 The majority of articles (n=67) focused on adults, either diagnosed with or perceived to have a mental 50 51 health problem, such as psychoses or severe mental illness (Table 3). A number of articles focused on 52 adult offenders with mental health problems (n=22) or adults with mental health and/or substance 53 54 misuse problems (n=7). Articles including children and youth generally focused on those who had been 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 9 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 10 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 exposed to or victimised by violence (n=4); child offenders with mental health and/or substance abuse 4 problems (n=3); or those with behavioural problems (n=2). Three articles included children and adults. 5 6 7 [Table 3 about here] 8 9 Table 3: Care recipient group 10 11 Care recipient group Number of Reference number 12 13 studies (%) 14 15 Adults Mental health problems 67 (53.2%) [28-37,40-43,45,46,48- 16 For peer review only50,54,55,64,65,67- 17 18 69,71,72,74,77,82,83,88,90,92,94,95,97, 19 99,101- 20 21 106,109,114,117,118,120,122,124,126- 22 23 128,131,133,136,138,141,143,145,146,1 24 48-150] 25 26 Mental health and/or substance misuse dual 7 (5.6%) [44,52,62,113,134,135,152] 27 diagnosis 28 29 Mental health, substance misuse dual 3 (2.4%) [108,129,142] 30 31 diagnosis and/or homelessness 32
Learning disabilities 3 (2.4%) [56,79,80] http://bmjopen.bmj.com/ 33 34 Metal health problems and homelessness 1 (0.8%) [53] 35 Offenders with mental illness 22 [32,47,51,59,63,73,76,81,84- 36 37 87,89,91,107,111,112,115,121,132,144, 38 39 151] 40
Offenders with learning disabilities 1 (0.8%) [70] on September 26, 2021 by guest. Protected copyright. 41 42 Individuals with pathological fixations, 4 (3.2%) [38,39,75,98] 43 deemed to be mentally ill 44 45 Vulnerable adults, including mental health, 5 (4%) [57,58,60,61,100] 46 47 learning disabilities and other special needs 48 Children At risk children and youth 4 (3.2%) [93,116,119,147] 49 50 and young Offenders with learning disabilities 1 (0.8%) [66] 51 people Offenders with mental health and/or 3 (2.4%) [110,139,140] 52 53 substance abuse problems 54 55 Behavioural problems 2 (1.6%) [96,137] 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 10 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 11 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Children and adolescents who have been 1 (0.8%) [123] 4 exposed to or victimized by violence 5 6 Men, women, adolescents and older people 1 (0.8%) [78] 7 8 with mental health, learning disability or 9 acquired brain injury. 10 11 Mixed Children and families exposed to violence 1 (0.8%) [125] 12 adults and and trauma 13 14 children People with Alzheimer’s, children with autism 1 (0.8%) [130] 15 16 and DownFor syndrome peer review only 17 Men, women, adolescents and older people 1 (0.8%) [78] 18 19 with mental health, learning disability or 20 acquired brain injury 21 22 23 24 Models of inter-agency collaboration and agency composition 25 26 Fourteen different models of inter-agency collaboration were described in the included articles; 27 28 although there was often an overlap in agency composition. A number of articles reported on more 29 than one model; therefore papers are represented in each relevant section. The terminology used to 30 31 describe the different models of interagency collaboration was directly derived from the primary 32 papers. Detailed descriptions of the models are provided in Appendix 3. http://bmjopen.bmj.com/ 33 34 35 The models identified involved collaborations between the police and a wide range of other services 36 (Table 4). The ‘consultation model’, ‘joint investigation training’ and ‘embedded models’ only involved 37 38 the police and mental health services; the remaining models were highly multi-disciplinary involving a 39 range of organisations. Information sharing agreements and court diversion models involved the 40 on September 26, 2021 by guest. Protected copyright. 41 widest combination of agencies. Across all the collaborations with the police, mental health clinicians, 42 43 mental health services and criminal justice agencies were the most frequently occurring partners. 44 45 [Table 4 about here] 46 47 48 49 50 51 52 53 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 11 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml
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Welfare services Welfare
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services workers/social Social
Schools/Colleges
Probation services Probation
Primary care Primary
Policy makers Policy
Police
Nurses
Mental health services health Mental
Mental health clinicians health Mental
Housing services Housing
Hospitals (acute general) (acute Hospitals
30
of of
Employment support Employment Agency composition composition Agency
12
Emergency services Emergency
Page Page
Courts/criminal justice Courts/criminal
Community organisations Community
BMJ Open Children and family services family and Children
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Ambulance
Advocacy
Adult protection services protection Adult
Addiction services Addiction
on September 26, 2021 by guest. Protected copyright.
24 hour crisis services crisis hour 24
For peer review only For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml
Type of model (number of studies) of studies) (number model of Type Integrated model (n=1) (n=1) model Integrated Re-entry programmes (n=2) (n=2) programmes Re-entry Joint investigation training (n=2) (n=2) training investigation Joint Consultation model (n=3) (n=3) model Consultation Special protective measures (n=3) (n=3) measures protective Special Comprehensive systems organisation organisation systems Comprehensive (n=3) Service integration model (n=3) (n=3) model integration Service Co-location (n=5) (n=5) Co-location Court Diversion (n=11) (n=11) Diversion Court Information sharing agreement models models agreement sharing Information (n=13) Post-booking jail diversion (n=30) (n=30) diversion jail Post-booking Co-response (n=36) (n=36) Co-response Pre-arrest diversion (n=43) (n=43) diversion Pre-arrest
Table 4: Overview of models and agency composition composition agency and models of Overview 4: Table
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1 2 3 4 Pre-arrest diversion 5 The most frequently reported model (43 articles), was pre-arrest diversion, from 6 7 Australia;[30,31,33,34,36,38] Canada;[43,45] the UK;[61,68,75] 8 USA;[29,94,95,97,99,101,103,104,114,116-118,124,126,127,129,133-135,138,143,145,149]; and two 9 10 articles including Australia, Canada and the US.[111,150] Pre-arrest diversion models were described 11 12 as involving police officers who had special mental health training, serving as the first-line police 13 response to mental health crises in the community and acting as liaisons to the formal mental health 14 15 system. The reported purpose of pre-arrest diversion models was to equip police offers to better 16 manage situationsFor involving peer people with review mental health, substance only abuse, and/or homelessness 17 18 problems who became involved with the police, and to offer treatment as an alternative to arrest. The 19 20 most widely reported pre-arrest diversion model was the US-based Crisis Intervention Team (CIT) 21 model.[29,34,43,99,103,104,111,114,116,118,124,126,127,133,138,145,150] CIT is a police-based first- 22 23 responder programme for people in mental health crisis who come into contact with the police and 24 provides police-based crisis intervention training. This model involved collaboration between police, 25 26 emergency services, and treatment providers such as clinical staff from local health departments, 27 hospital emergency departments, and specialised mental health services. CIT trained officers worked in 28 29 partnership with mental health professionals to assist people with mental illness, family members, and 30 31 other police officers. 32 http://bmjopen.bmj.com/ 33 Co-response 34 35 Co-response models were reported in 36 articles, from Australia;[28,29,32,33,35,41] 36 Canada;[33,43,44,48-50] UK;[43,69,71,90] USA;[95,101,102,105,106,111-113,122,131,146,152] and 37 38 multinational studies involving Australia, Canada and the UK.[111,150] In this model, a shared protocol 39 paired specially trained police officers with mental health professionals to attend police call outs 40 on September 26, 2021 by guest. Protected copyright. 41 involving people with mental health problems. The reported aims were to provide assistance to people 42 43 in mental health crisis and prevent their unnecessary incarceration or hospitalisation. An example of 44 this model is the UK based ‘Street Triage’,[69,71,90] where a dedicated police officer and psychiatric 45 46 nurse together attend the scene of incidents requiring support for mental health needs. In Street 47 Triage, the team did not provide the initial response to events. Rather, police call handlers allocated 48 49 incidents to the Street Triage team if the incident required additional mental health support. 50 51 Telephone support to police colleagues attending a new incident was provided if the team were 52 already busy. 53 54 55 Post-booking jail diversion 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 13 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 14 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Thirty articles reported post-booking jail diversion programmes, from the UK 4 [59,63,65,66,70,72,74,81,83,84,86,87,89] and USA.[107,108,110,115,121,127,128,132- 5 6 134,140,141,143,149] This is a multi-agency liaison scheme, comprising of a rapid screening and 7 mental health assessment of people arrested at the earliest point of contact with the criminal justice 8 9 system, plus a mechanism for appropriate referral or diversion to health, treatment, social and 10 11 community services. An example is Diversion at the Point of Arrest (DAPA),[86,87] a UK based model in 12 which people arrested and detained at police stations were assessed by a community psychiatric 13 14 nurse, who then acted as the co-ordinator for the involvement of other mental health care workers 15 and services as needed. 16 For peer review only 17 18 Information sharing agreement models 19 20 Information sharing agreement models were reported in 13 papers from Australia;[37] Canada;[46] 21 Denmark;[52] France;[53] the UK;[56,67,70,85] and USA.[100,144] In this model information about 22 23 people with mental health problems were shared between police and other agencies; or between the 24 individual with mental health problems and the police and other agencies. The reported aims of 25 26 information models were to improve support to people with mental health problems; foster better 27 relations between agencies and between the police and people with mental health problems; identify 28 29 hard-to-find at risk people with mental health problems; and protect the public from offenders with 30 31 mental health problems. An example is the Multi-Agency Public Protection Arrangements (MAPPA) 32
which aims to protect the public from harm by sexual and violent offenders, who may have mental http://bmjopen.bmj.com/ 33 34 health problems.[85] Agency composition includes the police, other law enforcement agencies and 35 mental health services. MAPPA agencies work together by: identifying individuals who should be under 36 37 MAPPA; managing such individuals; multi-agency storing and sharing information about offenders; 38 disclosure of information to the public about individual offenders in particular circumstances; risk 39 40 assessment and management; multiagency meetings and case reviews. on September 26, 2021 by guest. Protected copyright. 41 42 43 Court diversion models 44 Eleven articles reported court diversion models from Canada;[47] the UK;[61,64,72,76,88,153] 45 46 Ireland;[54] and USA.[74,110,136] Offenders were ‘diverted’ from prosecution and into a specialised 47 community-based service. Court diversion occurred following arrest whilst the individual was initially 48 49 detained, during initial hearings, or while being assisted by pre-trial services offer community based 50 51 alternatives to standard prosecution. An example of such a service is ‘Liaison and diversion’, which 52 identifies and supports people with mental health problems, learning difficulties and other 53 54 vulnerabilities in police stations and courts.[61,153] 55 56 Co-location 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 14 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 15 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Co-location was a model reported in five articles from Australia;[29] the UK;[78] and USA.[95,101,145] 4 In this model, mental health professionals were employed by police departments to provide on-site 5 6 and telephone consultations to officers in the field. Another variant of the co-location model involved 7 a dedicated police officer being based in an office within a mental health hospital; an example of this is 8 9 the ‘Police Liaison Forum’.[78] 10 11 12 Comprehensive systems model 13 Three papers from the USA reported a ‘comprehensive systems’ approach to reducing crime and 14 15 arrests, three of which focused on reducing in school arrests.[96,119,137] An example was Project 16 SOBEIT,[119] whereFor school-based peer police officers review worked with children, only staff and external agencies to 17 18 encourage pro-social behaviour and reduce drug use and criminalisation. 19 20 21 Consultation model 22 Three papers from Australia;[42] the UK;[62] and USA [98] reported on a ‘consultation’ model. In this 23 24 model police agencies accessed advice from mental health professionals when working with people 25 with mental health problems. Typically the advice was delivered over the telephone and generally 26 27 aimed to maximise the resources provided by a specialist team and to assess and prevent criminal 28 behaviour, protect life, arrest the perpetrator and protect property. An example is the Oldham Phone 29 30 Triage/Rapid Assessment Interface,[62] which consisted of a dedicated 24-hour telephone number for 31 32 professional advice and assistance from, the local health service’s psychiatric liaison service for local http://bmjopen.bmj.com/ 33 police officers. 34 35 36 Service integration models 37 Three articles from Canada;[43] the Netherlands;[55] and the USA [93] reported on ‘service 38 39 integration’ models. The agencies involved were mental health providers, police officers, educational 40 institutions, and the children and family services (see Table 5). The aims of these models were to on September 26, 2021 by guest. Protected copyright. 41 42 bridge gaps between services, decrease arrest, decrease violence, improve educational attendance and 43 44 completion, and reduce symptoms of mental illness and psychological distress. An example of a service 45 integration model is the ‘Community-care networks’.[55] A Network coordinator (often community 46 47 psychiatric nurse), received reports from network partners about any person of concern and gathered 48 relevant information, established a plan of action and monitored implementation. Responsibility was 49 50 transferred to the most appropriate agency as soon as possible. 51 52 Special protective measures 53 54 Three articles from the UK [57] and USA [123,130] focused on ‘special protective measures’, with the 55 56 reported aim of identifying and protecting people with mental health problems, learning disabilities 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 15 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 16 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 and other vulnerable people. An example of this was ‘Speaking up for justice’,[57] a collaboration 4 between the police, the courts, hospitals and other agencies aimed at improving how vulnerable and 5 6 intimidated witnesses were treated. 7 8 Joint investigation training 9 10 Two papers from the UK reported on a ‘joint investigation training’ model,[58,80] which focused on 11 12 adults with mental health problems, learning disabilities or other vulnerable adults who had crimes 13 committed against them. This model involved joint mental health training for the police, social 14 15 workers, mental health and adult protection services aimed at improving multi-agency adult protection 16 investigations, andFor promoting peer collaborative review working to support vulnerableonly adults. An example of such 17 18 training is the ‘Joint adult Protection Investigations’ training. [58] 19 20 21 Re-entry programmes 22 Two articles from the USA [128,139] reported on ‘re-entry’ programmes, which aimed to assist 23 24 individuals with mental illness to re-integrate into the community. This included institutional and 25 community-based programmes serving individuals with mental illness following release from prison or 26 27 hospitalisation. The ‘Prime Time Project’,[139] involves a collaborative alliance with local police officers 28 to involve young people with mental health problems who have been detained by the police and 29 30 involves activities in the community training in job skills and other aspects of managing daily life. 31 32 http://bmjopen.bmj.com/ 33 Integrated model 34 One article reported an Early Psychosis Program from Australia.[40] In this model police could become 35 36 involved in the voluntary or involuntary admission process of people with mental health problems into 37 the Early Psychosis Programme. The aim was to provide continuity, familiarity and support at an early 38 39 stage throughout the health service to facilitate trust and reduce distress. 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 DISCUSSION 44 45 Overview of main findings 46 47 The scoping review identified fourteen distinctive interagency collaboration models for people with 48 mental health problems in contact with the police, mainly from the US, UK and Australia. Although the 49 50 majority of articles focused on adults with mental health problems, a substantial body of the literature 51 52 focused on offenders with mental illness. The area most commonly covered was the relationship 53 between the police and mental health services; unsurprising as this is a critical interface for the police 54 55 service. However, it is noteworthy that several key agencies were not identified as agency 56 collaborators. For example, the ambulance service was a named agency in only three models; yet in 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 16 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 17 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 countries like the UK, the legal frameworks and guidance stipulate that people with mental health 4 problems taken to a health based place of safety should ideally be transported by ambulance.[18,154] 5 6 Additionally, ten articles included people with dual diagnoses of mental health and substance abuse 7 problems, yet addiction services featured as an agency in only one of the models. This may be 8 9 indicative of conflicting priorities for services; however there is potential for mutual benefit through 10 11 greater interagency working. 12 13 Our review did not evaluate the risk of bias in the included studies, but in general the study designs 14 15 used are unlikely to provide robust evidence about effectiveness: there were no RCTs. The main focus 16 in the articles wasFor the impact peer of the model reviewon organisational level only outcomes routinely collected by the 17 18 police such as arrest and diversion rates, which they are required to collect.[155] Several articles 19 reported the views and experiences of members of the public coming into contact with the service as 20 21 well as the different agencies involved. There are sufficient studies identified to justify development of 22 focussed questions for systematic review. 23 24 25 Strengths and limitations 26 27 A strength of our review is that the broad scope has facilitated mapping of the evidence available on 28 interagency collaboration models between the police and other agencies, to appropriately manage 29 30 people with apparent mental problems who come into contact with the police. The lack of an 31 assessment of study quality and synthesis of the findings means we were unable to make conclusions 32 http://bmjopen.bmj.com/ 33 about the effectiveness of individual models. However, this scoping review provides an overview of the 34 35 literature not previously available.[26] 36 37 Identifying all available evidence on complex topics can be difficult as the relevant studies can be 38 spread across numerous databases covering a range of disciplines. Furthermore, the key concepts may 39 40 also be described using different terminology in each database so the search strategies need significant on September 26, 2021 by guest. Protected copyright. 41 42 adaptation.[156] To address these issues, the search strategy was developed by an information 43 specialist with input from members of the team including a police officer. We also undertook grey 44 45 literature searches and hand searching to maximise retrieval. 46 47 Two reviewers independently undertook study selection and the data extraction and study coding was 48 49 checked by a second researcher to ensure robustness in these processes. Mapping focussed on 50 identifying distinctive models and has a subjective element. We assigned each study to a 51 52 methodological grouping based on the description of the methods used, which may or may not have 53 matched with the author’s categorisation of the study. 54 55 56 Comparison with existing literature 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 17 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 18 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 To our knowledge this is the first systematic scoping review to focus on interagency collaboration 4 models for people with mental health problems in contact with the police. We identified no definitive 5 6 evaluations of models of interagency collaboration such as RCTs. Such a lack of evidence has been 7 found in other fields assessing the evidence for interagency models.[157] Our categorisation of the 8 9 various interagency models, such as ‘pre-arrest diversion’, ‘post booking diversion’ and ‘court 10 11 diversion’ fits with the Sequential Intercept Model.[158] The Sequential Intercept Model is a 12 framework for conceptualising the range of community-based alternatives for people with mental 13 14 health problems in contact with the criminal justice system. The model suggests a series of ‘points of 15 interception’ at which interventions can be targeted to prevent individuals from entering or 16 For peer review only 17 penetrating deeper into the criminal justice system. Our review is broader and considers interagency 18 19 collaboration models outside the criminal justice system. For example, we highlight ‘joint investigation 20 training’ or ‘special protective’ models as efforts that focus on people with mental illness as victims of 21 22 crime or as vulnerable witnesses. 23 24 Although the majority of articles focused on adults with mental health problems, a number focused on 25 26 offenders with mental illness; possibly because individuals with mental health problems are 27 disproportionally more likely to be arrested and enter the criminal justice system.[159,160] 28 29 30 Knowledge gaps and implications for research, policy and professional 31 32 practice http://bmjopen.bmj.com/ 33 While not all the models may be distinctive enough to make an RCT appropriate, there are a number of 34 35 models where this approach would be appropriate. We identified an absence of high quality evidence 36 on effectiveness, despite the fact that models such as street triage and CIT are now routinely 37 38 implemented within policing. Few evaluations considered the views of people with mental health 39 problems, or indeed the views and experiences of staff in the collaborating agencies. 40 on September 26, 2021 by guest. Protected copyright. 41 42 Interagency collaboration models are complex interventions involving several interactive components 43 and agencies. Existing guidance on the development and evaluation of theoretically informed, complex 44 45 interventions may be useful in informing future development and evaluation of interagency models 46 47 [161]. More research is required to examine the efficacy, effectiveness, cost effectiveness, barriers and 48 benefits of interagency collaboration models. The latter is important for designing ‘effective’ models 49 50 which might have significant benefit for healthcare. Whilst there is significant political pressure on 51 agencies to collaborate [18,154,162], at present there is no clear understanding of the most effective 52 53 or cost-effective ways of developing, implementing and delivering such models. Studies in this area 54 should move from simple descriptions of models of care to prospective exploratory and experimental 55 56 evaluations that include primary and secondary outcomes. We identified sufficient literature for some 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 18 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 19 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 models such as pre-arrest diversion, co-response and post-booking diversion which warrant more in- 4 depth evaluation in a systematic review; some of this research is already underway with an upcoming 5 6 systematic review focusing on the effectiveness of liaison and diversion, street triage and specialist 7 staff embedded in police control rooms [163]. Evaluations of the cost-effectiveness of such models 8 9 would be important from a policy perspective, since one of the key drivers for inter-agency 10 11 collaboration is to streamline services and improve efficiency [162] particularly in the current UK 12 context of austerity[164]. 13 14 15 Health services played a significant role in many of these models; however only 5.5% of the articles 16 assessed patient For health outcomes, peer pointing review to a need to identify only the health related benefits of 17 18 interagency collaboration for patients and carers using robust methods. More work is also needed to 19 develop conceptual clarity and frameworks around collaboration models encompassing people with 20 21 mental health problems in contact with the police as suspects or perpetrators, as well as victims or 22 vulnerable witnesses. Future studies could include the views of people with mental health problems in 23 24 the development and evaluation of models. Ideally, researchers should specify the influence of the 25 26 research context on their findings and explain any discrepancies between their findings and the 27 findings of other studies, given the differences in context. This could involve the adoption of process 28 29 evaluation methods, where guidance already exists to inform such work [165]. 30 31 32 http://bmjopen.bmj.com/ 33 CONCLUSIONS 34 We identified 14 different inter-agency collaboration models aimed at supporting people with mental 35 36 health problems; including adults, children and different severities of condition and comorbidities. 37 There were wide variations in the number of agencies involved within the models. All but one of these 38 39 models included collaboration between the police and mental health professionals and/or services; 40 and many of the identified models included other organisations relevant to the purpose of the on September 26, 2021 by guest. Protected copyright. 41 42 collaboration. We have identified models where sufficient literature exists to warrant full systematic 43 44 reviews to assess their effectiveness. We have also identified other areas which have highlighted the 45 need for robust evaluation by RCT where appropriate. Important outcomes for future evaluations 46 47 should include the impact on and experiences of the people the collaborations aim to assist, on staff 48 from the agencies involved, as well as health related outcomes for patients. 49 50 51 52 ACKNOWLEDGEMENTS 53 54 We thank Kat Chatterton for assistance with sourcing inter-library loans. 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 19 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 20 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 FUNDING STATEMENT 4 5 This work was supported by the Higher Education Funding Council for England (HEFCE) and the Home 6 Office through the College of Policing, grant number J05. This review is part of Connect, the Co- 7 8 production of policing evidence, research and training: focus mental health project 9 (http://connectebp.org/). 10 11 12 13 COMPETING INTERESTS 14 15 The authors declare that they have no competing interests. 16 For peer review only 17 18 19 AUTHORS’ CONTRIBUTIONS 20 AP lead the review and was responsible for writing the protocol, study selection, data extraction, grey 21 22 literature and hand searches and writing the final report. KW devised the search strategies and carried 23 out the literature searches and wrote the search methodology section of the paper. AP, AB, and AS 24 25 undertook study selection and data extraction. AP, AB, AS, CM, JCM and WJS inputted into the study 26 conception and design. All the authors commented on the draft protocol and the final report. CM 27 28 provided input at all stages, commented on all draft documents and had overall responsibility for the 29 30 review. All authors read and approved the final manuscript. 31 32 http://bmjopen.bmj.com/ 33 DATA SHARING STATEMENT 34 35 The data extraction tables will be made available by placing a reasonable request with the lead author. 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 20 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 21 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 REFERENCE LIST 4 5 1. Department of Health and Concordat signatories. Mental Health Crisis Care Concordat Improving 6 outcomes for people experiencing mental health crisis. February 2014 7 2. Home Office. Multi-Agency Working and Information Sharing Project: Final Report. In: Office H, ed., 8 2014. 9 3. UK Crown. Mental Health Act 1983. The Stationery Office. UK, 1983. 10 4. UK Crown. Mental Health Act 2007. The Stationery Office. UK, 2007. 11 5. Home Office. Supporting vulnerable people who encounter the police: A strategic guide for police 12 forces and their partners. 2015 13 6. Home Office, Department of Health. No Secrets: Guidance on developing and implementing multi- 14 agency policies and procedures to protect vulnerable adults from abuse. In: Health HOaDo, ed. 15 London, 2000. 16 7. Health Do. StatementFor of Governmentpeer Policy review on Adult Safeguarding. only In: Health Do, ed., 2013. 17 8. National Mental Health Working Group. National safety priorities in mental health: a national plan 18 for reducing harm. In: Health Priorities and Suicide Prevention Branch DoHaA, ed. Publications 19 approval number: 3725 (JN9187) ed. Canberra: Commonwealth of Australia, 2005. 20 9. Metropolitan Police. Inter-agency joint working protocol for the management of mental health: 21 22 Metropolitan Police, 2011. 23 10. Robinson M, Atkinson M, Downing D. Supporting Theory Building in Integrated Services Research: 24 ERIC 2008. 25 11. Oliver C, Mooney A, Statham J. Integrated working: a review of the evidence. 2010 26 12. Atkinson M, Jones M, Lamont E. Multi-agency working and its implications for practice. Reading: 27 CfBT Education Trust 2007 28 13. Darlington Y, Feeney JA, Rixon K. Interagency collaboration between child protection and mental 29 health services: Practices, attitudes and barriers. Child Abuse & Neglect 2005;29(10):1085-98. 30 doi: http://dx.doi.org/10.1016/j.chiabu.2005.04.005 31 14. Walter U, Petr C. A template for family-centered interagency collaboration. Families in Society: The 32 Journal of Contemporary Social Services 2000;81(5):494-503. http://bmjopen.bmj.com/ 33 15. Home Office. Multi-Agency Working and Information Sharing Project Early Findings. In: Office H, 34 ed., 2013. 35 16. Johnson P, Wistow G, Schulz R, et al. Interagency and interprofessional collaboration in community 36 care: the interdependence of structures and values. Journal of Interprofessional care 37 2003;17(1):70-83. 38 17. Paton FCW, Wright K, Ayre N, et al. Improving outcomes for people in mental health crisis: a rapid 39 synthesis of the evidence for available models of care. Health Technology Assessment 2016:1- 40 161. on September 26, 2021 by guest. Protected copyright. 41 42 18. House of Commons Home Affairs Committee. Policing and mental health: Eleventh Report of 43 Session 2014–15. London: The Stationery Office Limited 2015 44 19. Sainsbury Centre for Mental Health. Diversion: A better way for criminal justice and mental health. 45 London: Nuffield Press 2009. 46 20. Jenkins K. Information-sharing in mental health care provision: a review. 2014 47 21. Williams I. Offender health and social care: a review of the evidence on inter‐agency collaboration. 48 Health & social care in the community 2009;17(6):573-80. 49 22. Phillips C, Considine M, Lewis R. A review of audits and strategies produced by crime and disorder 50 partnerships in 1999: Home Office, Research, Development and Statistics Directorate, Policing 51 and Reducing Crime Unit 2000. 52 23. Mays N, Roberts E, Popay J. Synthesising research evidence. Studying the organisation and delivery 53 54 of health services: Research methods 2001:188-220. 55 24. Centre for R, Dissemination. Systematic Reviews: CRD’s Guidance for Undertaking Reviews in 56 Healthcare. York: University of York 2009. 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 21 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 22 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 25. Hughes-Morley A, Clarke A, MacBryde J, et al. What models or mechanisms for inter-agency 4 collaboration between the police or law enforcement and other statutory agencies for people 5 with mental problems have been evaluated, and what evidence is available on their 6 effectiveness? A systematic scoping review 2016 [Available from: http://connectebp.org/wp- 7 content/uploads/2016/09/Inter-Agency-Scoping-Review-Protocol-v1-05.09.2016.pdf accessed 8 17th March 2017. 9 26. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. International journal 10 of social research methodology 2005;8(1):19-32. 11 27. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta- 12 analyses: the PRISMA statement. PLoS Med 2009;6(7):e1000097. 13 28. Allen Consulting Group. Police, Ambulance and Clinical Early Response (PACER) Evaluation. April 14 2012;Final Report:1-66. 15 29. Boscarato K, Lee S, Kroschel J, et al. Consumer experience of formal crisis-response services and 16 preferredFor methods peer of crisis intervention. review International only Journal of Mental Health Nursing 17 2014;23(4):287-95. doi: http://dx.doi.org/10.1111/inm.12059 18 19 30. Herrington V, Clifford K, Lawrence P, et al. The impact of the NSW police force mental health 20 intervention team: final evaluation report. New South Wales: Charles Sturt University 2009 21 31. Herrington V. Inter-agency Cooperation and Joined-up Working in Police Responses to Persons with 22 a Mental Illness: Lessons from New South Wales. Policing: A Journal of Policy & Practice 23 2012;6(4):388-97. 24 32. Hollander Y, Lee SJ, Tahtalian S, et al. Challenges Relating to the Interface Between Crisis Mental 25 Health Clinicians and Police When Engaging with People with a Mental Illness. Psychiatry, 26 Psychology and Law 2012;19(3):402-11. doi: 27 http://dx.doi.org/10.1080/13218719.2011.585131 28 33. Huppert D, Griffiths M. Police Mental Health Partnership project: Police Ambulance Crisis 29 Emergency Response (PACER) model development. Australasian Psychiatry 2015;23(5):520-23. 30 doi: http://dx.doi.org/10.1177/1039856215597533 31 34. Laing R, Halsey R, Donohue D, et al. Application of a model for the development of a mental health 32
service delivery collaboration between police and the health service. Issues Ment Health Nurs http://bmjopen.bmj.com/ 33 2009;30(5):337-41. doi: http://dx.doi.org/10.1080/01612840902754644 34 35. McKenna B, Furness T, Oakes J, et al. Police and mental health clinician partnership in response to 35 mental health crisis: A qualitative study. International Journal of Mental Health Nursing 36 2015;24(5):386-93. 37 36. Meehan T, Stedman T. Trends in the use of Emergency Examination Orders in Queensland since the 38 39 implementation of the Mental Health Intervention Project. Australasian psychiatry : bulletin of 40 Royal Australian and New Zealand College of Psychiatrists 2012;20(4):287-90. on September 26, 2021 by guest. Protected copyright. 41 37. Ogloff JRP, Thomas SDM, Luebbers S, et al. Policing Services With Mentally Ill People: Developing 42 Greater Understanding and Best Practice. Australian Psychologist 2013;48(1):57-68. doi: 43 http://dx.doi.org/10.1111/j.1742-9544.2012.00088.x 44 38. Pathe MT, Haworth DJ, Lowry TJ, et al. A model for managing the mentally ill fixated person at 45 major events. Aust N Z J Psychiatry 2015;49(7):610-15. doi: 46 http://dx.doi.org/10.1177/0004867415581022 47 39. Pathe MT, Lowry T, Haworth DJ, et al. Assessing and managing the threat posed by fixated persons 48 in Australia. Journal of Forensic Psychiatry and Psychology 2015;26(4):425-38. doi: 49 http://dx.doi.org/10.1080/14789949.2015.1037332 50 40. Petrakis M, Penno S, Oxley J, et al. Early psychosis treatment in an integrated model within an adult 51 mental health service.[Erratum appears in Eur Psychiatry. 2013 Mar;28(3):197]. Eur Psychiatry 52 2012;27(7):483-8. doi: http://dx.doi.org/10.1016/j.eurpsy.2011.03.004 53 41. Victorian Auditor General’s Report. Responding to mental health crisis in the community. Victorian 54 Auditor General’s Report: Victorian Government Printer, 2009. 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 22 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 23 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 42. Webster S, Harrison L. The multidisciplinary approach to mental health crisis management: an 4 Australian example. J Psychiatr Ment Health Nurs 2004;11(1):21-29. doi: 10.1111/j.1365- 5 2850.2004.00647.x 6 43. Winters S, Magalhaes L, Kinsella EA. Interprofessional collaboration in mental health crisis response 7 systems: a scoping review. Disabil Rehabil 2015;37(23):2212-24. doi: 8 http://dx.doi.org/10.3109/09638288.2014.1002576 9 44. Baess E. Integrated Mobile Crisis Response Team (IMCRT): Review of pairing police with mental 10 health outreach services. Victoria, BC: Vancouver Island Health Authority 2005 11 45. Cant IR. The secondary family: the result of strong community partnering. Mental Health Review 12 Journal 2007;12(3):30-33. 13 46. Coleman TG, Cotton DH. Reducing Risk and Improving Outcomes of Police Interactions with People 14 with Mental Illness. Journal of Police Crisis Negotiations 2010;10(1/2):39-57. 15 47. De Caire G. A wrap-around social service solution. Blue Line Magazine 2013;25(8):14-14. 16 48. Forchuk C, JensenFor E, Martin peer M-L, et al.review Psychiatric Crisis Servicesonly in Three Communities. Can J 17 Commun Ment Health 2010;29(S5):73-86. doi: 10.7870/cjcmh-2010-0035 18 19 49. Kirst M, Francombe Pridham K, Narrandes R, et al. Examining implementation of mobile, police- 20 mental health crisis intervention teams in a large urban center. J Ment Health 2015;24(6):369- 21 74. doi: http://dx.doi.org/10.3109/09638237.2015.1036970 22 50. Kisely S, Campbell LA, Peddle S, et al. A controlled before-and-after evaluation of a mobile crisis 23 partnership between mental health and police services in Nova Scotia. Can J Psychiatry 24 2010;55(10):662-68. 25 51. Swaminath RS, Mendonca JD, Vidal C, et al. Experiments in change: Pretrial diversion of offenders 26 with mental illness. Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie 27 2002;47(5):450-58. 28 52. Sestoft D, Rasmussen MF, Vitus K, et al. The police, social services and psychiatry cooperation in 29 Denmark--a new model of working practice between governmental sectors. A description of 30 the concept, process, practice and experience. International Journal of Law & Psychiatry 31 2014;37(4):370-5. doi: http://dx.doi.org/10.1016/j.ijlp.2014.02.007 32
53. Girard V, Bonin J, Tinland A, et al. Mental health outreach and street policing in the downtown of a http://bmjopen.bmj.com/ 33 large French city. Int J Law Psychiatry 2014;37(4):376-82. 34 54. Mental Health Commission and An Garda Siochana. Report of joint working group on mental health 35 services and the police. . Mental Health Commission and An Garda Siochana (2009) 2009:1- 36 104. 37 55. Wierdsma AI, Poodt HD, Mulder CL. Effects of community-care networks on psychiatric emergency 38 39 contacts, hospitalisation and involuntary admission. J Epidemiol Community Health 40 2007;61(7):613-18. doi: http://dx.doi.org/10.1136/jech.2005.044974 on September 26, 2021 by guest. Protected copyright. 41 56. Bailey A, McAllister A, McAuley WJ. The development of a protocol for the joint investigation of 42 crimes committed against vulnerable adults. Tizard Learning Disability Review 2004;9(2):18-22. 43 57. Burton M, Evans R, Sanders A. Are special measures for vulnerable & intimidated witnesses 44 working? Evidence from the criminal justice agencies2006. 45 58. Cambridge P, Parkes T. The Management and Practice of Joint Adult Protection Investigations 46 between Health and Social Services: Issues Arising from a Training Intervention. Social Work 47 Education 2006;25(8):824-37. doi: http://dx.doi.org/10.1080/02615470600915886 48 59. Donnelly M, McGilloway S. Mental illness in the UK criminal justice system: a police liaison scheme 49 for mentally disordered offenders in Belfast. J Ment Health 2004;13(3):263-75. 50 60. Durcan D. Keys to diversion: Best practice for offenders with multiple needs. : Centre for Mental 51 Health, 2014. 52 61. Earl F, Cocksedge K, Rheeder B, et al. Neighbourhood outreach: a novel approach to Liaison and 53 Diversion. Journal of Forensic Psychiatry & Psychology 2015;26(5):573-85. 54 62. Edmondson D, Cummins I. Oldham Mental Health Phone Triage/RAID Pilot Project Evaluation 55 Report: Manchester Metropolitan University 2014. 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 23 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 24 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 63. Etherington D. The Police Liaison Community Psychiatric Nurse Project. Mental Health Review 4 Journal 1996;1(2):21-24. doi: 10.1108/13619322199600017 5 64. Exworthy T, Parrott J. Comparative evaluation of a diversion from custody scheme. The Journal of 6 Forensic Psychiatry 1997;8(2):406-16. doi: 10.1080/09585189708412020 7 65. Finn W, Hyslop J, Truman C. Mental health, multiple needs and the police: findings from the 8 Revolving Doors Agency link worker scheme. London: Revolving Doors 2000. 9 66. Fyson R. Young People with Learning Disabilities Who Sexually Harm Others: The Role of Criminal 10 Justice within a Multi-Agency Response. British Journal of Learning Disabilities 2007;35(3):181- 11 86. 12 67. Gibson S, Hamilton S, K J. Evaluation of the Crisis Care Concordat implementation Final Report: 13 McPin Foundation for Mind, 2016. 14 68. Great Britain Home Office. Alternative place of safety: the West Sussex pilot evaluation 2015. 15 London: Great Britain. Home Office 2015. 16 69. Heslin M, CallaghanFor L, Packwoodpeer M, etreview al. Decision analytic only model exploring the cost and cost- 17 offset implications of street triage. BMJ Open 2016;6 (2) (no pagination)(e009670) doi: 18 19 http://dx.doi.org/10.1136/bmjopen-2015-009670 20 70. Hollingsworth N. A fair hearing. Nurs Times 2000;96(50):41-42. 21 71. Irvine A, Allen L, Webber M. Evaluation of the Scarborough, Whitby and Ryedale Street Triage 22 Service. York: University of York 2015. 23 72. James DV, Harlow P. Increasing the power of psychiatric court diversion: a new model of supra- 24 district diversion centre. Medicine Science and the Law 2000;40(1):52-60. 25 73. James D, Cripps J, Gilluley P, et al. A court-focused model of forensic psychiatry provision to central 26 London: Abolishing remands to prison? The Journal of Forensic Psychiatry 1997;8(2):390-405. 27 doi: 10.1080/09585189708412019 28 74. James DV. Police station diversion schemes: Role and efficacy in central London. J Forensic 29 Psychiatry 2000;11(3):532-55. doi: http://dx.doi.org/10.1080/09585180010004801 30 75. James DV, Kerrigan TR, Forfar R, et al. The fixated threat assessment centre: Preventing harm and 31 facilitating care. Journal of Forensic Psychiatry and Psychology 2010;21(4):521-36. doi: 32
http://dx.doi.org/10.1080/14789941003596981 http://bmjopen.bmj.com/ 33 76. Kirkland J, Baron E. Using a cognitive analytic approach to formulate a complex sexual and violent 34 offender to inform multi-agency working: developing a shared understanding. Journal of 35 Sexual Aggression 2015;21(3):394-405. 36 77. Lennox C, Mason J, McDonnell S, et al. Information sharing between the National Health Service 37 and criminal justice system in the United Kingdom. Journal of Forensic Nursing 2012;8(3):131- 38 39 37. doi: http://dx.doi.org/10.1111/j.1939-3938.2012.01138.x 40 78. Mann A, Sugarman P, Rooney C, et al. Service innovation: Policing mental health - The St. Andrew's on September 26, 2021 by guest. Protected copyright. 41 scheme. Psychiatr Bull R Coll Psychiatr 2007;31(3):97-98. doi: 42 http://dx.doi.org/10.1192/pb.bp.106.011007 43 79. Marlow K. Achieving best evidence. Llais 2003(68):3-5. 44 80. McAllister A, Bailey A, Barr O. Training in joint investigation of alleged crimes against people with 45 learning disabilities in Northern Ireland. Journal of Adult Protection 2002;4(2):21-27. 46 81. McGilloway S, Donnelly M. Mental illness in the UK criminal justice system: A police liaison scheme 47 for Mentally Disordered Offenders in Belfast. J Ment Health 2004;13(3):263-75. doi: 48 10.1080/09638230410001700899 49 82. McLean N, Marshall LA. A front line police perspective of mental health issues and services. 50 Criminal Behaviour & Mental Health 2010;20(1):62-71. 51 83. Noga H, Foreman A, Walsh E, et al. Multi-agency action learning: Challenging institutional barriers 52 in policing and mental health services. Action Research 2016;14(2):132-50. doi: 53 10.1177/1476750315583315 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 24 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 25 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 84. Pakes F, Winstone J. A site visit survey of 101 mental health liaison and diversion schemes in 4 England. The Journal of Forensic Psychiatry & Psychology 2010;21(6):873-86. doi: 5 http://dx.doi.org/10.1080/14789949.2010.511241 6 85. Penny C, Craissati J. Decisions on disclosure to third parties made at MAPP meetings: Opinions and 7 practice. Psychiatrist 2012;36(10):379-85. doi: http://dx.doi.org/10.1192/pb.bp.112.038786 8 86. Riordan S, Wix S, Kenney-Herbert J, et al. Diversion at the point of arrest: Mentally disordered 9 people and contact with the police. J Forensic Psychiatry 2000;11(3):683-90. doi: 10 http://dx.doi.org/10.1080/09585180010004937 11 87. Riordan S, Wix S, Haque MS, et al. Multiple contacts with diversion at the point of arrest. Medicine, 12 science, and the law 2003;43(2):105-10. 13 88. Rowlands R, Inch H, Rodger W, et al. Diverted to where? What happens to the diverted mentally 14 disordered offender. The Journal of Forensic Psychiatry 1996;7(2):284-96. doi: 15 10.1080/09585189608415013 16 89. Scott D, McGillowayFor S, peer Donnelly M. A review prospective comparative only evaluation of a Criminal Justice 17 Liaison and Diversion Service in Belfast. The Journal of Forensic Psychiatry & Psychology 18 19 2016;27(2):198. 20 90. Police TV. Thames Valley police (2015). Oxfordshire Mental Health Street Triage Pilot. . 2015 21 91. Vaughan PJ, Kelly M, Pullen N. The working practices of the police in relation to mentally 22 disordered offenders and diversion services. Medicine, science, and the law 2001;41(1):13-20. 23 92. Wain N. May the force be with you. Community Care 2000;31:22-23. 24 93. Barrett JG, Janopaul-Naylor E. Description of a collaborative community approach to impacting 25 juvenile arrests. Psychological Services 2016;13(2):133. 26 94. Bonkiewicz L, Green AM, Moyer K, et al. Left alone when the cops go home: evaluating a post- 27 mental health crisis assistance program. Policing-an International Journal of Police Strategies & 28 Management 2014;37(4):762-78. doi: 10.1108/pijpsm-04-2014-0035 29 95. Borum R, Deane MW, Steadman HJ, et al. Police perspectives on responding to mentally ill people 30 in crisis: perceptions of program effectiveness. Behav Sci Law 1998;16(4):393-405. 31 96. Bracey JR, Foley Geib C, Plant R, et al. Connecticut's Comprehensive Approach to Reducing In- 32
School Arrests: Changes in Statewide Policy, Systems Coordination and School Practices. Family http://bmjopen.bmj.com/ 33 Court Review 2013;51(3):427-34. 34 97. Clayfield JC, Grudzinskas JAJ, Fisher WH, et al. E pluribus unum: creating a multi-organizational 35 structure for serving arrestees with serious mental illness. Research in Social Problems & Public 36 Policy 2005;12:27-49. 37 98. Coggins MH, Pynchon MR. Mental health consultant to law enforcement: Secret Service 38 39 development of a Mental Health Liaison Program. Behav Sci Law 1998;16(4):407-22. 40 99. Compton MT, Broussard B, Hankerson-Dyson D, et al. System- and Policy-Level Challenges to Full on September 26, 2021 by guest. Protected copyright. 41 Implementation of the Crisis Intervention Team (CIT) Model. Journal of Police Crisis 42 Negotiations 2010;10(1/2):72-85. 43 100. Crutcher KD. The Early Notification Program. FBI Law Enforcement Bulletin 2011;80(7):12-15. 44 101. Deane MW, Steadman HJ, Borum R, et al. Emerging partnerships between mental health and law 45 enforcement. Psychiatr Serv 1999;50(1):99-101. 46 102. DeCuir W, Lamb R. Police response to the dangerous mentally ill. The Police Chief 1996:99-106. 47 103. Dupont R, Cochran S, Pillsbury S. Crisis Intervention Team core elements. The University of 48 Memphis School of Urban Affairs and Public Policy, Dept. of Criminology and Criminal Justice, 49 CIT Center2007 [Available from: 50 http://www.cit.memphis.edu/information_files/CoreElements.pdf accessed 2016 2016. 51 104. el-Mallakh RS, Wulfman G, Smock W, et al. Implementation of a crisis intervention program for 52 police response to mental health emergencies in Louisville. J Ky Med Assoc 2003;101(6):241-3. 53 [published Online First: 2003/07/04] 54 105. Frank J, Eck J, Ratansi S. Mobile crisis team/police collaboration evaluation2004. 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 25 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 26 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 106. Geller J, L., , Fisher W, H, , McDermet MA. A national survey of mobile crisis services and their 4 evaluation. Psychiatr Serv 1995;46(9):893-97. doi: 10.1176/ps.46.9.893 5 107. Gordon C, Chabot L. Jail diversion program shows power of teamwork. Behav Healthc Tomorrow 6 2004;13(4):31-35. 7 108. Grudzinskas AJ, Jr., Clayfield JC, Roy-Bujnowski K, et al. Integrating the criminal justice system into 8 mental health service delivery: the worcester diversion experience. Behav Sci Law 9 2005;23(2):277-93. 10 109. Hails J, Borum R. Police training and specialized approaches to respond to people with mental 11 illnesses. Crime & Delinquency 2003;49(1):52-61. doi: 10.1177/0011128702239235 12 110. Hamilton ZK, Sullivan CJ, Veysey BM, et al. Diverting Multi-Problem Youth from Juvenile Justice: 13 Investigating the Importance of Community Influence on Placement and Recidivism. Behav Sci 14 Law 2007;25(1):137-58. doi: http://dx.doi.org/10.1002/bsl.720 15 111. Hartford K, Carey R, Mendonca J. Pre-arrest Diversion of People with Mental Illness: Literature 16 Review For and International peer Survey.review Behav Sci only Law 2006;24(6):845-56. doi: 17 http://dx.doi.org/10.1002/bsl.738 18 19 112. Hatcher C, Mohandie K, Turner J, et al. The role of the psychologist in crisis/hostage negotiations. 20 Behav Sci Law 1998;16(4):455-72. 21 113. Helfgott JB, Hickman MJ, Labossiere AP. A descriptive evaluation of the Seattle Police 22 Department's crisis response team officer/mental health professional partnership pilot 23 program. Int J Law Psychiatry 2016;44:109-22. doi: 24 http://dx.doi.org/10.1016/j.ijlp.2015.08.038 25 114. Hill R, Quill G, Ellis K. The Montgomery County CIT model: Interacting with people with mental 26 illness. FBI Law Enforcement Bulletin 2004;73(7):18-25. 27 115. Hoff RA, Baranosky MV, Buchanan J, et al. The effects of a jail diversion program on incarceration: 28 A retrospective cohort study. Journal of the American Academy of Psychiatry and the Law 29 Online 1999;27(3):377-86. 30 116. James RK, Logan J, Davis SA. Including School Resource Officers in school-based crisis intervention: 31 Strengthening student support. School Psychology International 2011;32(2):210-24. 32
117. Janofsky Js, Tamburello AC. Diversion to the Mental Health System: Emergency Psychiatric http://bmjopen.bmj.com/ 33 Evaluations. J Am Acad Psychiatry Law 2006;34(3):283-91. 34 118. Klein M. Law Enforcement's Response to People with Mental Illness. FBI Law Enforcement Bulletin 35 2002;71(2):11. 36 119. Lacey CH. Collaborative Partnerships and School Change: Evaluating Project SOBEIT: Online 37 Submission, 2006. 38 39 120. Lamb HR, Shaner R, Elliott DM, et al. Outcome for psychiatric emergency patients seen by an 40 outreach police–mental health team. New Dir Ment Health Serv 1995;2001(90):67-76. doi: on September 26, 2021 by guest. Protected copyright. 41 10.1002/yd.23320019007 42 121. Lattimore PK, Broner N, Sherman R, et al. A Comparison of Prebooking and Postbooking Diversion 43 Programs for Mentally Ill Substance-Using Individuals With Justice Involvement. Journal of 44 Contemporary Criminal Justice 2003;19(1):30. 45 122. Lord VB, Bjerregaard B. Helping Persons with Mental Illness: Partnerships between Police and 46 Mobile Crisis Units. Victims & Offenders 2014;9(4):455-74. 47 123. Marans S, Berkowitz SJ, Cohen DJ. Police and mental health professionals: Collaborative responses 48 to the impact of violence on children and families. Child Adolesc Psychiatr Clin N Am 49 1998;7(3):635-51. 50 124. McGuire AB, Bond GR. Critical elements of the crisis intervention team model of jail diversion: an 51 expert survey. Behav Sci Law 2011;29(1):81-94. doi: http://dx.doi.org/10.1002/bsl.941 52 125. Murphy RA, Rosenheck RA, Berkowitz SJ. Acute service delivery in a police-mental health program 53 for children exposed to violence and trauma. Psychiatr Q 2005;76(2):107-21. 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 26 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 27 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 126. Oliva JR, Compton MT. A statewide Crisis Intervention Team (CIT) initiative: evolution of the 4 Georgia CIT program. J Am Acad Psychiatry Law 2008;36(1):38-46. [published Online First: 5 2008/03/21] 6 127. Perez A, Leifman S, Estrada A. Reversing the criminalization of mental illness. Crime & Delinquency 7 2003;49(1):62-78. doi: 10.1177/0011128702239236 8 128. Project Link DoP, University of Rochester, Rochester New York. Gold Award: Prevention of Jail and 9 Hospital Recidivism Among Persons With Severe Mental Illness. Psychiatr Serv 10 1999;50(11):1477-80. 11 129. Rosenbaum N. Street-Level Psychiatry—A Psychiatrist's Role with the Albuquerque Police 12 Department's Crisis Outreach and Support Team. Journal of Police Crisis Negotiations 13 2010;10(1/2):175-81. 14 130. Saunders JEG. Missing and Wandering Children with Autism and Down Syndrome: The Project 15 Lifesaver Partnership Meets the Challenge. Sheriff 2006;58(5):26-28. 16 131. Scott RL. EvaluationFor peer of a Mobile Crisisreview Program: Effectiveness, only Efficiency, and Consumer 17 Satisfaction. Psychiatr Serv 2000;51(9):1153-56. doi: 10.1176/appi.ps.51.9.1153 18 19 132. Shafer MS, Arthur B, Franczak MJ. An analysis of post-booking jail diversion programming for 20 persons with co-occurring disorders. Behav Sci Law 2004;22(6):771-85. 21 133. Skubby D, Bonfine N, Novisky M, et al. Crisis Intervention Team (CIT) programs in rural 22 communities: A focus group study. Community Ment Health J 2013;49(6):756-64. 23 134. Steadman HJ, Deane MW, Morrissey JP, et al. A SAMHSA Research Initiative Assessing the 24 Effectiveness of Jail Diversion Programs for Mentally Ill Persons. Psychiatr Serv 25 1999;50(12):1620-23. doi: 10.1176/ps.50.12.1620 26 135. Steadman HJ, Naples M. Assessing the effectiveness of jail diversion programs for persons with 27 serious mental illness and co-occurring substance use disorders. Behav Sci Law 28 2005;23(2):163-70. doi: 10.1002/bsl.640 [published Online First: 2005/04/09] 29 136. Swartz MS, Swanson JW, Kim M, et al. Use of outpatient commitment or related civil court 30 treatment orders in five U.S. communities. Psychiatr Serv 2006;57(3):343-49. doi: 31 http://dx.doi.org/10.1176/appi.ps.57.3.343 32
137. Teske SC. A study of zero tolerance policies in schools: a multi-integrated systems approach to http://bmjopen.bmj.com/ 33 improve outcomes for adolescents. Journal of child and adolescent psychiatric nursing : official 34 publication of the Association of Child and Adolescent Psychiatric Nurses, Inc 2011;24(2):88-97. 35 doi: http://dx.doi.org/10.1111/j.1744-6171.2011.00273.x 36 138. Teller JL, Munetz MR, Gil KM, et al. Crisis intervention team training for police officers responding 37 to mental disturbance calls. Psychiatr Serv 2006;57(2):232-7. 38 39 139. Trupin EW, Selby PM, McCauley E, et al. The Prime Time Project: Developing an Intensive 40 Community-Based Intervention for Youth in the Juvenile Justice System, 1996. on September 26, 2021 by guest. Protected copyright. 41 140. Van Hasselt VB, Killam G, Schlessinger KM, et al. The Adolescent Drug Abuse Prevention and 42 Treatment (ADAPT) Program: A Mental Health-Law Enforcement Collaboration. J Child Adolesc 43 Subst Abuse 2005;15(2):87-104. 44 141. Wolff N. Interactions between mental health and law enforcement systems: problems and 45 prospects for cooperation. Journal of Health Politics, Policy & Law 1998;23(1):133-74. 46 142. Wood JD, Beierschmitt L. Beyond police crisis intervention: Moving "upstream" to manage cases 47 and places of behavioral health vulnerability. Int J Law Psychiatry 2014;37(5):439-47. doi: 48 http://dx.doi.org/10.1016/j.ijlp.2014.02.016 49 143. Meehan AJ. From conversion to coercion: The police role in medication compliance: Psychiatric 50 Quarterly 1995. 51 144. Sharp CR. Theoretical and Practical Application of Loose Coupling: A Study of Criminal Justice 52 Agencies in the State of Florida. Southwest Journal of Criminal Justice 2009;6(1):45-58. 53 145. Steadman HJ, Deane MW, Borum R, et al. Comparing outcomes of major models of police 54 responses to mental health emergencies. Psychiatr Serv 2000;51(5):645-49. doi: 55 http://dx.doi.org/10.1176/appi.ps.51.5.645 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 27 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 28 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 146. Wellborn. Responding to individuals with mental illness. FBI Law Enforcement Bulletin 4 1999;68(11):6. 5 147. Rollison J, Hill G, Yu P, et al. Evaluation of a complex, multisite, multilevel grants initiative. Eval 6 Program Plann 2012;35(2):273-79. 7 148. Wolff N, Frueh BC, Huening J, et al. Practice informs the next generation of behavioral health and 8 criminal justice interventions. Int J Law Psychiatry 2013;36(1):1-10. 9 149. Wolff N, Diamond RJ, Helminiak TW. A new look at an old issue: People with mental illness and 10 the law enforcement system. J Ment Health Adm 1997;24(2):152-65. 11 150. Crisp AP. Understanding Best Practice: The Emergency Response to Mental Illness-An Exploratory 12 Report. 2015 13 151. Steadman HJ, Cocozza JJ, Veysey BM. Comparing outcomes for diverted and nondiverted jail 14 detainees with mental illnesses. Law Hum Behav 1999;23(6):615-27. [published Online First: 15 2000/01/14] 16 152. Ligon JAN, For Thyer BA. peer CLIENT AND FAMILYreview SATISFACTION only WITH BRIEF COMMUNITY MENTAL 17 HEALTH, SUBSTANCE ABUSE, AND MOBILE CRISIS SERVICES IN AN URBAN SETTING. Crisis 18 19 Intervention and Time-Limited Treatment 2000;6(2):93-99. doi: 10.1080/10645130008951135 20 153. Durcan G, et a. The Bradley report five years on: an independent review of progress to date and 21 priorities for further development. London: Centre for Mental Health 2014. 22 154. Department of Health. Mental Health Act 1983: Code of Practice. In: Health Do, ed. Norwich: The 23 Stationery Office, 2015. 24 155. College of Policing. Statistical data: College of Policing; 2017 [The annual data requirement (ADR) 25 is a list of all requests for data made to all police forces in England and Wales under the Home 26 Secretary’s statutory powers and is used to report crime and policing related statistics. A list of 27 current data requirement publications can be found below:]. accessed 14th July 2017 2017. 28 29 156. O'Mara‐Eves A, Brunton G, McDaid D, et al. Techniques for identifying cross‐disciplinary and ‘ 30 31 hard‐to‐detect’evidence for systematic review. Research synthesis methods 2014;5(1):50-59. 32 157. Macvean M, Humphreys C, Healey L, et al. The PATRICIA Project: PAThways and Research in http://bmjopen.bmj.com/ 33 Collaborative Inter-Agency working: State of knowledge paper Sydney: ANROWS Landscapes 34 14/2015, 2015. 35 158. Munetz MR, Griffin PA. Use of the sequential intercept model as an approach to decriminalization 36 of people with serious mental illness. Psychiatr Serv 2006;57(4):544-49. doi: 37 10.1176/appi.ps.57.4.544 38 159. Charette Y, Crocker AG, Billette I. Police encounters involving citizens with mental illness: use of 39 resources and outcomes. Psychiatr Serv 2014;65(4):511-16. 40
160. McManus S, Meltzer H, Brugha T, et al. Adult psychiatric morbidity in England, 2007: results of a on September 26, 2021 by guest. Protected copyright. 41 household survey: The NHS Information Centre for health and social care 2009. 42 161. Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: the new 43 Medical Research Council guidance. BMJ 2008;337:a1655. 44 162. Department of Health and Concordat signatories. Mental Health Crisis Care Concordat: Improving 45 outcomes for people experiencing mental health crisis. In: Health Do, ed.: HM Government, 46 47 2014. 48 163. Kane E, Evans E, Shokraneh F. Effectiveness of current policing-related mental health 49 interventions in England and Wales and Crisis Intervention Teams as a future potential model: 50 a systematic review. Systematic Reviews 2017;6(1):85. doi: 10.1186/s13643-017-0478-7 51 164. Innes M. A ‘Mirror’ and a ‘Motor’: Researching and Reforming Policing in an Age of Austerity1. 52 Policing: A Journal of Policy and Practice 2010;4(2):127-34. doi: 10.1093/police/pap058 53 165. Moore GF, Audrey S, Barker M, et al. Process evaluation of complex interventions: Medical 54 Research Council guidance. BMJ : British Medical Journal 2015;350 doi: 10.1136/bmj.h1258 55 166. Mental Health Act 1983 Section 136. The Stationery Office. UK, 56 http://www.legislation.gov.uk/ukpga/1983/20/section/136 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 28 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 29 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 167. National Policing Improvement Agency on behalf of the Association of Chief Police Officers. 4 Guidance on responding to people with mental ill health or learning disabilities, 2010. 5 168. The Police and Criminal Evidence Act 1984. The Stationery Office. UK, 6 http://www.legislation.gov.uk/ukpga/1984/60/contents. 7 169. World Health Organization. Adolescent development: World Health Organization; 2016 [Available 8 from: http://www.who.int/maternal_child_adolescent/topics/adolescence/dev/en/ accessed 9 30th June 2016. 10 170. Cheminais R. Effective multi-agency partnerships: Putting every child matters into practice: Sage 11 2009. 12 171. Trodd L, Chivers L. Interprofessional Working In Practice: Learning And Working Together For 13 Children And Families: Learning and working together for children and families: McGraw-Hill 14 Education (UK) 2011. 15 172. Rawlings A, Paliokosta P. Learning for interprofessionalism: pedagogy for all. Interprofessional 16 Working InFor Practice: peer Learning And Workingreview Together For only Children And Families: Learning and 17 working together for children and families 2011:53. 18 19 173. Cooper M, Evans Y, Pybis J. Interagency collaboration in children and young people's mental 20 health: a systematic review of outcomes, facilitating factors and inhibiting factors. Child: care, 21 health and development 2016;42(3):325-42. doi: 10.1111/cch.12322 [published Online First: 22 2016/02/11] 23 174. National Audit Office. What are third sector organisations and their benefits for commissioners? 24 2016 [Available from: https://www.nao.org.uk/successful-commissioning/introduction/what- 25 are-civil-society-organisations-and-their-benefits-for-commissioners/. 26 175. Colquhoun HL, Levac D, O'Brien KK, et al. Scoping reviews: time for clarity in definition, methods, 27 and reporting. J Clin Epidemiol 2014;67(12):1291-94. 28 176. Berger ML, Dreyer N, Anderson F, et al. Prospective Observational Studies to Assess Comparative 29 Effectiveness: The ISPOR Good Research Practices Task Force Report. Value Health 30 2012;15(2):217-30. doi: http://dx.doi.org/10.1016/j.jval.2011.12.010 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 29 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 30 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Interagency scoping review manuscript v6 24/08/2017 Page 30 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 31 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 5 APPENDIX 1 6 7 The following eligibility criteria were applied: 8 9 Population 10 The police and collaborating organisations who deal with members of the public appearing to be 11 12 suffering from mental disorder, mental vulnerability or learning disability. We use the following 13 definitions to define our population of interest: 14 15 16 • ‘Police’ referFor to law peer enforcement review agencies broadly, includingonly regional and national police 17 forces as well as bodies with limited executive powers and their staff. Examples from the UK 18 19 include the British Transport Police and the UK Border Force. 20 • ‘In line with the UK 1983 MHA [166], ‘mental disorder’ refers to ‘people who appear to be 21 22 suffering from mental disorder’ rather than people with a known diagnosis of mental 23 24 illness.The following additional definitions, based on the UK National Policing Improvement 25 Agency (NPIA) ‘Guidance on responding to people with mental ill health or learning 26 27 disabilities’, are used [167]: ‘Mental ill health’ is used broadly to encompass all other mental 28 health terms, including mental health disorders, mental illness, and mental health needs. 29 30 ‘Mental disorder’ refers to ‘any disorder or disability of the mind’ and includes conditions such 31 as schizophrenia, depression, bipolar disorder, anxiety disorder, obsessive-compulsive 32 http://bmjopen.bmj.com/ 33 disorder, personality disorders, eating disorders and dementia. Not all mental disorders meet 34 35 the criteria for the exercise of powers under the Mental Health Act. ‘Mentally vulnerable’ 36 refers to people who ‘because of their mental state or capacity may not understand the 37 38 significance of what is said to them (for example in the form of questions) or of their replies’ 39 [168]. 40 on September 26, 2021 by guest. Protected copyright. 41 • People with learning disabilities were also included: their needs and disability may not be 42 43 obvious but they may be extremely vulnerable and learning disabilities frequently co-occur 44 with mental ill health. 45 46 • We included children, adolescents and adults. Adolescence is defined as the period including 47 and between 10–19 years as defined by the World Health Organization [169]. 48 49 50 Intervention 51 We focused on models of inter-agency collaboration between the police and other organisations. 52 53 • A number of different terms have been used to describe inter-agency and inter-professional 54 55 models These including: ‘multi-agency partnerships’, ‘inter-professional collaboration’, 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 32 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 ‘integrated care’, ‘inter-agency working’ and ‘joint working’ [12,170,171]. Although these 4 terms are often used interchangeably, they can refer to distinctive forms of activity. The prefix 5 6 ‘multi-’ (e.g. multi-agency) is sometimes used to refer to specific collaborative activities around 7 an individual person [172]; while ‘inter-’ (e.g. inter-agency) tends to have a more inclusive 8 9 meaning, referring to collaborative activities across the wider network of professional 10 11 relationships and structures. ‘Inter-professional’ may vary from ‘inter-agency’ in that the 12 former refers to collaborative working across individuals (potentially at the same site), while 13 14 the latter refers to collaborative working across services. ‘Integration’ is sometimes used to 15 refer to the highest level of synthesis [173]. 16 For peer review only 17 • ‘Inter-agency collaboration’ refers to a broad range of collaborative activities and models 18 19 across professional relationships and structures, which include the core principles of 20 information sharing, joint decision making and coordinated intervention. 21 22 • Organisations collaborating with the police refer to any agency or organisation, professional 23 agencies statutory or otherwise, involved in the care of people perceived to be suffering from 24 25 mental health problems. This can include other emergency services such as the ambulance 26 27 service, accident and emergency, crisis resolution and home treatment teams, etc.; other 28 health care providers such as mental health early intervention services; or third sector 29 30 organisations [174]. Third sector organisations are patient and carer organisations which 31 represent and support patients and the family, friends and significant others of people with 32 http://bmjopen.bmj.com/ 33 mental health problems. 34 • We included models that focus, either exclusively or predominantly, on close collaboration 35 36 between the police and at least one other organisation that offers help to people with mental 37 38 health problems. This included models that focus on multi-agency working at a single site; 39 models that focus on collaboration across child and adult mental health services; and models 40 on September 26, 2021 by guest. Protected copyright. 41 where inter-agency collaboration was one of several other components, provided there is a 42 clear reporting of the inter-agency collaboration component. 43 44 45 Comparator(s) 46 Any comparators were included, as were studies with no comparator. 47 48 Outcomes 49 All outcomes were eligible as the purpose of this review was to map the available evidence. Outcomes 50 51 measured could include perceived benefits such as enhanced effectiveness of services; impact on 52 service users, such as improved access to services, through speedier and more appropriate referral; 53 54 mental health outcomes; and early intervention. 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 33 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Context 4 Inter-agency collaboration models could be in the context of: the national level; county or state wide; 5 cities or rural setting; private or public services or settings; or in homes, police stations, on the street, 6 7 safe havens, schools, accident and emergency, etc. We included police working at the interface with 8 9 the criminal justice system, for instance at the court level or as part of a rehabilitation service; 10 however we did not include prisons since separate arrangements exist for prisons. 11 12 13 UK-based evidence and international literature from Organisation for Economic Co-operation and 14 Development (OECD) countries were included. We hypothesised that OECD countries would have 15 16 sufficiently similarFor health andpeer criminal justice review systems to allow only lessons learned to be potentially 17 transferable. 18 19 20 Study Design 21 Eligible studies included empirical evaluations or descriptions of models of inter-agency collaboration. 22 Other relevant legislation and good practice guidance were included, where these were subject to 23 24 empirical evaluation. 25 26 • Evidence from empirically-based research and evaluation, both qualitative and quantitative, 27 28 provided there was systematic data collection and analysis. We included systematic reviews; 29 30 Randomised Controlled Trials (RCTs); non-randomised controlled trials; observational studies 31 such as cohort, interrupted time series and case studies describing or evaluating an 32 http://bmjopen.bmj.com/ 33 intervention to determine the range of approaches that have been tried and described, and 34 ideally, potentially promising or unacceptable approaches 35 36 • We included qualitative studies exploring issues around inter-agency collaboration, such as 37 barriers or facilitators around implementing inter-agency models 38 39 40 Exclusion criteria on September 26, 2021 by guest. Protected copyright. 41 42 The following were excluded: 43 44 • Studies where the interagency collaboration was focused solely on substance abuse, without 45 46 including individuals with co-occurring mental health problems 47 • Diagrammatical and mathematical modelling of inter-agency collaboration models for 48 49 organisations 50 • Patient-doctor or patient-clinician shared decision-making 51 52 • Inter-agency collaboration without the involvement of the police 53 54 • Studies published in languages other than English 55 • Opinion pieces and editorial articles 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 34 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 • Due to changing context of data protection legislation, studies published before 1995 4 5 6 7 8 9 10 11 12 13 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 35 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 5 APPENDIX 2: SEARCH STRATEGY USED IN ASSIA 6 7 ASSIA 8 9 Via Proquest 10 11 Search date=25th July 2016 12 13 14 Records retrieved=138 records 15 16 Set# Searched forFor peer review only Databases Results 17 18 19 S1 SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 10841 20 21 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing) Sciences Index &° 22 Abstracts 23 24 (ASSIA) 25 26 27 S2 police OR policing Applied Social 10762 28 Sciences Index & 29 ° 30 Abstracts 31 (ASSIA) 32 http://bmjopen.bmj.com/ 33 34 S3 (SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 10841 35 36 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) Sciences Index &° 37 OR (police OR policing) Abstracts 38 39 (ASSIA) 40 on September 26, 2021 by guest. Protected copyright. 41 42 S4 SU.EXACT("Service integration") Applied Social 78° 43 Sciences Index & 44 45 Abstracts 46 (ASSIA) 47 48 49 S5 SU.EXACT("Interagency collaboration") Applied Social 757 50 ° 51 Sciences Index & 52 Abstracts 53 54 (ASSIA) 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 36 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 S6 (multi-agency NEAR/2 (approach* or collaborat* or cooperat* or coordinat* Applied Social 264° 4 5 or department* or model* or team* or partner* or program* or working)) ORSciences Index & 6 (multiagency NEAR/2 (approach* or collaborat* or cooperat* or coordinat* Abstracts 7 8 or department* or model* or team* or partner* or program* or working)) (ASSIA) 9 10 11 S7 (multi-professional NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 182° 12 coordinat* OR department* OR model* OR team* OR partner* OR program*S ciences Index & 13 14 OR working)) OR (multiprofessional NEAR/2 (approach* OR collaborat* OR Abstracts 15 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 16 For peer review only 17 OR program* OR working)) 18 19 20 S8 (multi-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 2159° 21 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 22 23 OR working)) OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 24 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 25 26 OR program* OR working)) 27 28 29 S9 (inter-agency NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 1025° 30 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 31 32 OR working)) OR (interagency NEAR/2 (approach* OR collaborat* OR Abstracts http://bmjopen.bmj.com/ 33 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 34 35 OR program* OR working)) 36 37 38 S10 (inter-professional NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 131° 39 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 40 on September 26, 2021 by guest. Protected copyright. 41 OR working)) OR (interprofesional NEAR/2 (approach* OR collaborat* OR Abstracts 42 43 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 44 OR program* OR working)) 45 46 47 S11 (inter-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 4128° 48 49 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 50 OR working)) OR (interdisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 51 52 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 53 OR program* OR working)) 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 37 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 S12 (trans-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 119° 4 5 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 6 OR working)) OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 7 8 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 9 OR program* OR working)) 10 11 12 S13 "joint agency" or "joint approach" or "joint collaborat*" or "joint cooperat*" Applied Social 450 13 ° 14 or "joint coordinat*" or "joint department*" or "joint team*" or "joint Sciences Index & 15 partner*" or "joint program*" or "joint working" Abstracts 16 For peer review only 17 (ASSIA) 18 19 20 S14 integrat* NEAR/2 (agency or approach* or department* or model* or team* Applied Social 4279° 21 or partner* or program* or working) Sciences Index & 22 23 Abstracts 24 (ASSIA) 25 26 27 S15 "cross agency" or "cross department*" or "cross team*" or "cross partner*" Applied Social 54 28 ° 29 or "cross program*" Sciences Index & 30 Abstracts 31 32 (ASSIA) http://bmjopen.bmj.com/ 33 34 35 S16 "across agency" or "across department*" or "across team*" or "across Applied Social 116° 36 partner*" or "across program*" Sciences Index & 37 38 Abstracts 39 (ASSIA) 40 on September 26, 2021 by guest. Protected copyright. 41 42 S19 information NEAR/1 (integrat* or governance or share* or sharing or Applied Social 1765 43 ° 44 transfer*) Sciences Index & 45 Abstracts 46 47 (ASSIA) 48 49 50 S20 knowledge NEAR/1 (integrat* or governance or share* or sharing or Applied Social 913° 51 transfer*) Sciences Index & 52 53 Abstracts 54 (ASSIA) 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 38 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 S21 data NEAR/1 (integrat* OR governance OR share* OR sharing OR transfer*) Applied Social 391° 4 5 Sciences Index & 6 Abstracts 7 8 (ASSIA) 9 10 11 S22 technology NEAR/1 (integrat* OR governance OR share* OR sharing OR Applied Social 398° 12 transfer*) Sciences Index & 13 14 Abstracts 15 (ASSIA) 16 For peer review only 17 18 S23 "communities of practice" Applied Social 208° 19 20 Sciences Index & 21 Abstracts 22 23 (ASSIA) 24 25 26 S24 SU.EXACT("Clinical risk management" OR "Risk management") Applied Social 866° 27 Sciences Index & 28 29 Abstracts 30 (ASSIA) 31 32 http://bmjopen.bmj.com/ 33 S25 "single assessment process" Applied Social 18 34 ° 35 Sciences Index & 36 Abstracts 37 38 (ASSIA) 39 40 on September 26, 2021 by guest. Protected copyright. 41 S26 SU.EXACT("Service integration") OR SU.EXACT("Interagency collaboration") Applied Social 15367 42 OR ((multi-agency NEAR/2 (approach* or collaborat* or cooperat* or Sciences Index & 43 ° 44 coordinat* or department* or model* or team* or partner* or program* or Abstracts 45 working)) OR (multiagency NEAR/2 (approach* or collaborat* or cooperat* or(ASSIA) 46 47 coordinat* or department* or model* or team* or partner* or program* or 48 49 working))) OR ((multi-professional NEAR/2 (approach* OR collaborat* OR 50 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 51 52 OR program* OR working)) OR (multiprofessional NEAR/2 (approach* OR 53 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 54 55 team* OR partner* OR program* OR working))) OR ((multi-disciplinary 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 39 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 4 5 department* OR model* OR team* OR partner* OR program* OR working)) 6 OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 7 8 coordinat* OR department* OR model* OR team* OR partner* OR program* 9 OR working))) OR ((inter-agency NEAR/2 (approach* OR collaborat* OR 10 11 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 12 OR program* OR working)) OR (interagency NEAR/2 (approach* OR 13 14 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 15 16 team* OR partner*For OR peer program* OR reviewworking))) OR ((inter-professional only 17 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 18 19 department* OR model* OR team* OR partner* OR program* OR working)) 20 OR (interprofesional NEAR/2 (approach* OR collaborat* OR cooperat* OR 21 22 coordinat* OR department* OR model* OR team* OR partner* OR program* 23 OR working))) OR ((inter-disciplinary NEAR/2 (approach* OR collaborat* OR 24 25 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 26 27 OR program* OR working)) OR (interdisciplinary NEAR/2 (approach* OR 28 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 29 30 team* OR partner* OR program* OR working))) OR ((trans-disciplinary 31 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 32 http://bmjopen.bmj.com/ 33 department* OR model* OR team* OR partner* OR program* OR working)) 34 35 OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 36 coordinat* OR department* OR model* OR team* OR partner* OR program* 37 38 OR working))) OR ("joint agency" or "joint approach" or "joint collaborat*" or 39 "joint cooperat*" or "joint coordinat*" or "joint department*" or "joint 40 on September 26, 2021 by guest. Protected copyright. 41 team*" or "joint partner*" or "joint program*" or "joint working") OR 42 (integrat* NEAR/2 (agency or approach* or department* or model* or team* 43 44 or partner* or program* or working)) OR ("cross agency" or "cross 45 46 department*" or "cross team*" or "cross partner*" or "cross program*") OR 47 ("across agency" or "across department*" or "across team*" or "across 48 49 partner*" or "across program*") OR (information NEAR/1 (integrat* or 50 governance or share* or sharing or transfer*)) OR (knowledge NEAR/1 51 52 (integrat* or governance or share* or sharing or transfer*)) OR (data NEAR/1 53 (integrat* OR governance OR share* OR sharing OR transfer*)) OR 54 55 (technology NEAR/1 (integrat* OR governance OR share* OR sharing OR 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 40 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 transfer*)) OR "communities of practice" OR SU.EXACT("Clinical risk 4 5 management" OR "Risk management") OR "single assessment process" 6 7 S27 "criminal justice" or "youth justice" or" juvenile justice" Applied Social 8 7998° 9 Sciences Index & 10 11 Abstracts 12 (ASSIA) 13 14 15 S28 (probation or parole or court* or justice) NEAR/2 (personnel or staff or Applied Social 993° 16 worker* orFor caseworker* peer or office* or review official* or employee*) only Sciences Index & 17 18 Abstracts 19 20 (ASSIA) 21 22 S29 SU.EXACT("Probation service") Applied Social 23 727° 24 Sciences Index & 25 26 Abstracts 27 (ASSIA) 28 29 30 S30 paramedic* or para-medic* Applied Social 267° 31 32 Sciences Index & http://bmjopen.bmj.com/ 33 Abstracts 34 35 (ASSIA) 36 37 S31 (emergency or ambulance or casualty) NEAR/2 (personnel or staff or worker*Applied Social 38 363° 39 or office* or official* or employee*) Sciences Index & 40 on September 26, 2021 by guest. Protected copyright. 41 Abstracts 42 (ASSIA) 43 44 45 S32 SU.EXACT("Presentence reports" OR "Social services departments") OR Applied Social 8979° 46 47 SU.EXACT("Befriending" OR "Care assistants" OR "Child care centres" OR Sciences Index & 48 "Child contact centres" OR "Community care" OR "Consumer operated drop Abstracts 49 50 in centres" OR "Day care" OR "Day care centres" OR "Day centres" OR (ASSIA) 51 "Deinstitutionalization" OR "Drop in centres" OR "Family centres" OR 52 53 "Halfway houses" OR "Home care" OR "Home health aides" OR "Home helps" 54 OR "Home ventilation" OR "Hospital at home schemes" OR "Local health and 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 41 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 social service centres" OR "Long term community care" OR "Long term home 4 5 care" OR "Meals on wheels" OR "Out of school care" OR "Probation day 6 centres" OR "Psychiatric day centres" OR "Social services" OR "Welfare 7 8 services") OR SU.EXACT("Jewish Association for Services for the Aged" OR 9 "Social services agencies") 10 11 12 S33 SU.EXACT("Analytical social work" OR "Behavioural social work" OR "Care Applied Social 15597 13 14 orders" OR "Child care" OR "Child protection" OR "Childminding" OR "Clinical Sciences Index &° 15 social work" OR "Community nurseries" OR "Community work" OR "Creches" Abstracts 16 For peer review only 17 OR "Critical social work" OR "Day foster care" OR "Day nurseries" OR (ASSIA) 18 "Detached youth work" OR "Educational social work" OR "Family child care" 19 20 OR "Family preservation services" OR "Family social work" OR "Feminist 21 22 community work" OR "Feminist people" OR "Feminist social work" OR "Foster 23 care" OR "Geriatric social work" OR "Guardians ad litem" OR "Guardianship" 24 25 OR "Hospital social work" OR "In care" OR "Kinship foster care" OR "Leaving 26 care" OR "Long term foster care" OR "Medical social work" OR 27 28 "Neighbourhood work" OR "Nurseries" OR "Occupational social work" OR 29 "Parent aide services" OR "Political social work" OR "Postadoption services" 30 31 OR "Private foster care" OR "Psychiatric social work" OR "Quality child care" 32 http://bmjopen.bmj.com/ 33 OR "Radical community work" OR "Radical social work" OR "Residential social 34 work" OR "Social casework" OR "Social work" OR "Temporary foster care" OR 35 36 "Therapeutic child care" OR "Voluntary social work" OR "Wardship" OR 37 "Youth work") 38 39 40
S34 "social services" or "social work" Applied Social 32896 on September 26, 2021 by guest. Protected copyright. 41 42 Sciences Index &° 43 Abstracts 44 45 (ASSIA) 46 47 48 S35 "voluntary group*" or "voluntary work" Applied Social 236° 49 Sciences Index & 50 51 Abstracts 52 (ASSIA) 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 42 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 S36 SU.EXACT("Voluntary work") Applied Social 139° 4 5 Sciences Index & 6 Abstracts 7 8 (ASSIA) 9 10 11 S37 "community group*" or "self help group*" or "third sector" or "social Applied Social 1005° 12 enterprise*" Sciences Index & 13 14 Abstracts 15 (ASSIA) 16 For peer review only 17 18 S38 SU.EXACT("Community groups") Applied Social 119° 19 20 Sciences Index & 21 Abstracts 22 23 (ASSIA) 24 25 26 S39 SU.EXACT("Selfhelp groups") Applied Social 439° 27 Sciences Index & 28 29 Abstracts 30 (ASSIA) 31 32 http://bmjopen.bmj.com/ 33 S40 SU.EXACT("Social enterprises") Applied Social 47 34 ° 35 Sciences Index & 36 Abstracts 37 38 (ASSIA) 39 40 on September 26, 2021 by guest. Protected copyright. 41 S41 ("criminal justice" or "youth justice" or" juvenile justice") OR ((probation or Applied Social 51930 42 parole or court* or justice) NEAR/2 (personnel or staff or worker* or Sciences Index & 43 ° 44 caseworker* or office* or official* or employee*)) OR SU.EXACT("Probation Abstracts 45 service") OR (paramedic* or para-medic*) OR ((emergency or ambulance or (ASSIA) 46 47 casualty) NEAR/2 (personnel or staff or worker* or office* or official* or 48 These databases employee*)) OR (SU.EXACT("Presentence reports" OR "Social services 49 are searched for 50 departments") OR SU.EXACT("Befriending" OR "Care assistants" OR "Child 51 part of your 52 care centres" OR "Child contact centres" OR "Community care" OR query. 53 "Consumer operated drop in centres" OR "Day care" OR "Day care centres" 54 55 OR "Day centres" OR "Deinstitutionalization" OR "Drop in centres" OR "Family 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 43 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 centres" OR "Halfway houses" OR "Home care" OR "Home health aides" OR 4 5 "Home helps" OR "Home ventilation" OR "Hospital at home schemes" OR 6 "Local health and social service centres" OR "Long term community care" OR 7 8 "Long term home care" OR "Meals on wheels" OR "Out of school care" OR 9 "Probation day centres" OR "Psychiatric day centres" OR "Social services" OR 10 11 "Welfare services") OR SU.EXACT("Jewish Association for Services for the 12 Aged" OR "Social services agencies")) OR SU.EXACT("Analytical social work" 13 14 OR "Behavioural social work" OR "Care orders" OR "Child care" OR "Child 15 16 protection"For OR "Childminding" peer OR "Clinical review social work" OR only "Community 17 nurseries" OR "Community work" OR "Creches" OR "Critical social work" OR 18 19 "Day foster care" OR "Day nurseries" OR "Detached youth work" OR 20 "Educational social work" OR "Family child care" OR "Family preservation 21 22 services" OR "Family social work" OR "Feminist community work" OR 23 "Feminist people" OR "Feminist social work" OR "Foster care" OR "Geriatric 24 25 social work" OR "Guardians ad litem" OR "Guardianship" OR "Hospital social 26 27 work" OR "In care" OR "Kinship foster care" OR "Leaving care" OR "Long term 28 foster care" OR "Medical social work" OR "Neighbourhood work" OR 29 30 "Nurseries" OR "Occupational social work" OR "Parent aide services" OR 31 "Political social work" OR "Postadoption services" OR "Private foster care" OR 32 http://bmjopen.bmj.com/ 33 "Psychiatric social work" OR "Quality child care" OR "Radical community 34 35 work" OR "Radical social work" OR "Residential social work" OR "Social 36 casework" OR "Social work" OR "Temporary foster care" OR "Therapeutic 37 38 child care" OR "Voluntary social work" OR "Wardship" OR "Youth work") OR 39 ("social services" or "social work") OR ("voluntary group*" or "voluntary 40 on September 26, 2021 by guest. Protected copyright. 41 work") OR SU.EXACT("Voluntary work") OR ("community group*" or "self help 42 group*" or "third sector" or "social enterprise*") OR SU.EXACT("Community 43 44 groups") OR SU.EXACT("Selfhelp groups") OR SU.EXACT("Social enterprises") 45 46 47 S43 SU.EXACT("Suicide") Applied Social 3383° 48 Sciences Index & 49 50 Abstracts 51 52 (ASSIA) 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 44 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 S44 SU.EXACT("Vulnerable people") Applied Social 389° 4 5 Sciences Index & 6 Abstracts 7 8 (ASSIA) 9 10 11 S45 SU.EXACT("Stigmatization") Applied Social 2448° 12 Sciences Index & 13 14 Abstracts 15 (ASSIA) 16 For peer review only 17 18 S46 SU.EXACT("Learning disabilities") Applied Social 2054° 19 20 Sciences Index & 21 Abstracts 22 23 (ASSIA) 24 25 26 S47 "learning disabilit*" or "learning difficult*" or "learning disorder*" or Applied Social 11637 27 "intellectual disabilit*" or "mental retard*" or "special need*" Sciences Index & 28 ° 29 Abstracts 30 (ASSIA) 31 32 http://bmjopen.bmj.com/ 33 S48 mental* NEAR/2 (ill* or vulnerab*) Applied Social 11374 34 35 Sciences Index &° 36 Abstracts 37 38 (ASSIA) 39 40 on September 26, 2021 by guest. Protected copyright. 41 S49 SU.EXACT("Mental health") Applied Social 8565° 42 Sciences Index & 43 44 Abstracts 45 (ASSIA) 46 47 48 S50 SU.EXACT("Psychiatric disorders") Applied Social 6061 49 ° 50 Sciences Index & 51 Abstracts 52 53 (ASSIA) 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 45 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 S51 "mental disorder*" Applied Social 4204° 4 5 Sciences Index & 6 Abstracts 7 8 (ASSIA) 9 10 11 S52 SU.EXACT("Schizophrenia") Applied Social 4882° 12 Sciences Index & 13 14 Abstracts 15 (ASSIA) 16 For peer review only 17 18 S53 SU.EXACT("Bipolar affective disorder") Applied Social 2330° 19 20 Sciences Index & 21 Abstracts 22 23 (ASSIA) 24 25 26 S54 SU.EXACT("Depression") Applied Social 18305 27 Sciences Index & 28 ° 29 Abstracts 30 (ASSIA) 31 32 http://bmjopen.bmj.com/ 33 S55 SU.EXACT("Suicide") OR SU.EXACT("Vulnerable people") OR Applied Social 62157 34 35 SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") OR Sciences Index &° 36 ("learning disabilit*" or "learning difficult*" or "learning disorder*" or Abstracts 37 38 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* (ASSIA) 39 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 40
These databases on September 26, 2021 by guest. Protected copyright. 41 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 42 are searched for SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR 43 part of your 44 SU.EXACT("Depression") 45 query. 46 47 48 S56 ((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 409° 49 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) Sciences Index & 50 51 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable Abstracts 52 people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities")(ASSIA) 53 54 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 55 These databases 56 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 46 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR are searched for 4 5 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR part of your 6 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR query. 7 8 SU.EXACT("Depression")) 9 10 11 S57 (SU.EXACT("Service integration") OR SU.EXACT("Interagency collaboration") Applied Social 21° 12 OR ((multi-agency NEAR/2 (approach* or collaborat* or cooperat* or Sciences Index & 13 14 coordinat* or department* or model* or team* or partner* or program* or Abstracts 15 working)) OR (multiagency NEAR/2 (approach* or collaborat* or cooperat* or(ASSIA) 16 For peer review only 17 coordinat* or department* or model* or team* or partner* or program* or 18 These databases working))) OR ((multi-professional NEAR/2 (approach* OR collaborat* OR 19 are searched for 20 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 21 part of your OR program* OR working)) OR (multiprofessional NEAR/2 (approach* OR 22 query. 23 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 24 25 team* OR partner* OR program* OR working))) OR ((multi-disciplinary 26 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 27 28 department* OR model* OR team* OR partner* OR program* OR working)) 29 OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 30 31 coordinat* OR department* OR model* OR team* OR partner* OR program* 32 http://bmjopen.bmj.com/ 33 OR working))) OR ((inter-agency NEAR/2 (approach* OR collaborat* OR 34 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 35 36 OR program* OR working)) OR (interagency NEAR/2 (approach* OR 37 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 38 39 team* OR partner* OR program* OR working))) OR ((inter-professional 40 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR on September 26, 2021 by guest. Protected copyright. 41 42 department* OR model* OR team* OR partner* OR program* OR working)) 43 44 OR (interprofesional NEAR/2 (approach* OR collaborat* OR cooperat* OR 45 coordinat* OR department* OR model* OR team* OR partner* OR program* 46 47 OR working))) OR ((inter-disciplinary NEAR/2 (approach* OR collaborat* OR 48 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 49 50 OR program* OR working)) OR (interdisciplinary NEAR/2 (approach* OR 51 52 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 53 team* OR partner* OR program* OR working))) OR ((trans-disciplinary 54 55 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 47 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 department* OR model* OR team* OR partner* OR program* OR working)) 4 5 OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 6 coordinat* OR department* OR model* OR team* OR partner* OR program* 7 8 OR working))) OR ("joint agency" or "joint approach" or "joint collaborat*" or 9 "joint cooperat*" or "joint coordinat*" or "joint department*" or "joint 10 11 team*" or "joint partner*" or "joint program*" or "joint working") OR 12 (integrat* NEAR/2 (agency or approach* or department* or model* or team* 13 14 or partner* or program* or working)) OR ("cross agency" or "cross 15 16 department*"For or "cross peer team*" or "cross review partner*" or "cross only program*") OR 17 ("across agency" or "across department*" or "across team*" or "across 18 19 partner*" or "across program*") OR (information NEAR/1 (integrat* or 20 governance or share* or sharing or transfer*)) OR (knowledge NEAR/1 21 22 (integrat* or governance or share* or sharing or transfer*)) OR (data NEAR/1 23 (integrat* OR governance OR share* OR sharing OR transfer*)) OR 24 25 (technology NEAR/1 (integrat* OR governance OR share* OR sharing OR 26 27 transfer*)) OR "communities of practice" OR SU.EXACT("Clinical risk 28 management" OR "Risk management") OR "single assessment process") AND 29 30 (((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR 31 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) 32 http://bmjopen.bmj.com/ 33 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable 34 35 people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") 36 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 37 38 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 39 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 40 on September 26, 2021 by guest. Protected copyright. 41 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 42 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR 43 44 SU.EXACT("Depression"))) 45 46 47 S58 (("criminal justice" or "youth justice" or" juvenile justice") OR ((probation or Applied Social 130° 48 parole or court* or justice) NEAR/2 (personnel or staff or worker* or Sciences Index & 49 50 caseworker* or office* or official* or employee*)) OR SU.EXACT("Probation Abstracts 51 52 service") OR (paramedic* or para-medic*) OR ((emergency or ambulance or (ASSIA) 53 casualty) NEAR/2 (personnel or staff or worker* or office* or official* or 54 These databases 55 employee*)) OR (SU.EXACT("Presentence reports" OR "Social services are searched for 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 48 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 departments") OR SU.EXACT("Befriending" OR "Care assistants" OR "Child part of your 4 5 care centres" OR "Child contact centres" OR "Community care" OR query. 6 "Consumer operated drop in centres" OR "Day care" OR "Day care centres" 7 8 OR "Day centres" OR "Deinstitutionalization" OR "Drop in centres" OR "Family 9 centres" OR "Halfway houses" OR "Home care" OR "Home health aides" OR 10 11 "Home helps" OR "Home ventilation" OR "Hospital at home schemes" OR 12 "Local health and social service centres" OR "Long term community care" OR 13 14 "Long term home care" OR "Meals on wheels" OR "Out of school care" OR 15 16 "Probation Forday centres" peer OR "Psychiatric review day centres" OR "Socialonly services" OR 17 "Welfare services") OR SU.EXACT("Jewish Association for Services for the 18 19 Aged" OR "Social services agencies")) OR SU.EXACT("Analytical social work" 20 OR "Behavioural social work" OR "Care orders" OR "Child care" OR "Child 21 22 protection" OR "Childminding" OR "Clinical social work" OR "Community 23 nurseries" OR "Community work" OR "Creches" OR "Critical social work" OR 24 25 "Day foster care" OR "Day nurseries" OR "Detached youth work" OR 26 27 "Educational social work" OR "Family child care" OR "Family preservation 28 services" OR "Family social work" OR "Feminist community work" OR 29 30 "Feminist people" OR "Feminist social work" OR "Foster care" OR "Geriatric 31 social work" OR "Guardians ad litem" OR "Guardianship" OR "Hospital social 32 http://bmjopen.bmj.com/ 33 work" OR "In care" OR "Kinship foster care" OR "Leaving care" OR "Long term 34 35 foster care" OR "Medical social work" OR "Neighbourhood work" OR 36 "Nurseries" OR "Occupational social work" OR "Parent aide services" OR 37 38 "Political social work" OR "Postadoption services" OR "Private foster care" OR 39 "Psychiatric social work" OR "Quality child care" OR "Radical community 40 on September 26, 2021 by guest. Protected copyright. 41 work" OR "Radical social work" OR "Residential social work" OR "Social 42 casework" OR "Social work" OR "Temporary foster care" OR "Therapeutic 43 44 child care" OR "Voluntary social work" OR "Wardship" OR "Youth work") OR 45 46 ("social services" or "social work") OR ("voluntary group*" or "voluntary 47 work") OR SU.EXACT("Voluntary work") OR ("community group*" or "self help 48 49 group*" or "third sector" or "social enterprise*") OR SU.EXACT("Community 50 groups") OR SU.EXACT("Selfhelp groups") OR SU.EXACT("Social enterprises")) 51 52 AND (((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR 53 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) 54 55 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 49 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") 4 5 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 6 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 7 8 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 9 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 10 11 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR 12 SU.EXACT("Depression"))) 13 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 50 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 51 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 5 APPENDIX 3: DESCRIPTION OF STUDY DESIGNS 6 7 Study Design Description 8 Audit An assessment of current practice within a specific setting or 9 context, in line with best practice or to inform best practice, using 10 for instance an audit checklist [ ] 11 Case study Description of policy or model within a specific context or setting, 12 along with presentation of routinely collected data pre- and post- 13 introduction, such as Teske et al. ( ) [ ] 14 Qualitative Qualitative research concerns itself with aspects of research such as 15 experience and understanding. Techniques used include in-depth 16 Forsemi-structured peer interviewsreview and focus onlygroups, and data can take any 17 form including audio recordings or words, such as Boscarto et al. 18 ( ) [ ] 19 Scoping review “A scoping review or scoping study is a form of 20 knowledge synthesis that addresses an exploratory research 21 22 question aimed at mapping key concepts, types of evidence, and 23 gaps in research related to a defined area or field by systematically 24 searching, selecting, and synthesising existing knowledge” [ ] 25 Mixed methods Involves quantitative components such as a national survey 26 involving the police; and qualitative components such as focus 27 groups and interviews [ ]. 28 Controlled before A controlled before and after study compares one group receiving 29 and after study an intervention with another (control) group that typically does 30 not receive the intervention. This can be a parallel group where the 31 comparison is made at the same time that the intervention group 32
receives the intervention, or a retrospective comparison can be http://bmjopen.bmj.com/ 33 made where for example those referred to court diversion schemes 34 are compared with a retrospective group of defendants referred for 35 psychiatric reports by the same courts in the - year period 36 immediately prior to the introduction of the diversion scheme [ ]. 37 Service evaluation This describes and evaluates a service or model to examine 38 practicality, feasibility or pilot of a model within its’ initial stages. 39 40 For example, to examine the practicability of a recommendation to on September 26, 2021 by guest. Protected copyright. 41 abolish or amend Magistrates’ power to remand people perceived 42 to have mental health problems in custody for psychiatric reports 43 and report the first months of the service [ ]. 44 Survey Typically using questionnaire to gather information within a 45 specific time point. For example, using a questionnaire distributed 46 to health and criminal justice staff to explore factors that impede 47 or facilitate information exchange between criminal justice and 48 health agencies [ ]. 49 Description of model Description of the development and implementation of a model of 50 interagency collaboration, for example of a joint protocol for the 51 investigation of crimes against vulnerable adults [ ] 52 Prospective An observational study, often longitudinal in nature, for which the 53 observational study consequential outcomes of interest occur after study 54 commencement (including creation of a study protocol and 55 analysis plan, and study initiation) [ ]. 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 52 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 53 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 Appendix 4: Detailed description of the models 5 Arranged in the order of the most frequently occurring models. 6 7 Name Definition No of Type of model 8 9 studies 10 11 Police-based specialised Police-based specialised police response. These 2 Pre-arrest 12 police response [95,145] models involve sworn diversion 13 14 officers who have special mental health training, 15 serving as the first-line 16 For peer review only 17 police response to mental health crises in the 18 community and acting as liaisons 19 20 to the formal mental health system. 21 22 Mental health training Police officer receive training by mental health 3 Pre-arrest 23 [101,118,143] professional to increase awareness and diversion 24 25 sensitivity to mental health issues and crisis and 26 facilitate access to services. Urban and rural 27 population. When receive a call police officer 28 who has been trained is assigned wherever 29 possible. Site also implemented pilot project 30 31 where psychiatric nurse who could admit people 32 directly to ward was paired with trained police http://bmjopen.bmj.com/ 33 officer to attend crisis calls and conduct follow- 34 up assessments on people in recent contact with 35 36 police. 37 38 39 40 Another example is the Multi-agency training on September 26, 2021 by guest. Protected copyright. 41 initiative. The half day course included reception 42 of patients at the hospital, legal requirements 43 (use of Sections 135 and 136 of the MHA 1983), 44 missing patients, restraint of patients, police use 45 46 of CS spray and liaison with other professionals. 47 48 Post-crisis Assistance Post-crisis Assistance Program (PCAP). Police 1 Pre-arrest 49 Program (PCAP) [94] officers can refer individuals (via email) to diversion 50 Mental Health Association after incidents and 51 can make referrals for any ‘consumers’ in crisis. 52 Data sharing between police and mental health 53 54 is primarily via email referrals. Following referral 55 the mental health association sends a ‘peer 56 specialist’ contacts the consumer in person. Peer 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 54 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialists are consumers with long term mental 4 health plans. They make consumers aware of 5 services relevant to their needs. 6 7 The alternative place of The alternative place of safety (APoS) legislation, 1 Pre-arrest jail 8 safety (APoS) [68] which held adults under the Mental Health Act Diversion 9 10 outside of a custody suite or traditional health- 11 based place of safety (HBPoS), to give people a 12 better experience whilst they await a mental 13 health assessment 14 15 Emergency Examination Emergency Examination Orders, which 1 Pre-arrest jail 16 For peer review only 17 Orders [36] empowers police and ambulance officers (and Diversion 18 psychiatrists) to transport patients to an 19 Emergency Department or other authorised 20 mental health service for assessment 21 22 The Secondary Family ‘The Secondary Family’, a community crisis 1 Pre-arrest jail 23 [45] response model which provides support for Diversion 24 25 people with mental illness in times of crisis. This 26 is as partnership of hospitals, Police and a 27 Community Crisis Response programme who 28 provide a collective approach to support 29 provision. The aim was to help individuals in 30 31 mental health crisis experience supportive 32 relationships in order to help them build http://bmjopen.bmj.com/ 33 resilience, to direct them in the right direction 34 35 The Substance The Substance Abuse and Mental Health 1 Pre-arrest jail 36 Services Administration (SAMHSA) jail Diversion 37 Abuse and Mental Health 38 Services diversion initiative, which are pre-booking and 39 40 post-booking programmes Administration (SAMHSA) on September 26, 2021 by guest. Protected copyright. 41 42 jail 43 44 diversion initiative [134] 45 46 Massachusetts Mental Massachusetts Mental Health Diversion and 1 Pre-arrest jail 47 Health Diversion and Integration Programme, a ‘Memphis-like CIT- Diversion 48 Integration Programme programme’ that also included the local police 49 [97] department and community care 50 representatives. The aim was to develop 51 52 integrated treatment alternatives for people 53 with mental health, substance abuse, and/or 54 homelessness issues who become involved with 55 law enforcement 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 55 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 The Montgomery CIT The Montgomery CIT. Aimed to provide law 1 Pre-arrest jail 4 [114] enforcement officers with the skills they need to Diversion 5 safely deescalate situations with people with 6 mental illness in crisis 7 8 Mobile Community Based on the Training in Community Living 1 Pre-arrest jail 9 10 Treatment program Program. Diversion 11 (MCT) [149] 12 13 14 Philosophy based on outreach efforts, with staff 15 often going to clients’ home and working to 16 For connectpeer in any wayreview possible from providing only rids 17 to the grocery store to crisis intervention to help 18 with specific skill training. Linkages developed 19 20 with other community agencies including 21 hospital emergency rooms, police and county 22 jail. 23 24 ‘It is typical of a growing number of ACT 25 programs that are all based on similar operating 26 27 principles in a similar population.’ ACT provides 28 mental health and other support on an on-going 29 basis, using community-based outreach 30 treatment teams. 31 32
Crisis Outreach And Crisis Outreach And Support Team (COAST) 1 Pre-arrest jail http://bmjopen.bmj.com/ 33 Support Team (COAST) Diversion 34 Expanded CIT program involving civilians in crisis 35 [129] outreach. The five “crisis specialists” in the 36 37 civilian unit are employees of and supervised by 38 the police. COAST workers are college graduates 39 with a background in case management, social 40 work, or psychology and includes a psychiatrist. on September 26, 2021 by guest. Protected copyright. 41 They respond on-site in the field; conduct non- 42 43 urgent follow-ups; and make proactive visits to 44 homeless people to engage them with services 45 46 Crisis Intervention Team Pre-booking, police-based programs that provide 17 Pre-arrest jail 47 (CIT) mental health treatment in lieu of arrests. Pre- Diversion 48 [29,34,43,99,103,104,111 arrest diversion generally involves collaboration 49 50 ,114,116,118,124,126,12 between state and local law enforcement, 51 7,133,138,145,150] emergency services (e.g., dispatchers and 52 ambulatory services), and community 53 behavioural health treatment providers such as 54 clinical staff from local behavioural health 55 56 departments, hospital emergency departments, 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 56 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialised psychiatric centres. 4 5 6 7 The most common pre-arrest diversion model is 8 the Memphis Crisis Intervention Team (CIT), 9 which is a police based first responder program 10 of pre-arrest jail diversion for those in a mental 11 12 illness crisis. This provides law enforcement 13 based crisis intervention training for helping 14 those individuals with mental illness. In addition, 15 CIT works in partnership with mental health 16 For professionalspeer to review provide a system of servicesonly to 17 18 assist to the individuals with mental illness, 19 family members, and the police officers. 20 21 The Community Crisis The Community Crisis Intervention Team (CCIT); 1 Pre-arrest jail 22 Intervention Team (CCIT) an innovative program utilizing crisis Diversion 23 [43] intervention services and mobile crisis outreach 24 25 within an emergency room (ER) setting 26 27 Civil commitment law Civil commitment law, which allows for the 1 Pre-arrest jail 28 [117] forced hospitalization Diversion 29 30 of mentally ill individuals who are in need of 31 care, who are dangerous to themselves or 32
others, and http://bmjopen.bmj.com/ 33 34 who are either unwilling or unable to consent to 35 hospitalisation. The aim was to allow people 36 37 who are mentally ill and exhibit problematic 38 behaviour in the community to be diverted, 39 before booking, from the criminal justice system 40 into the mental health system without the on September 26, 2021 by guest. Protected copyright. 41 necessity of arrest or criminal court involvement 42 43 School Resource School Resource 1 Pre-arrest jail 44 45 Diversion Officers (SROs) [116] Officers (SROs), school-based police officers with 46 47 CIT mental health training 48 49 who are trained to deal with a wide variety of 50 both instrumental and 51 52 expressive criminal acts 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 57 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 The Fixated Threat The Fixated Threat Assessment Centre (FTAC), a 1 Pre-arrest jail 4 Assessment Centre joint police/ Diversion 5 (FTAC) [75] 6 National Health Service unit in the United 7 Kingdom, which was set up 8 9 to assess and manage risks in people with 10 intense pathological fixation with public figures 11 12 Queensland Fixated Queensland Fixated Threat Assessment Centre. 1 Pre-arrest jail 13 14 Threat Assessment Involves intelligence gathering, risk assessment, Diversion 15 Centre [38] alerting and awareness training for police and 16 For healthpeer professionals. review QFTAC staff have only specialist 17 skills in the evaluation of the fixated, particularly 18 risks of violence, and from persistence, 19 20 disruption and escalation, which minimises 21 uncertainty and unmet security needs. 22 23 The Community Service The Community Service Officer (CSO) model. A 1 Pre-arrest jail 24 Officer (CSO) model [111] Community Service Officer (CSO), provides Diversion 25 support in crime prevention, investigation, and 26 27 response where full police powers are 28 unnecessary and assists police officers in 29 upholding law and order 30 31 Pre-arrest jail Diversion A separate but collaborative approach between 3 Pre-arrest jail 32 [135] mental health and police teams. Police bring Diversion http://bmjopen.bmj.com/ 33 individuals in mental health crisis to emergency 34 35 department where mental health nurse is on 36 duty to assist. 37 38 Mental Health Mental Health Intervention Team (MHIT). Front 2 Pre-arrest jail 39 Intervention Team line police officers receive enhanced mental Diversion 40 (MHIT) [30,31] health. Key aims are: on September 26, 2021 by guest. Protected copyright. 41 42 1. Reduce the risk of injury to police and mental 43 44 health consumers during mental health crisis 45 events; 46 47 2. Improve awareness by frontline police of risks 48 involved in dealing with mental health 49 consumers and strategies to reduce injuries to 50 police and consumers; 51 52 3. Improve collaboration with other government 53 54 and non-government agencies in the response 55 to and management of mental health crisis 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 58 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 events; and 4 5 4. Reduce the time taken by police in the 6 handover of mental health consumers into the 7 health care system. 8 9 The Cornwall A pilot Neighbourhood Outreach scheme to 1 Pre-arrest jail 10 support police with vulnerable individuals with diversion 11 Criminal Justice Liaison 12 suspected mental illness but not necessarily and Diversion Service 13 criminal involvement. 14 (CJLDS) [61] 15 16 Victoria model of For Victoriapeer model ofreview Responding to Mental only Health 1 Co-response 17 Responding to Mental Crises in the Community. Aims to provide 18 Health Crises in the assistance to people in mental health crises and 19 maintain their safety and that of others, and to 20 Community [41] 21 receive assessment and treatment 22 23 The Psychiatric The Psychiatric Emergency Response Team 2 Co-response 24 Emergency Response (PERT) model. The Psychiatric Emergency 25 Team (PERT) model Response Teams (PERT) consist of specially 26 trained officers and deputies who are paired 27 [33,111] with licensed mental health professionals. 28 29 Together, they respond on-scene to situations 30 involving people who are experiencing a mental 31 health related crisis and have come to the 32 attention of law enforcement. The goal is to http://bmjopen.bmj.com/ 33 provide the most appropriate resolution to the 34 35 crisis by linking people to the least restrictive 36 level of care and to help prevent the 37 unnecessary incarceration or hospitalization of 38 those seen. 39 40 Mental-health-based Mental-health-based specialized mental health 1 Co-response on September 26, 2021 by guest. Protected copyright. 41 42 specialised mental health response. In this more traditional model, 43 response [95] partnerships or cooperative agreements are 44 developed 45 46 between police and mobile mental health crisis 47 teams (MCTs) that exist as 48 49 part of the local community mental health 50 services system and operate independently of 51 52 the police department. 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 59 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Mobile Crisis Teams Mobile Crisis Teams. In this instance, when 9 Co-response 4 [101,105,111] necessary, calls involving mentally disordered 5 [43,48,50,106,131] [152] individuals are handled by community health Zealberg 6 [122] [146] based crisis teams in coordination with the excluded 7 8 police department. Aimed to improve the 9 handling of calls involving mentally impaired 10 individuals, and provide benefit to the 11 Cincinnati Police Division and the local criminal 12 justice system generally. 13 14
15 16 For Mobilepeer psychiatric review crisis assessment andonly 17 18 treatment teams, independently of but 19 responsive to requests from police. Shared 20 protocols providing guidelines for police and 21 mental health staff in handling situations 22 23 requiring a joint response have also been 24 implemented. 25 26 Co-responding Police- Mobile Crisis Intervention Teams (MCITs), a 3 Co-response 27 Mental Health programs police and mental health system co-response 28 (police and mental health partnership to assist police in responding to Excluded 29 professional) [29,43,49] people experiencing mental Shapiro 30 31 health crises 32 http://bmjopen.bmj.com/ 33 Street triage [69,71,90] Street triage, this model involved a psychiatric 3 Co-response 34 35 nurse attending incidents with a police 36 constable. The model of street triage 37 implemented contains the following 38 39 key elements: 40 on September 26, 2021 by guest. Protected copyright. 41 ▸ The street triage team consists of one 42 dedicated police constable and one psychiatric 43 44 nurse; 45 46 ▸ The team physically attends the scene of 47 incidents reported, unless they are already 48 attending another 49 50 incident, in which case telephone support is 51 provided; 52 53 ▸ Call handlers filter calls to Sussex Police and 54 allocate incidents to the street triage team if 55 56 there is an indication that the incident requires 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 60 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 support for mental health needs or crises; 4 5 ▸ The street triage team are not the initial 6 response to emergency or life-threatening 7 events; 8 9 The Birmingham The Birmingham Community Service Officers- 1 Co-response 10 11 Community Service police-based specialised mental health response: 12 Officers [95] mental health professionals are employed by 13 police department to provide on-site telephone 14 consultations to officers in the field. 15 16 For peer review only 17 18 The Knoxville Program The Knoxville Program: Mental-health-based 1 Co-response 19 [95] specialised mental health response: partnerships 20 21 or cooperative agreements are developed 22 between police and mobile mental health crisis 23 teams that exist as part of the local community 24 mental health service system and operate 25 independently to police department 26 27 Mental Evaluation Unit Mental Evaluation Unit (MEU), consisting of a 1 Co-response 28 29 (MEU) [150] SystemWide Mental Assessment Response 30 Team, Case Assessment Management 31 Programme, and Mental Health Intervention 32 Training. The aim was to provide response to http://bmjopen.bmj.com/ 33 34 people in mental health crisis 35 36 The Systemwide Mental The Systemwide Mental Assessment Response 3 Co-response 37 Assessment Response Team, which allows mental health clinicians to 38 Team (SMART) [102] be present at incidents to employ and explore 39 non judicial alternatives such as diversion to a 40 private hospital, substance abuse centre or on September 26, 2021 by guest. Protected copyright. 41 42 outpatient mental health programme. To 43 provide a more effective and reliable way for 44 police to handle acutely mentally ill in the field 45 46 Police Ambulance Crisis PACER (Police Ambulance Crisis Emergency 1 Co-response 47 Emergency Response) model. PACER was a dual secondary 48 Response(PACER) model service to MHFA for new police recruits, with 49 50 [28] mental health personnel travelling with police 51 and working together to manage individuals in 52 crisis in the community. 53 54 Northern Police and Northern Police and Clinician Emergency 1 Co-response 55 Clinician Emergency Response (NPACER) team. Second response 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 61 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Response (NPACER) [35] model consisting of police officer and mental 4 health professional attending mental health 5 crisis in the community, after initial police 6 response requires the person to be assessed by 7 8 mental health practitioner. 9 10 Mental Health Mental Health Emergency Service, where police 1 Co-response 11 Emergency Service [150] officer and mental health nurse respond to 12 mental health calls. The aim was to provide 13 response to people in mental health crisis 14 15 Assertive Outreach Team Assertive Outreach Team, a multi-professional 1 Co-response 16 For peer review only 17 [150] approach placing police officers as part of a 18 mental health team that addresses problematic 19 clients. The aim was to provide response to 20 people in mental health crisis 21 22 Behavioural Health Behavioural Health Specialised Co-Response 1 Co-response 23 Specialised Co-Response Team builds on CIT model to have a full time 24 25 Team [150] Mental Health Coordinator, a clinician. The aim 26 was to provide response to people in mental 27 health crisis 28 29 Co-response Model [150] A Co-response Model, which partners a police 1 Co-response 30 officer and mental health practitioner as a police 31 response team. The aim was to provide 32 http://bmjopen.bmj.com/ 33 response to people in mental health crisis 34 35 Hostage/barricade crisis Crisis negotiation co-response. Psychologist or 2 Co-response 36 negotiation co-response. mental health professional as an integrated 37 [112] team member 38 39 Police, Ambulance and PACER was a joint crisis response from police 1 Co-response 40 Clinical Early Response and mental health clinicians to people on September 26, 2021 by guest. Protected copyright. 41 42 (PACER) [33] experiencing a behavioural disturbance in the 43 community. Mental health clinician and police 44 operating together in an 8 hour shift. PACER unit 45 is a secondary unit that can be requested by a 46 primary responder police unit attending an 47 48 incident in the community. PACER can also be 49 requested by ambulance via police 50 communications 51 52 The Integrated Mobile The Integrated Mobile Crisis Response Team , 1 Co-response 53 Crisis Response [44] which aims to combine varied front-line crisis 54 55 responder elements into 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 62 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 a more efficient, responsive, and 4 interdisciplinary crisis response team that can 5 attend to the full continuum of community 6 crises 7 8 Crisis Response Team Crisis Response Team (CRT) consisting of 1 Co-response 9 10 (CRT) [113] dedicated Crisis Intervention Team (CIT) officers 11 (OFC) paired with a Mental Health Professional 12 (MHP). Aims to improve the police response in 13 situations involving mentally ill and chemically 14 15 dependent 16 For individualspeer through review specialized mental only health 17 18 provider response 19 20 in the field 21 22 A multi-agency police A multi-agency police liaison scheme comprising 1 Post booking 23 liaison scheme [59] a rapid screening and mental health assessment jail diversion 24 at the earliest point of contact with the criminal 25 justice system, plus a mechanism for 26 27 appropriate referral or diversion to health and 28 social services 29 30 The Adolescent Drug A multi-component, cognitive-behavioural 1 Post booking 31 Abuse Prevention and outpatient intervention serving children and jail diversion 32 Treatment (ADAPT) youths referred directly from local police http://bmjopen.bmj.com/ 33 Program [140] agencies 34 35 Mental Health/Juvenile Mental Health/Juvenile Justice Diversion Project 1 Post booking 36 37 Justice Diversion Project (MH/JJ) jail diversion 38 (MH/JJ) [110] 39 Involves diverting youth out of the juvenile 40 justice system and linking them to appropriate on September 26, 2021 by guest. Protected copyright. 41 treatments in their counties. Aims to (1) to 42 reduce out-of-community placement, (2) to 43 44 prevent recidivism, and (3) to increase the 45 general functioning of youth and their families 46 47 PolQuest [83] Developed a manual and training package for 1 Post-booking 48 PolQuest, a new police custody questionnaire. jail diversion 49 50 51 52 PolQuest-police and mental health screening 53 questionnaire which aimed to bridge the gap 54 between mental health services and police by 55 56 helping with the identification and referral of 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 63 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 individuals with mental health problems. 4 5 The Massachusetts The Massachusetts Mental Health Diversion and 1 Post-booking 6 Mental Health Diversion Integration jail diversion 7 and Integration 8 Program (MMHDIP), identify service strengths 9 Program (MMHDIP) [108] and gaps in delivering effective, integrated 10 services to persons suffering with mental illness, 11 12 substance abuse, and/or homelessness issues. 13 This aimed to address the current needs for our 14 target population and facilitate better 15 interagency communication, cooperation, and 16 For peer review only 17 resource sharing. 18 19 Youth offending team Youth offending team-multi-disciplinary teams 1 Post-booking 20 [66] that work with young people who have jail diversion 21 committed crimes or who are believed to be at 22 risk of committing crimes. 23 24 Assertive community The Assertive community treatment is a post- 3 Post-booking 25 treatment (ACT). An booking, jail-based diversion program diverting jail diversion 26 27 Intensive case individuals into psychiatric treatment in lieu of 28 management incarceration or reduced incarceration (with 29 [141,143,149] possible reductions in charges) 30 31 The Police Liaison The Police Liaison Community Psychiatric Nurse 1 Post-booking 32 Community Psychiatric Project. Three aims: 1) Identify and assess jail diversion http://bmjopen.bmj.com/ 33 Nurse Project [63] mentally disordered offenders; 2) direct these 34 35 cases into the healthcare system; 3) provide a 36 quantitative indication of the size of the 37 problem, in order to make recommendations for 38 future services. The aim was to identify and 39 40 assess mentally disordered offenders and direct on September 26, 2021 by guest. Protected copyright. 41 these cases into the healthcare system 42 43 The ‘Link Worker The ‘Link Worker Scheme’, aimed at establishing 1 Post-booking 44 Scheme’ [65] relationships with people with mental health jail diversion 45 and multiple problems in contact with the police 46 in order to improve the ways in which the full 47 48 range of their needs can be understood and met 49 50 Court diversion scheme Court diversion scheme. Defendants are 2 Post-booking 51 [72,74] screened prior to their appearance in court, by jail diversion 52 forensic community psychiatric nurses. They 53 look at charge sheets and previous convictions, 54 for any unusual aspects such as multiple drug or 55 56 alcohol related offences or and possible serious 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 64 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 mental illness. Custody or probation officers may 4 refer a prisoner they have concerns about. 5 6 Belfast screening, The police station provides a setting for the 1 Post-booking 7 assessment and referral treatment, questioning and identification of jail diversion 8 service for mentally mentally disordered suspects. Service based on 9 10 disordered offenders [89] the Diversion at the point of arrest model, 11 providing mental health assessment at the 12 earliest point of contact with the criminal justice 13 system and guidance and referrals to local 14 15 health and social services. Provided by 16 For Communitypeer mental review health nurses and only supported 17 by forensic psychiatry. Nurses screen custody 18 record forms of all detainees. Individuals may 19 also be referred by an Forensic Medical officer, 20 21 custody sergeant or magistrate. Following 22 assessment make recommendations for 23 treatment and support. 24 25 Diversion at the point of Diversion at the point of arrest (DAPA) 2 Post-booking 26 arrest (DAPA) [86,87] jail diversion 27 28 Multi-agency police Multi-agency police liaison scheme. The service 1 Post-booking 29 liaison scheme [59] comprises a rapid screening of custody records jail diversion 30 31 for all detainees and mental health assessment 32 where needed at the earliest point of contact http://bmjopen.bmj.com/ 33 with the CJS, plus a mechanism for appropriate 34 referral or diversion to health and social 35 36 services. The nurses also co-ordinate follow-up 37 care and provide ongoing advice and support to 38 offenders, the police and health care 39 professionals. Aimed to identify offenders with 40 psychiatric illness and/or learning disabilities on September 26, 2021 by guest. Protected copyright. 41 42 within the integrated health and social care 43 system 44 45 Jail diversion programme Jail diversion programme, a process where 13 Post-booking 46 [59,70,74,81,84,107,115, alternatives to criminal sanctions are made jail diversion 47 121,127,132,133,134{Ste available to persons with mental illness (PMI) 48 adman, 2005 #3785] who have come into contact with the law. To 49 50 identify detainees who have SMI and/or
51 substance misuse problems and establish mental 52 health treatment programs that meet their 53 needs in the least restrictive environment. 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 65 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Outreach team and Outreach team and police department. The 1 Information 4 police department [53] team contact police for help in finding missing sharing 5 persons and the police contact the team when agreements 6 they observed strange behaviour in a homeless 7 8 person that suggests the need for mental health 9 information. By establishing ongoing 10 communication with the police, outreach team 11 hoped it could foster better relations with the 12 police and between the police and the target 13 14 population, leading to fewer arrests and 15 incarcerations of people with mental health 16 For problemspeer and arereview homeless. Also helped only the 17 police would help them find hard-to-find at risk 18 19 people with mental health problems that are 20 living on the streets. 21 22 Crisis Care concordat [67] The Crisis Care Concordat, a national agreement 1 Information 23 between the different agencies and services sharing 24 involved in the care of people experiencing, or at agreements 25 risk of experiencing, a mental health crisis in the 26 27 UK. Twenty-seven national bodies have signed 28 up to the Concordat, representing health, the 29 police, social care, housing, national and local 30 government (including the Home Office, 31 Department of Health and the Ministry of 32 http://bmjopen.bmj.com/ 33 Defence) and voluntary and community sector 34 organisations. Aims to improve the quality and 35 availability of help and support, with a focus on 36 acute mental health crises, although it also 37 recognises the importance of prevention and 38 39 recovery. The four main aims of the Concordat 40 are to improve: access to support before crisis on September 26, 2021 by guest. Protected copyright. 41 point; urgent and emergency access to crisis 42 care; Quality of treatment and care when in 43 44 crisis; Recovery and staying well 45 46 The Psychiatry/ Mental . Formally organised at two levels: managerial 1 Information 47 Health Services and operational level. Managerial level has one sharing 48 cooperation model [52] representative from each sector and the agreements 49 operational level has one representative at mid- 50 level from each of the three sectors and a 51 52 coordinator who is also a member at managerial 53 level. ‘The most important task’ is to coordinate 54 the information about vulnerable citizens and 55 their situation to designate the most appropriate 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 66 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 sector to deal with their issues. 4 5 6 7 Early Notification Early Notification Program (ENP) 1 Information 8 Program (ENP) sharing A system where people with mental illnesses 9 agreements 10 [100] and special needs can voluntarily provide the 11 police with their medical information to aid 12 interaction. The aim was to provide officers with 13 14 medical information to enable them to resolve 15 situations while protecting themselves and 16 For maintainingpeer the review safety of the individual only and the 17 community. 18 19 Information sharing Multi-Agency Public Protection Arrangements 1 Information 20 agreements,(e.g. with (MAPPA) is a legal requirement in the UK under EXCLUDE sharing 21 22 CJS; part of risk the Criminal Justice Act 2003. The aim of MAPPA D Jenkins agreements 23 management (Multi- is to protect the public, including previous 2014 24 Agency Public Protection victims of crime, from serious harm by sexual 25 Arrangements - MAPPA); and violent offenders. MAPPA requires the local 26 safeguarding) [85] criminal justice agencies and other bodies 27 28 dealing with offenders to work together in 29 partnership in dealing with these offenders, by 30 identifying individuals who should be under 31 MAPPA; management of such individuals; multi- 32 agency storing and sharing information about http://bmjopen.bmj.com/ 33 34 offenders; disclosure of information to the 35 public about individual offenders in particular 36 circumstances; risk assessment and 37 management; multiagency meetings and case 38 39 reviews: 40 on September 26, 2021 by guest. Protected copyright. 41 ‘Loose coupling’ [144] ‘Loose coupling’ is a concept that suggests a 1 Information 42 43 resilient system of independent agencies that sharing 44 work harmoniously in an exchange relationship agreements 45 while the different parts retain physical and 46 professional autonomy. 47 48 49 50 The flexibility of loose coupling allows for 51 systems such as criminal justice and mental 52 53 health that seem ideologically incompatible to 54 join when a need arises and create composite 55 services. 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 67 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Learning Disabled Learning Disabled Offenders' Forum. Initially a 1 Information 4 Offenders' Forum [70] support group for sharing issues; membership sharing 5 expanded to enable not only interagency agreements 6 communication but to be instrumental in 7 8 improving services and their delivery. Aimed to 9 improve communication between professionals 10 and agencies 11 12 Information sharing Legislation and good practice guidance 3 Information 13 agreements [56] [54] documents. sharing 14 agreements 15 16 For peer review only 17 For example: Information sharing between NHS 18 and criminal justice system. The study explored 19 20 factors that enable or impede information 21 sharing and determined what information is 22 received and needed for NHS and criminal 23 justice system agencies as well as attitudes and 24 25 practises about information sharing rather than 26 one model. 27 28 29 30 Example: Recommendations made: 31 32 Move to community-based mental health http://bmjopen.bmj.com/ 33 services. Implement the Primary Care Strategy. 34 Provide social work services 24hrs, 7 days a 35 week. 36 37 Mental health training for An Garda Síochána. 38 39 Examine the feasibility of CITs. Develop joint 40 protocol and formal liaison systems. To examine on September 26, 2021 by guest. Protected copyright. 41 the introduction of District court diversion 42 programme 43 44 ‘Contemporary Policing ‘Contemporary Policing Guidelines for Working 1 Information 45 Guidelines for Working with the Mental Health System’. This outlines a sharing 46 47 with the Mental Health proactive police approach to interactions with agreements 48 System’ [46] people with mental illness and with the mental 49 health system and identifies principles that can 50 be used by police organisations. The aim was to 51 maximize the likelihood that crisis interactions 52 53 between police and people with mental illnesses 54 are prevented when possible and resolved safely 55 and respectfully when they do occur 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 68 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Best practice model of The program of work is culminating in the 1 Information 4 policing people with development of a best practice model of policing sharing 5 mental illness [37] people with mental illness. agreements 6 7 Protocol for the Joint This aims to strengthen communication and 1 Information 8 collaboration between agencies in order to sharing 9 Investigation of Crimes 10 protect vulnerable adults; to provide a agreements 11 Committed against framework for early cross-referral of Cases; to 12 ensure police involvement in the referral process 13 Vulnerable Adults [56] to ascertain whether a crime has been 14 15 committed; to minimise the number of 16 For interviewspeer conducted review with the victim; only to ensure 17 through good planning that criminal enquiries 18 run parallel to other lines of enquiry; to allow 19 accurate data to be collected on the incidence of 20 21 crimes against vulnerable adults. 22 23 Psychiatric assessment Psychiatric assessment scheme. Referred from 1 Court 24 scheme [64] court or other agencies for assessment. diversion 25 26 Cognitive Analytic Cognitive Analytic Therapy (CAT) is a 1 Court 27 Therapy (CAT) [76] collaborative time-limited psychotherapy. The diversion 28 approach aims to formulate how early 29 experiences influence the development 30 31 of unhelpful patterns that maintain a person’s 32 http://bmjopen.bmj.com/ 33 current difficult experiences. This is represented 34 diagrammatically in a map. 35 36 Court diversion Diversion includes all community-based 5 Court 37 [54,72,74,88,110] alternatives to standard prosecution that occur diversion 38 before an offender has 39 40 entered a plea or goes to trial; thus, the offender on September 26, 2021 by guest. Protected copyright. 41 42 is ‘diverted’ from standard 43 44 prosecution and into specialised community- 45 based services that are better able to meet their 46 needs. Court diversion programmes occur 47 following arrest whilst the individual is 48 49 in initial detention, during initial hearings, or 50 while being assisted by 51 52 pre-trial services offer community based 53 54 alternatives to standard prosecution 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 69 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Outpatient commitment Outpatient commitment- a civil court procedure 1 Court 4 [136] mandating adherence to outpatient mental diversion 5 health treatment. Statutorily defined outpatient 6 commitment requires compliance with 7 8 recommended outpatient treatment but does 9 not permit forced medication of legally 10 competent individuals. If fail to comply with 11 treatment, outpatient statutes permit the 12 clinician to request law enforcement officers 13 14 transport the individual to an outpatient facility, 15 where clinicians will attempt to persuade them 16 For topeer accept treatment review or undertake an onlyevaluation 17 for inpatient commitment. 18 19 20 21 Additionally, a number of related civil judicial 22 23 mechanisms may be used to compel outpatient 24 treatment. 25 26 Liaison and diversion Liaison and diversion services aim to identify and 2 Court 27 services [61,153] support people with mental health problems, diversion 28 learning difficulties and other vulnerabilities in 29 police stations and courts. The aim is to identify 30 31 and support people with mental health 32 problems, learning difficulties and other http://bmjopen.bmj.com/ 33 vulnerabilities in police stations and courts 34 35 Social Navigator Project. Social Navigator Project. (SNP) 1 Court 36 (SNP) [47] diversion 37 The social navigator is a full time paramedic who 38 works closely with ACTION (anti-violence) 39 officers to help repeat offenders The Navigator 40 on September 26, 2021 by guest. Protected copyright. 41 works with social agencies to provide care that 42 serves the need. The aim is to reduce contacts 43 with repeat offenders and get them the 44 appropriate care 45 46 Police-based specialised Police-based specialised mental health response. 1 Co-location 47 48 mental health response In this model, mental 49 [101] 50 health professionals (not sworn officers) are 51 employed by the police department to provide 52 on-site and telephone consultations to officers 53 in the field. Of the departments, 12% had this 54 type of program. 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 70 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Alabama, police-based Community services officers provide crisis 1 Co-location 4 specialised mental health intervention and some follow-up assistance. 5 response [145] Community service officers receive 6 weeks 6 training. Also attend social service calls 7 8 (domestic violence) where required. 9 10 Embedded model [78] Police Liaison Forum. 1 Co-location 11 12 Community police officer dedicated to charity 13 funded hospital facilities for mental health, 14 learning disability or acquired brain injury. 15 Officer is managed as police officer but has 16 For officepeer at the hospital. review Aimed to improve only 17 18 communications, consistency of decision- 19 making, police response, and reduce number of 20 violent incidents. and have a common approach 21 to referral to criminal justice system 22 23 Embedded model [29,95] Embedded model where police employ mental 2 Co-location 24 25 health professionals who assess consumers 26 brought into police stations by frontline officers. 27 28 McLean Hospital’s McLean Hospital’s College Mental Health 1 Service 29 College Mental Health Program was established as an institutional integration 30 Program [43] response to escalating, national college mental model 31 health concerns. McLean Hospital is the first 32 http://bmjopen.bmj.com/ 33 psychiatric hospital to develop a 34 35 comprehensive college student program that 36 bridges the gap 37 38 between a psychiatric hospital and multiple 39 campus settings 40 on September 26, 2021 by guest. Protected copyright. 41 as an attempt to address the specific needs of 42 college student-patients across levels of 43 psychiatric care and 44 45 diagnostic areas/programs. Using a bioecological 46 47 systems framework, this review examines (1) the 48 strategic clinical, education/outreach, and 49 research efforts that collectively 50 51 represent a paradigm shift to extend 52 responsibility for addressing serious college 53 54 mental health challenges beyond college and 55 university campuses, (2) the challenges and 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 71 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 benefits of creating stronger multi- 4 campus/hospital collaborations 5 6 in order to improve our understanding of college 7 students with serious mental illness, and (3) the 8 progress in 9 10 addressing these needs more effectively and in 11 12 establishing 13 14 documented best practices and policies through 15 effective and innovative partnerships. 16 For peer review only 17 Community-care Network coordinator (often community 1 Service 18 networks[55] psychiatric nurse). Patient reported by one of integration 19 the network partners who gather relevant model 20 information and if necessary the coordinator 21 22 starts intensive outreach to contact the person. 23 A plan of action is established and the 24 coordinator monitors implementation. As soon 25 as possible community care involvement is 26 27 reduced and responsibility is transferred to the 28 most appropriate agency e.g. mental health. 29 30 The Safety Net This is a multiagency integrated model of 1 Service 31 Collaborative [93] preventive services for at-risk youth involving integration 32
mental health providers, police officers, schools, model http://bmjopen.bmj.com/ 33 and the department of youth and families. The 34 35 aim of the service was to decrease youth arrest, 36 decrease youth violence, improve school 37 attendance and completion, and reduce 38 symptoms of mental illness and psychological 39 distress. Notably in this program, youth police 40 on September 26, 2021 by guest. Protected copyright. 41 officers are actively involved in the follow-up 42 and outreach to at-risk youth. 43 44 Juvenile justice policy Comprehensive three-pronged approach to 1 Comprehensiv 45 reform, advocacy and reducing in-school arrests through reforms to e systems 46 systems coordination juvenile justice policy, advocacy and systems organisation 47 48 efforts, and changes to coordination efforts, and changes to school 49 school practice and practice and policy 50 policy from an 51 interdisciplinary 52 collaborative approach 53 54 [96] 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 72 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Project SOBEIT [119] Project SOBEIT, which included six elements: (1) 1 Comprehensiv 4 safe school environment, e systems 5 organisation 6 (2) alcohol and other drug and violence 7 prevention and early intervention programs, (3) 8 school and community mental health preventive 9 10 and treatment intervention services, (4) 11 12 early childhood psychosocial and emotional 13 development programs, (5) educational reform, 14 and (6) safe school policies. Aimed to provide 15 students and their families with enhanced 16 For comprehensivepeer revieweducational, mental health,only 17 18 social service, law enforcements and juvenile 19 justice services 20 21 that promote healthy childhood development 22 and prevent violence and alcohol and other drug 23 abuse. In this model, school police officers 24 worked with other agencies to encourage pro- 25 26 social behaviour and reduce drug use 27 28 School Referral School Referral Reduction Protocol 1 Comprehensiv 29 Reduction Protocol [137] e systems 30 Integrates community systems to reduce organisation 31 reliance on punitive measures while at the same 32
time providing additional resources for school http://bmjopen.bmj.com/ 33 systems to assess and treat disruptive students. 34 35 Police agencies use Police agencies use mental health professional 1 Consultation 36 37 mental health consultants working with police negotiation model 38 professional consultants teams in hostage and barricade situations. The 39 to the negotiation team aim of the model is to preserve life, apprehend 40 the perpetrator and protect property on September 26, 2021 by guest. Protected copyright. 41 [98] 42 43 44 45 The multidisciplinary The multidisciplinary 1 Consultation 46 model 47 mental health care team mental health care team, provides a backup of 48 [42] skilled mental health workers to the general 49 hospital and community support services such as 50 51 the police, and contributes to the skill 52 development 53 54 of staff, and maximizes the resources provided 55 by a 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 73 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialist team 4 5 Oldham Phone Oldham Phone Triage/RAID Pilot Project, 1 Consultation 6 Triage/RAID Pilot Project consists of a 24-hour telephone number for model 7 [62] professional advice and assistance from RAID 8 (Rapid Assessment Interface and Discharge), the 9 10 Trust’s psychiatric liaison service. The aim was to 11 provide a service available to local police officers 12 who attend incidents where an individual 13 14 appears to be experiencing mental health 15 problems. 16 For peer review only 17 ‘Joint adult Protection ‘Joint adult Protection Investigations’ training, in 1 Joint 18 19 Investigations’ training, line with the UK government policy, ‘No Secrets’. investigation 20 in line with the UK The aim was to improve the conduct of joint or training 21 government policy, ‘No multi-agency adult protection investigations 22 Secrets’. [80] 23 by social care and health professionals and to 24 promote collaborative working in order to 25 achieve best practice in joint investigations and 26 27 in supporting the vulnerable adults involved. 28 29 Joint investigation Pilot scheme of joint training for the police and 1 Joint 30 training [58] Homefirst community trust-focussing on inter- investigation 31 agency reporting and investigation of crimes training 32 committed against vulnerable adults. Training http://bmjopen.bmj.com/ 33 aimed to provide opportunities for police 34 35 officers and social workers to explore issues 36 around joint investigation of crimes committed 37 against vulnerable adults. 38 39 Prime Time Project [139] The project makes contact with youths and their 1 Re-entry 40 families while the youths are detained and then on September 26, 2021 by guest. Protected copyright. 41 Programmes 42 follows them into the community upon release. 43 Activities include:(1) structured activities in a 44 local community center;(2) vocational training, 45 including hands-on job skills training; (3) training 46 such as social skills, affect management, 47 48 interpersonal problem-solving, and drug and 49 alcohol abuse; and (4) a youth and parent group 50 meeting 51 52 Project Link [128] Project Link 1 Re-entry 53 54 Programmes 55 56 A consortium of community service agencies 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 74 of 75 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 based on assertive community treatment and 4 intensive case management. There is a mobile 5 treatment team and case advocates in each of 6 five agencies who link consumers to psychiatric, 7 8 medical, residential and social services in the 9 community 10 11 ‘Speaking up for justice’, Special measures throughout the criminal justice 1 Special 12 Special measures to system to protect vulnerable and intimidated protective 13 protect vulnerable witnesses. Special measures were brought under measures 14 15 witnesses [57] the 1999 Criminal Justice Act. This aimed to 16 For improvepeer how vulnerable review and intimidated only 17 witnesses are treated. This included the 18 identification and support of vulnerable 19 witnesses. 20 21 Child Development- Child Development-Community Policing Project. 1 Special 22 23 Community Policing Comprises: training; police exposure to social protective 24 Project [123] and clinical services and clinician exposure to measures 25 police practice; 24 hour access to clinician; case 26 conferences. 27 28 Project Lifesaver [130] People enrolled in the project wear a 1 Special 29 personalised wristband tracking device. Teams protective 30 31 are specially trained to use electronic tracking measures 32 equipment and how to approach a person who http://bmjopen.bmj.com/ 33 has special needs and gain their trust. 34 35 Integrated model [93] Early Psychosis Program, an integrated model of 1 Integrated 36 enhanced management within an adult mental model 37 38 health service. The aim is to provide continuity, 39 familiarity and 40 on September 26, 2021 by guest. Protected copyright. 41 support at an early stage throughout all settings 42 in the health service in order to facilitate trust, 43 reduce distress and trauma 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 75 of 75 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 PRISMA 2009 Flow Diagram 4 5 6 7 8 9 10 11 Records identified through database Additional records identified through 12 searching other sources 13 (n = 3701) (n = 172) 14 15 16 For peer review only 17 18 19 Records after duplicates removed 20 (n = 2802) 21 22 23 24 25 26 Records screened Records excluded 27 (n = 2802) (n =2462) 28 29 30 31 Full-text articles assessed for 32 Full-text articles excluded, with eligibility http://bmjopen.bmj.com/ 33 reasons (n = 340) 34 (n = 214) 35 • Not research, n=87 36 • Not inter-agency, n=45 37 • Unobtainable, n=28 38 • Police not involved, Studies included in review 39 n=16 40 (n = 126) • Not mental health, n=14 on September 26, 2021 by guest. Protected copyright. 41 • Published <1995, n=8 42 • Not English language, 43 n=4 44 • Duplicate, n=4 45 Not OECD, n=1 46 • 47 • Non-systematic review, 48 n=7 49 50 51 52 53 54 55 56 From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta- Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097 57 58 For more information, visit www.prisma-statement.org. 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
Inter-agency collaboration models for people with mental ill-health in contact with the police: a systematic scoping review
ForJournal: peerBMJ Open review only Manuscript ID bmjopen-2017-019312.R1
Article Type: Research
Date Submitted by the Author: 22-Nov-2017
Complete List of Authors: Parker, Adwoa; University of York, York Trials Unit, Department of Health Sciences Scantlebury, Arabella; University of York, University of York, York Trials Unit, Department of Health Sciences ARRC Building Department of health Sciences, Faculty of Sciences Booth, Alison; York University, University of York, York Trials Unit, Department of Health Sciences ARRC Building Department of health Sciences, Faculty of Sciences Macbryde, Jillian; University of York, York Management School Scott, William; North Yorkshire Police Wright, Kath; University of York, Centre for Reviews & Dissemination McDaid, Catriona; University of York, York Trials Unit http://bmjopen.bmj.com/ Primary Subject Mental health Heading:
Health services research, Legal and forensic medicine, Mental health, Public Secondary Subject Heading: health
police, MENTAL HEALTH, systematic scoping review, inter-agency Keywords: collaboration
on September 26, 2021 by guest. Protected copyright.
For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 1 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 5 INTER-AGENCY COLLABORATION MODELS FOR PEOPLE WITH MENTAL 6 7 ILL-HEALTH IN CONTACT WITH THE POLICE: A SYSTEMATIC SCOPING 8 9 REVIEW 10
11 12 1* 1 1 2 3 13 Adwoa Parker , Arabella Scantlebury , Alison Booth , Jillian Catherine MacBryde , William J Scott , 14 4 1 Kath Wright , Catriona McDaid 15 16 For peer review only 17 18 AUTHOR AFFILIATIONS 19 1 20 York Trials Unit, Department of Health Sciences, University of York, YO10 5DD, United Kingdom, 21 22 2The York Management School, University of York, YO10 5DD 23 24 3North Yorkshire Police, Newby Wiske Hall, Northallerton, North Yorkshire, DL7 9HA 25 26 27 4Centre for Reviews and Dissemination, University of York, YO10 5DD 28 29 30 31 CORRESPONDING AUTHOR 32 *Adwoa Parker, Email: [email protected] http://bmjopen.bmj.com/ 33 34 35 36 37 38 WORD COUNT: 3794 39 40
on September 26, 2021 by guest. Protected copyright. 41 42 43 Key Words: Police, mental health, systematic scoping review, inter-agency-collaboration 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 1 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 2 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 ABSTRACT 4 5 6 Objective: To identify existing evidence on inter-agency collaboration between law enforcement, 7 emergency services, statutory services and third sector agencies regarding people with mental ill- 8 9 health. 10 11 Design: Systematic scoping review. Scoping reviews map particular research areas to identify 12 13 research gaps. 14 15 Data sources and eligibility: ASSIA, CENTRAL, the Cochrane Library databases, Criminal Justice 16 Abstracts, ERIC, Embase,For MEDLINE, peer PsycINFO, review PROSPERO and Socialonly Care Online and Social Sciences 17 18 Citation Index, were searched up to 2017, as were grey literature and hand searches. Eligible articles 19 20 were empirical evaluations or descriptions of models of inter-agency collaboration between the police 21 and other agencies. 22 23 24 Study appraisal and synthesis: Screening and data extraction were undertaken 25 independently by two researchers. Arksey’s framework was used to collate and map included studies. 26 27 28 Results: One hundred and twenty-five studies were included. The majority of articles were of 29 descriptions of models (28%), mixed methods evaluations of models (18%) and single service 30 31 evaluations (14%). The most frequently reported outcomes (52%) were ‘organisational or service level 32 http://bmjopen.bmj.com/ 33 outcomes’ (e.g. arrest rates). Most articles (53%) focused on adults with mental ill-health, whilst others 34 focused on adult offenders with mental ill-health (17.4%). Thirteen models of inter-agency 35 36 collaboration were described, each involving between 2-13 agencies. Frequently reported models were 37 ‘pre-arrest diversion’ of people with mental ill-health (34%), ‘co-response’ involving joint response by 38 39 police officers paired with mental health professionals (28.6%) and ‘jail diversion’ following arrest 40 on September 26, 2021 by guest. Protected copyright. 41 (23.8%). 42 43 Conclusions: We identified 13 different inter-agency collaboration models catering for a range of 44 45 mental health related interactions. All but one of these models involved the police and mental health 46 services or professionals. Several models have sufficient literature to warrant full systematic reviews of 47 48 their effectiveness, while others need robust evaluation, by RCT where appropriate. Future evaluations 49 should focus on health related outcomes and the impact on key stakeholders. 50 51 52 53
54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 2 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 3 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Strengths and limitations of this study 4 5 • This is the first, broad scoping review to map the evidence available for inter-agency 6 collaboration models between the police and other agencies, for people with apparent mental 7 8 ill-health. 9 • We undertook rigorous searches for the available literature, including grey literature, led by an 10 11 information specialist with input from the team, including a police officer. 12 13 • Two reviewers independently undertook study selection and the data extraction and study 14 coding was checked by a second researcher to ensure robustness in these processes. 15 16 • The lack ofFor an assessment peer of study qualityreview and synthesis onlyof the findings means we were unable 17 to make conclusions about the effectiveness of individual models. 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 3 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 4 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 BACKGROUND 4 5 Globally, there has been increasing policy and legislative focus on inter-agency collaboration for people 6 with mental ill-health coming into contact with the police and other statutory agencies such as 7 8 healthcare providers.[1-7] In recent decades in the UK and elsewhere, mental health legislation has 9 required health departments to establish jointly agreed policies with other statutory agencies to 10 11 manage people with a range of mental ill-health.[3,4,8,9] 12 13 Inter-agency collaboration, also known as ‘integrated’, ‘multi-agency’ or ‘inter-professional’ 14 15 collaboration,[10,11] takes many forms [12] ranging from a low level of joint decision-making with 16 For peer review only 17 limited shared resources to multifaceted, fully-integrated services.[13,14] Regardless of the form, 18 inter-agency collaboration generally involves three core principles of information sharing, joint 19 20 decision-making and coordinated intervention.[2,15] Inter-agency collaborations involving the police 21 aim to improve health and social care outcomes for individuals with mental ill-health and the cost and 22 23 effectiveness of services.[16,17] 24 25 A disproportionate number of people with mental ill-health come into contact with police, who are 26 27 often the first public service to interact with such individuals. Between 20-45% of police time is spent 28 engaging with people experiencing mental ill-health, as victims, witnesses or offenders.[18] However, 29 30 mental ill-health is often unrecognised and poorly handled by the police, meaning that many people 31 end up incarcerated rather than receiving appropriate treatment.[19] 32 http://bmjopen.bmj.com/ 33 34 There have been few systematic reviews of inter-agency collaboration models involving the police, 35 with no current registered ongoing review; so the impacts, particularly health-related, of such models 36 37 remain unclear. One review focused on guidance and research in the UK related to information-sharing 38 39 practices within mental health services and the organisations they work in partnership with.[20] Other 40
reviews have focused on inter-agency working in general rather than law enforcement on September 26, 2021 by guest. Protected copyright. 41 42 agencies.[11,12,21,22] The extent, range and nature of the available literature on inter-agency 43 collaboration between the police and other agencies are unclear. 44 45 46 We therefore undertook a systematic scoping review of inter-agency collaboration models involving 47 the police or other law enforcement organisations and emergency services, health and social care and 48 49 third sector organisations, aimed at supporting people with mental ill-health. Scoping reviews are used 50 in complex areas or where there is no existing systematic review. They provide a map of ‘the key 51 52 concepts underpinning a research area and the main sources and types of evidence available’.[23] It is 53 54 then possible to identify areas where a full systematic review would be feasible and worthwhile, such 55 as to capture the effectiveness of certain interventions on health outcomes. 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 4 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 5 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 AIMS AND OBJECTIVES 4 5 We aimed to identify and map the existing research evidence evaluating and describing inter-agency 6 collaboration between the police or law enforcement and emergency services, health service, social 7 8 care, education and third sector agencies for people who appear to be suffering from mental health 9 disorder. 10 11 12 Our specific objectives were to identify and map the evidence available on: 13 14 1. Models or mechanisms for inter-agency collaboration that have been described and/or 15 16 evaluatedFor peer review only 17 2. The broad areas and issues covered 18 19 3. Views and experiences of the collaborative models 20 21 22 23 METHODS 24 We undertook a systematic scoping review of the published evidence. This followed systematic review 25 26 methodology, except for quality assessment of studies and the evidence identified is mapped rather 27 than the findings synthesised.[24] The protocol was made publicly available a priori via our project 28 29 website.[25] 30 31 32 Inclusion and exclusion criteria http://bmjopen.bmj.com/ 33 Eligible studies were empirical evaluations or descriptions of models of inter-agency collaboration 34 35 between the police and other organisations dealing with members of the public of any age appearing 36 to suffer from mental disorder, mental vulnerability or learning disability. We include all terms used to 37 38 describe inter-agency working, ranging from active collaboration (e.g. ‘inter-agency’ or inter- 39 professional collaboration) to professionals or services working in parallel with limited collaboration 40 on September 26, 2021 by guest. Protected copyright. 41 between them (e.g. ‘multiagency’ or ‘multiprofessional’ working) (see Appendix 1). In this manuscript 42 43 we predominantly use the term ‘inter-agency’; however ‘multi-agency’ is used where this is the term 44 used in the original papers. Evidence and international literature from Organisation for Economic Co- 45 46 operation and Development (OECD) countries were included. Studies with any or no comparator were 47 included. All outcomes measured were eligible for inclusion. 48 49 50 We excluded: studies undertaken in the prison setting since separate arrangements exist for prisons; 51 non-English language studies; studies where the inter-agency collaboration was focused solely on 52 53 substance abuse; and Inter-agency collaboration without the involvement of the police. Appendix 1 54 lists the full inclusion and exclusion criteria. 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 5 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 6 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Search strategy 4 5 The following electronic databases were searched from inception to March 2017 by an information 6 specialist: ASSIA, CENTRAL, Cochrane Database of Systematic Reviews, Database of Abstracts of 7 8 Reviews of Effects (DARE), Criminal Justice Abstracts, ERIC, MEDLINE, Embase, PsycINFO, Social Care 9 Online and Social Sciences Citation Index. The Cochrane Effective Practice and Organisation of Care 10 11 and PROSPERO were searched for relevant reviews. 12 13 The search strategy for ASSIA is provided in Appendix 2; the complete search strategies are available 14 15 from the authors on request. Searches were comprehensive and broadly combined domain terms and 16 their associationsFor for ‘inter-agency’ peer and ‘police’ review and ‘mental health’. only ‘Google Advanced Search’ was 17 18 used to identify documents and the websites of organisations such as the Centre for Mental Health, 19 20 Crisis Care Concordat, NHS England and the Society for Evidence Based Policing. We contacted the UK 21 College of Policing for relevant evaluations. The reference lists of eligible studies were hand searched. 22 23 24 Study selection and data extraction 25 Search results were downloaded into Endnote and duplicate references removed before titles and 26 27 abstracts were screened. Study selection was undertaken independently by two researchers. 28 Discrepancies were resolved by discussion or by recourse to a third researcher. Data extraction forms 29 30 were developed and piloted. One researcher extracted data and classified the included studies and this 31 32 was checked by a second researcher. Discrepancies were resolved by discussion or by recourse to a http://bmjopen.bmj.com/ 33 third researcher. Data extraction forms were developed for primary/descriptive studies and for 34 35 reviews. Information extracted included: type of study; model of inter-agency collaboration; target 36 audience; agencies involved; study setting and context; purpose of inter-agency collaboration; 37 38 outcomes evaluated; and whether stakeholder perspectives were evaluated. 39 40 Strategy for collating, summarising and reporting the data on September 26, 2021 by guest. Protected copyright. 41 42 We mapped the literature, following Arksey’s [26] framework. This involved developing a chart which 43 44 outlined key variables of data to be extracted. Data was extracted from the original papers into the 45 relevant sections of the chart; and were subsequently sorted and shifted according to key issues and 46 47 themes. This process is akin to a ‘narrative review’ in a standard systematic review. We firstly present 48 basic numerical analysis of the extent, nature and distribution of the studies. We collated: the 49 50 geographic and chronological distribution of studies, agencies involved and the care recipient groups; 51 52 research methods adopted; outcome measures reported; and inter-agency models. We grouped 53 studies according to the name of the inter-agency collaboration model and the definition of the model, 54 55 as provided by the authors. We then used the terminology reported in the primary papers to code and 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 6 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 7 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 categorise the different models. We present the studies grouped by the different models of inter- 4 agency collaboration. 5 6 7 8 RESULTS 9 10 11 Overview of included studies 12 After deduplication there were 2802 records; 340 full text articles were reviewed independently by 13 14 two authors and 125 were included (Figure 1). 15 16 Figure 1: FlowchartFor of study selectionpeer process, review adapted from PRISMA only [27] 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 7 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 8 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 The studies were from 8 countries: Australia,[28-42] Canada,[43-51] Denmark 4 5 ,[52] France,[53] Ireland,[54] Netherlands,[55] UK,[56-92] and USA;[93-149] two multinational studies 6 7 were undertaken in Australia, Canada and the USA.[111,150] The majority of studies were from the 8 USA (45%) and the UK (29%). 9 10 11 Study Design 12 The study designs of the 125 included articles are given in Table 1. Definitions for our classification of 13 14 study designs are in Appendix 3. 15 16 Table 1: ResearchFor methods adoptedpeer review only 17 18 19 Study Design Number of Reference number 20 studies (%) 21 Audit 3 (2.4%) [41,42,84] 22 Case study 6 (4.8%) [58,70,76,97,137,141] 23 Scoping review 1 (0.8%) [43] 24 25 Qualitative 11 (8.8%) [29,35,48,49,60,82,83,91,133,150,151] 26 27 Mixed methods 23 (18.4%) [28,30-32,37,50,52-54,57,62,66- 28 68,71,90,105,110,119,142,143,147,148] 29 Controlled before and 15 (12%) [40,55,64,65,69,74,80,89,115,121,131,132,135,145,149] 30 after study 31 Service evaluation 18 (14.4%) [36,39,44,73,75,81,86- 32 88,92,94,95,113,117,120,122,125,138] http://bmjopen.bmj.com/ 33 Survey 12 (9.6%) [59,61,77,85,101,106,109,111,124,136,144,152] 34 35 Description of model 35 (28%) [33,34,38,45-47,51,56,63,78,79,93,96,98-100,102- 36 104,107,108,112,114,116,118,123,126- 37 130,134,139,140,146] 38 Prospective 1 (0.8%) [72] 39 observational study 40
on September 26, 2021 by guest. Protected copyright. 41 42 43 Outcomes assessed 44 There was a wide range of outcomes assessed, with some studies reporting multiple outcomes. Where 45 46 this occurred we report outcomes in all relevant categories (Table 2); therefore some studies are 47 presented in multiple categories. The most frequently occurring outcomes (66 studies) were 48 49 ‘organisational or service level outcomes’. The views and experiences of agency staff were investigated 50 51 in 28 studies. 52 53 Table 2: Outcomes assessed 54 55 Outcomes assessed Number of Reference number 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 8 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 9 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 studies (%) 4 Organisational/service level 66 (52%) [30-33,36,39,40,42,44,47,50,51,54,55,59,62-65,69,71- 5 6 outcomes (e.g. arrest rates, 77,81,84-89,93,94,96,97,101,106,108-111,113,115,117,119- 7 8 diversion rates, mental health 122,124,125,128,131,132,134-138,140,141,144,145,147,148] 9 referrals, court referrals and 10 11 numbers of people under 12 emergency protective custody) 13 14 Views and experiences of agency 28 (22%) [29-32,35,37,48- 15 staff (e.g. police officers) 50,52,53,57,66,67,71,83,90,95,105,110,119,124,133,142,143,1 16 For peer review only 17 47,151] 18 19 Views and experiences of people 18 (14.2%) [30,31,44,48-50,53,54,57,59,60,66,67,90,91,110,119,152] 20 in community (e.g. service users, 21 22 families and carers) 23 Service user mental health 7 (5.5%) [59,61,63,81,102,119,140] 24 25 outcomes (e.g. improvement in 26 27 mood) 28 Cost effectiveness or wider 3 (2.4%) [28,61,65] 29 30 economic costs 31 Staff learning outcomes (e.g. staff 3 (2.4%) [58,80,92] 32 http://bmjopen.bmj.com/ 33 knowledge about mental health 34 35 following mental health training) 36 No outcomes reported 28 (22%) [34,38,43,45,46,56,70,78,79,98- 37 38 100,103,104,107,112,114,116,118,123,126,127,129,130,139,1 39 46,150] 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 Study population 45 The majority of articles (n=67) focused on adults, either diagnosed with or perceived to have a mental 46 47 health problem, such as psychoses or severe mental illness (Table 3). A number of articles focused on 48 adult offenders with mental ill-health (n=22) or adults with mental health and/or substance misuse 49 50 problems (n=7). Articles including children and youth generally focused on those who had been 51 exposed to or victimised by violence (n=4); child offenders with mental health and/or substance abuse 52 53 problems (n=3); or those with behavioural problems (n=2). Three articles included children and adults. 54 55 Table 3: Care recipient group 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 9 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 10 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Care recipient group Number of Reference number 4 studies (%) 5 6 Adults Mental ill-health 67 (53.2%) [28-37,40-43,45,46,48- 7 8 50,54,55,64,65,67- 9 69,71,72,74,77,82,83,88,90,92,94,95,97, 10 11 99,101- 12 106,109,114,117,118,120,122,124,126- 13 14 128,131,133,136,138,141,143,145,146,1 15 48-150] 16 For peer review only 17 Mental health and/or substance misuse dual 7 (5.6%) [44,52,62,113,134,135,152] 18 19 diagnosis 20 Mental health, substance misuse dual 3 (2.4%) [108,129,142] 21 22 diagnosis and/or homelessness 23 Learning disabilities 3 (2.4%) [56,79,80] 24 25 Mental ill-health and homelessness 1 (0.8%) [53] 26 27 Offenders with mental illness 22 [32,47,51,59,63,73,76,81,84- 28 87,89,91,107,111,112,115,121,132,144, 29 30 151] 31 Offenders with learning disabilities 1 (0.8%) [70] 32 http://bmjopen.bmj.com/ 33 Individuals with pathological fixations, 4 (3.2%) [38,39,75,98] 34 35 deemed to be mentally ill 36 Vulnerable adults, including mental health, 5 (4%) [57,58,60,61,100] 37 38 learning disabilities and other special needs 39 Children At risk children and youth 4 (3.2%) [93,116,119,147] 40 on September 26, 2021 by guest. Protected copyright. 41 and young Offenders with learning disabilities 1 (0.8%) [66] 42 43 people Offenders with mental health and/or 3 (2.4%) [110,139,140] 44 substance abuse problems 45 46 Behavioural problems 2 (1.6%) [96,137] 47 48 Children and adolescents who have been 1 (0.8%) [123] 49 exposed to or victimized by violence 50 51 Men, women, adolescents and older people 1 (0.8%) [78] 52 with mental health, learning disability or 53 54 acquired brain injury. 55 Mixed Children and families exposed to violence 1 (0.8%) [125] 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 10 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 11 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 adults and and trauma 4 children People with Alzheimer’s, children with autism 1 (0.8%) [130] 5 6 and Down syndrome 7 8 Men, women, adolescents and older people 1 (0.8%) [78] 9 with mental health, learning disability or 10 11 acquired brain injury 12
13 14 15 Models of inter-agency collaboration and agency composition 16 For peer review only 17 Thirteen different models of inter-agency collaboration were described in the included articles; 18 although there was often an overlap in agency composition. A number of articles reported on more 19 20 than one model; therefore papers are represented in each relevant section. The terminology used to 21 describe the different models of inter-agency collaboration was directly derived from the primary 22 23 papers. Detailed descriptions of the models are provided in Appendix 4. 24 25 The models identified involved collaborations between the police and a wide range of other services 26 27 (Table 4). The ‘consultation model’ and ‘joint investigation training’ only involved the police and 28 mental health services; the remaining models were highly multi-disciplinary involving a range of 29 30 organisations. Information sharing agreements and court diversion models involved the widest 31 32 combination of agencies. Across all the collaborations with the police, mental health clinicians, mental http://bmjopen.bmj.com/ 33 health services and criminal justice agencies were the most frequently occurring partners. 34 35
36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 11 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml
Witness services Witness BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
Welfare services Welfare
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services workers/social Social
Schools/Colleges
Probation services Probation
Primary care Primary
Policy makers Policy
Police
Nurses
Mental health services health Mental
Mental health clinicians health Mental
Housing services Housing
Hospitals (acute general) (acute Hospitals
30
of of
Employment support Employment Agency composition composition Agency
12
Emergency services Emergency
Page Page
Courts/criminal justice Courts/criminal
Community organisations Community
BMJ Open Children and family family and Children services services
http://bmjopen.bmj.com/
Ambulance
Advocacy
Adult protection services protection Adult
Addiction services Addiction
on September 26, 2021 by guest. Protected copyright.
24 hour crisis services crisis hour 24
For peer review only For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml
Type of model (number of studies) of studies) (number model of Type Integrated model (n=1) (n=1) model Integrated Re-entry programmes (n=2) (n=2) programmes Re-entry Joint investigation training (n=2) (n=2) training investigation Joint Consultation model (n=3) (n=3) model Consultation Special protective measures (n=3) (n=3) measures protective Special Comprehensive systems organisation organisation systems Comprehensive (n=3) Service integration model (n=3) (n=3) model integration Service Co-location (n=5) (n=5) Co-location Court Diversion (n=11) (n=11) Diversion Court Information sharing agreement models models agreement sharing Information (n=13) Post-booking jail diversion (n=30) (n=30) diversion jail Post-booking Co-response (n=36) (n=36) Co-response Pre-arrest diversion (n=43) (n=43) diversion Pre-arrest
Table 4: Overview of models and agency composition composition agency and models of Overview 4: Table
Inter-agency scoping review manuscript v8 v8 manuscript review scoping Inter-agency 22/11/2017 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Page 13 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 Pre-arrest diversion 5 The most frequently reported model (43 articles), was pre-arrest diversion, from 6 7 Australia;[30,31,33,34,36,38] Canada;[43,45] the UK;[61,68,75] 8 USA;[29,94,95,97,99,101,103,104,114,116-118,124,126,127,129,133-135,138,143,145,149]; and two 9 10 multi-national articles involving Australia, Canada and the US.[111,150] Pre-arrest diversion models are 11 12 described as involving police officers who had special mental health training, serving as the first-line 13 police response to mental health crises in the community and acting as liaisons to the formal mental 14 15 health system. The reported purpose of pre-arrest diversion models was to equip police officers to 16 better manage situationsFor involving peer people withreview mental health, substanceonly abuse, and/or homelessness 17 18 problems who became involved with the police, and to offer treatment as an alternative to arrest. The 19 20 most widely reported pre-arrest diversion model was the US-based Crisis Intervention Team (CIT) 21 model.[29,34,43,99,103,104,111,114,116,118,124,126,127,133,138,145,150] CIT is a police-based first- 22 23 responder programme for people in mental health crisis who come into contact with the police and 24 provides police-based crisis intervention training. This model involved collaboration between police, 25 26 emergency services, and treatment providers such as clinical staff from local health departments, 27 hospital emergency departments, and specialised mental health services. CIT trained officers worked in 28 29 partnership with mental health professionals to assist people with mental illness, family members, and 30 31 other police officers. 32 http://bmjopen.bmj.com/ 33 Co-response 34 35 Co-response models were reported in 36 articles, from Australia;[28,29,32,33,35,41] 36 Canada;[33,43,44,48-50] UK;[43,69,71,90] USA;[95,101,102,105,106,111-113,122,131,146,152] and 37 38 multinational studies involving Australia, Canada and the UK.[111,150] In this model, a shared protocol 39 paired specially trained police officers with mental health professionals to attend police call outs 40 on September 26, 2021 by guest. Protected copyright. 41 involving people with mental ill-health. The reported aims were to provide assistance to people in 42 43 mental health crisis and prevent their unnecessary incarceration or hospitalisation. An example of this 44 model is the UK based ‘Street Triage’,[69,71,90] where a dedicated police officer and psychiatric nurse 45 46 together attend the scene of incidents requiring support for mental health needs. In Street Triage, the 47 team did not provide the initial response to events. Rather, police call handlers allocated incidents to 48 49 the Street Triage team if the incident required additional mental health support. Telephone support to 50 51 police colleagues attending a new incident was provided if the team were already busy. 52 53 Post-booking jail diversion 54 55 Thirty articles reported post-booking jail diversion programmes, from the UK 56 [59,63,65,66,70,72,74,81,83,84,86,87,89] and USA.[107,108,110,115,121,127,132- 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 13 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 14 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 134,140,141,143,149] This is a multi-agency liaison scheme, comprising of a rapid screening and 4 mental health assessment of people arrested at the earliest point of contact with the criminal justice 5 6 system, plus a mechanism for appropriate referral or diversion to health, treatment, social and 7 community services. An example is Diversion at the Point of Arrest (DAPA),[86,87] a UK based model in 8 9 which people arrested and detained at police stations were assessed by a community psychiatric 10 11 nurse, who then acted as the co-ordinator for the involvement of other mental health care workers 12 and services as needed. 13 14 15 Information sharing agreement models 16 Information sharingFor agreement peer models were review reported in 13 papersonly from Australia;[37] Canada;[46] 17 18 Denmark;[52] France;[53] the UK;[56,67,70,85] and USA.[100,144] In this model information about 19 20 people with mental ill-health were shared between police and other agencies; or between the 21 individual with mental ill-health and the police and other agencies. The reported aims of information 22 23 models were to improve support to people with mental ill-health; foster better relations between 24 agencies and between the police and people with mental ill-health; identify hard-to-find at risk people 25 26 with mental ill-health; and protect the public from offenders with mental ill-health. An example is the 27 Multi-Agency Public Protection Arrangements (MAPPA) which aims to protect the public from harm by 28 29 sexual and violent offenders, who may have mental ill-health.[85] Agency composition includes the 30 31 police, other law enforcement agencies and mental health services. MAPPA agencies work together by: 32
identifying individuals who should be under MAPPA; managing such individuals; multi-agency storing http://bmjopen.bmj.com/ 33 34 and sharing information about offenders; disclosure of information to the public about individual 35 offenders in particular circumstances; risk assessment and management; multiagency meetings and 36 37 case reviews. 38 39 Court diversion models 40 on September 26, 2021 by guest. Protected copyright. 41 Eleven articles reported court diversion models from Canada;[47] the UK;[61,64,72,76,88,153] 42 43 Ireland;[54] and USA.[74,110,136] Offenders were ‘diverted’ from prosecution and into a specialised 44 community-based service. Court diversion occurred following arrest whilst the individual was initially 45 46 detained, during initial hearings, or while being assisted by pre-trial services to offer community based 47 alternatives to standard prosecution. An example of such a service is ‘Liaison and diversion’, which 48 49 identifies and supports people with mental ill-health, learning difficulties and other vulnerabilities in 50 51 police stations and courts.[61,153] 52 53 Co-location 54 55 Co-location was a model reported in five articles from Australia;[29] the UK;[78] and USA.[95,101,145] 56 In this model, mental health professionals were employed by police departments to provide on-site 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 14 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 15 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 and telephone consultations to officers in the field. Another variant of the co-location model involved 4 a dedicated police officer being based in an office within a mental health hospital; an example of this is 5 6 the ‘Police Liaison Forum’.[78] 7 8 Comprehensive systems model 9 10 Three papers from the USA reported a ‘comprehensive systems’ approach to reducing crime and 11 12 arrests, three of which focused on reducing in school arrests.[96,119,137] Comprehensive systems 13 models typically include policy reform, multi-systems coordination and changes to practice at multiple 14 15 levels. An example was Project SOBEIT,[119] which included six elements: 1) safe school environment, 16 2) alcohol and otherFor drug andpeer violence preventionreview and early interventiononly programs, 3) school and 17 18 community mental health preventive and treatment intervention services, 4) early childhood 19 20 psychosocial and emotional development programs, 5) educational reform, and 6) safe school policies. 21 In this model school-based police officers worked with children, staff and external agencies to 22 23 encourage pro-social behaviour and reduce drug use and criminalisation. 24 25 Consultation model 26 27 Three papers from Australia;[42] the UK;[62] and USA [98] reported on a ‘consultation’ model. In this 28 model police agencies accessed advice from mental health professionals when working with people 29 30 with mental ill-health. Typically the advice was delivered over the telephone and generally aimed to 31 32 maximise the resources provided by a specialist team and to assess and prevent criminal behaviour, http://bmjopen.bmj.com/ 33 protect life, arrest the perpetrator and protect property. An example is the Oldham Phone 34 35 Triage/Rapid Assessment Interface,[62] which consisted of a dedicated 24-hour telephone number for 36 professional advice and assistance from, the local health service’s psychiatric liaison service for local 37 38 police officers. 39 40 Service integration models on September 26, 2021 by guest. Protected copyright. 41 42 Three articles from Canada;[43] the Netherlands;[55] and the USA [93] reported on ‘service 43 44 integration’ models. The agencies involved were mental health providers, police officers, educational 45 institutions, and the children and family services (see Table 4). The aims of these models were to 46 47 integrate services by creating a network to bridge gaps between services, decrease arrest, decrease 48 violence, improve educational attendance and completion, and reduce symptoms of mental illness and 49 50 psychological distress. Such models typically involve a network coordinator who provides active follow- 51 52 up. An example of a service integration model is the ‘Community-care networks’.[55] A Network 53 coordinator (often community psychiatric nurse), received reports from network partners about any 54 55 person of concern and gathered relevant information, established a plan of action and monitored 56 implementation. Responsibility was transferred to the most appropriate agency as soon as possible. 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 15 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 16 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Special protective measures 4 5 Three articles from the UK [57] and USA [123,130] focused on ‘special protective measures’, with the 6 reported aim of identifying and protecting people with mental ill-health, learning disabilities and other 7 8 vulnerable people. An example of this was ‘Speaking up for justice’,[57] a collaboration between the 9 police, the courts, hospitals and other agencies aimed at improving how vulnerable and intimidated 10 11 witnesses were treated. 12 13 Joint investigation training 14 15 Two papers from the UK reported on a ‘joint investigation training’ model,[58,80] which focused on 16 For peer review only 17 adults with mental ill-health, learning disabilities or other vulnerable adults who had crimes committed 18 against them. This model involved joint mental health training for the police, social workers, mental 19 20 health and adult protection services aimed at improving multi-agency adult protection investigations, 21 and promoting collaborative working to support vulnerable adults. An example of such training is the 22 23 ‘Joint adult Protection Investigations’ training. [58] 24 25 Re-entry programmes 26 27 Two articles from the USA [128,139] reported on ‘re-entry’ programmes, which aimed to assist 28 29 individuals with mental illness to re-integrate into the community. This included institutional and 30 community-based programmes serving individuals with mental illness following release from prison or 31 32 hospitalisation. The ‘Prime Time Project’,[139] involves a collaborative alliance with local police officers http://bmjopen.bmj.com/ 33 to involve young people with mental ill-health who have been detained by the police and involves 34 35 activities in the community training in job skills and other aspects of managing daily life. 36 37 Integrated model 38 39 One article reported an Early Psychosis Program from Australia.[40] In this model police could become 40 on September 26, 2021 by guest. Protected copyright. 41 involved in the voluntary or involuntary admission process of people with mental ill-health into the 42 Early Psychosis Programme. The aim was to provide continuity, familiarity and support at an early 43 44 stage throughout the health service to facilitate trust and reduce distress. 45 46 47 48 DISCUSSION 49 50 Overview of main findings 51 52 The scoping review identified thirteen distinctive inter-agency collaboration models for people with 53 mental ill-health in contact with the police, mainly from the US, UK and Australia. Although the 54 55 majority of articles focused on adults with mental ill-health, a substantial body of the literature 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 16 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 17 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 focused on offenders with mental illness. The area most commonly covered was the relationship 4 between the police and mental health services; unsurprising as this is a critical interface for the police 5 6 service. However, it is noteworthy that several key agencies were not identified as agency 7 collaborators. For example, the ambulance service was a named agency in only three models; yet in 8 9 countries like the UK, the legal frameworks and guidance stipulate that people with mental ill-health 10 11 taken to a health-based place of safety should ideally be transported by ambulance.[18,154] 12 Additionally, ten articles included people with dual diagnoses of mental health and substance abuse 13 14 problems, yet addiction services featured as an agency in only one of the models. This may be 15 indicative of conflicting priorities for services; however there is potential for mutual benefit through 16 For peer review only 17 greater inter-agency working. 18 19 Our review did not evaluate the risk of bias in the included studies, but in general the study designs 20 21 used are unlikely to provide robust evidence about effectiveness: there were no RCTs. The main focus 22 in the articles was the impact of the model on organisational level outcomes routinely collected by the 23 24 police such as arrest and diversion rates, which they are required to collect.[155] Several articles 25 26 reported the views and experiences of members of the public coming into contact with the service as 27 well as the different agencies involved. There are sufficient studies identified to justify development of 28 29 focussed questions for systematic review. These should include study designs relevant to the specific 30 research question, such as qualitative studies if the focus of the review is to explore stakeholder 31 32 perspectives; and experimental designs if the aim is to explore effectiveness. http://bmjopen.bmj.com/ 33 34 35 Strengths and limitations 36 A strength of our review is that the broad scope has facilitated mapping of the evidence available on 37 38 inter-agency collaboration models between the police and other agencies, to appropriately manage 39 people with apparent mental problems who come into contact with the police. The lack of an 40 on September 26, 2021 by guest. Protected copyright. 41 assessment of study quality and synthesis of the findings means we were unable to make conclusions 42 about the effectiveness of individual models. However, this scoping review provides an overview of the 43 44 literature not previously available.[26] 45 46 Identifying all available evidence on complex topics can be difficult as the relevant studies can be 47 48 spread across numerous databases covering a range of disciplines. Furthermore, the key concepts may 49 also be described using different terminology in each database so the search strategies need significant 50 51 adaptation.[156] Additionally, ‘inter-agency’ is a nebulous concept which has multiple definitions; and 52 53 is often interchanged with other terms, making studies on the topic difficult to identify. To address 54 these issues, the search strategy was extensive and thorough, and developed by an information 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 17 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 18 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialist with input from members of the team including a police officer. We also undertook grey 4 literature searches and hand searching to maximise retrieval. 5 6 7 Mapping focussed on identifying distinctive models.Two reviewers independently undertook study 8 selection and the data extraction and study coding was also checked by a second researcher to ensure 9 10 robustness in these processes. However, the identification of the models inevitably has a subjective 11 component. We have mitigated against this as far as possible through involvement of two researchers 12 13 in the mapping as well as a providing examples and descriptions of each model. We assigned each 14 15 study to a methodological grouping based on the description of the methods used, which may or may 16 not have matchedFor with the author’speer categorisation review of the study. only 17 18 19 Comparison with existing literature 20 To our knowledge this is the first systematic scoping review to focus on inter-agency collaboration 21 22 models for people with mental ill-health in contact with the police. We identified no robust evaluations 23 of models of inter-agency collaboration such as RCTs. Such a lack of evidence has been found in other 24 25 fields assessing the evidence for inter-agency models.[157] Our categorisation of the various inter- 26 27 agency models, such as ‘pre-arrest diversion’, ‘post booking diversion’ and ‘court diversion’ fits with 28 the Sequential Intercept Model.[158] The Sequential Intercept Model is a framework for 29 30 conceptualising the range of community-based alternatives for people with mental ill-health in contact 31 with the criminal justice system. The model suggests a series of ‘points of interception’ at which 32 http://bmjopen.bmj.com/ 33 interventions can be targeted to prevent individuals from entering or penetrating deeper into the 34 35 criminal justice system. Our review is broader and considers inter-agency collaboration models outside 36 the criminal justice system. For example, we highlight ‘joint investigation training’ or ‘special 37 38 protective’ models as efforts that focus on people with mental illness as victims of crime or as 39 vulnerable witnesses. 40 on September 26, 2021 by guest. Protected copyright. 41 42 Although the majority of articles focused on adults with mental ill-health, a number focused on 43 offenders with mental illness; possibly because individuals with mental ill-health are disproportionally 44 45 more likely to be arrested and enter the criminal justice system.[159,160] 46 47 Knowledge gaps and implications for research, policy and professional 48 49 practice 50 51 While not all the models may be distinctive enough to make an RCT appropriate or feasible, there are a 52 number of models where this approach would be appropriate. We identified an absence of high quality 53 54 evidence on effectiveness, despite the fact that models such as Street Triage and CIT are now routinely 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 18 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 19 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 implemented within policing. Few evaluations considered the views of people with mental ill-health, or 4 indeed the views and experiences of staff in the collaborating agencies. 5 6 7 Inter-agency collaboration models are complex interventions involving several interactive components 8 and agencies. Existing guidance on the development and evaluation of theoretically informed, complex 9 10 interventions may be useful in informing future development and evaluation of inter-agency models 11 [161]. More research is required to examine the effectiveness, cost effectiveness, barriers and 12 13 benefits of inter-agency collaboration models. The latter is important for designing ‘effective’ models 14 15 which might have significant benefit for healthcare. Whilst there is significant political pressure on 16 agencies to collaborate,[18,154,162]For peer at present review there is no clear understandingonly of the most effective or 17 18 cost-effective ways of developing, implementing and delivering such models. Furthermore, legislative 19 and policy changes, and the speed with which they are implemented over time and in different 20 21 jurisdictions can influence the availability and even preferences for certain models. For example, in the 22 UK changes in legislation such as the 2017 Police and Crime Act,[163] which extends Police powers 23 24 under the Mental Health Act, is likely to impact on the adoption of certain models. Studies in this area 25 26 should move from simple descriptions of models of care to prospective exploratory and experimental 27 evaluations that include primary and secondary outcomes. We identified sufficient literature for some 28 29 models such as pre-arrest diversion, co-response and post-booking diversion which warrant more in- 30 depth evaluation in a systematic review; some of this research is already underway with an upcoming 31 32 systematic review focusing on the effectiveness of liaison and diversion, Street Triage and specialist http://bmjopen.bmj.com/ 33 34 staff embedded in police control rooms [164]. Evaluations of the cost-effectiveness of such models 35 would be important from a policy perspective, since one of the key drivers for inter-agency 36 37 collaboration is to streamline services and improve efficiency [162] particularly in the current UK 38 context of austerity.[165] 39 40 on September 26, 2021 by guest. Protected copyright. 41 Health services played a significant role in many of these models; however only 5.5% of the articles 42 assessed patient health outcomes, pointing to a need to identify the health related benefits of inter- 43 44 agency collaboration for patients and carers using robust methods. More work is also needed to 45 develop conceptual clarity and frameworks around collaboration models encompassing people with 46 47 mental ill-health in contact with the police as suspects or perpetrators, as well as victims or vulnerable 48 witnesses. Existing work in related areas could inform such work, such as a conceptual framework 49 50 combining the concepts of primary care and integrated care to understand the complexity of 51 52 integrated care.[166] Future studies could include the views of people with mental ill-health in the 53 development and evaluation of models. Ideally, researchers should specify the influence of the 54 55 research context on their findings and explain any discrepancies between their findings and the 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 19 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 20 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 findings of other studies, given the differences in context. This could involve the adoption of process 4 evaluation methods, where guidance already exists to inform such work.[167] 5 6 7 8 CONCLUSIONS 9 10 We identified 13 different inter-agency collaboration models aimed at supporting people with mental 11 ill-health; including adults, children and different severities of condition and comorbidities. There were 12 13 wide variations in the number of agencies involved within the models. All but one of these models 14 included collaboration between the police and mental health professionals and/or services; and many 15 16 of the identified modelsFor included peer other organisations review relevant to only the purpose of the collaboration. We 17 18 have identified models where sufficient literature exists to warrant full systematic reviews to assess 19 their effectiveness. We have also identified other areas which have highlighted the need for robust 20 21 evaluation by RCT where appropriate. Important outcomes for future evaluations should include the 22 impact on and experiences of the people the collaborations aim to assist, on staff from the agencies 23 24 involved, as well as health related outcomes for patients. 25 26 27 28 ACKNOWLEDGEMENTS 29 We thank Kat Chatterton for assistance with sourcing inter-library loans. 30 31 32 http://bmjopen.bmj.com/ 33 FUNDING STATEMENT 34 35 This work was supported by the Higher Education Funding Council for England (HEFCE) and the Home 36 Office through the College of Policing, grant number J05. This review is part of Connect, the Co- 37 38 production of policing evidence, research and training: focus mental health project 39 (http://connectebp.org/). 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 COMPETING INTERESTS 44 45 The authors declare that they have no competing interests. 46 47 48 49 AUTHORS’ CONTRIBUTIONS 50 AP lead the review and was responsible for writing the protocol, study selection, data extraction, grey 51 52 literature and hand searches and writing the final report. KW devised the search strategies and carried 53 out the literature searches and wrote the search methodology section of the paper. AP, AB, and AS 54 55 undertook study selection and data extraction. AP, AB, AS, CM, JCM and WJS inputted into the study 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 20 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 21 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 conception and design. All the authors commented on the draft protocol and the final report. CM 4 provided input at all stages, commented on all draft documents and had overall responsibility for the 5 6 review. All authors read and approved the final manuscript. 7 8 9 10 DATA SHARING STATEMENT 11 The data extraction tables will be made available by placing a reasonable request with the lead author. 12 13 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 21 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 22 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 REFERENCE LIST 4 5 1. Department of Health and Concordat signatories. Mental Health Crisis Care Concordat Improving 6 outcomes for people experiencing mental health crisis. February 2014 7 2. Home Office. Multi-Agency Working and Information Sharing Project: Final Report. In: Office H, ed., 8 2014. 9 3. UK Crown. Mental Health Act 1983. The Stationery Office. UK, 1983. 10 4. UK Crown. Mental Health Act 2007. The Stationery Office. UK, 2007. 11 5. Home Office. Supporting vulnerable people who encounter the police: A strategic guide for police 12 forces and their partners. 2015 13 6. Home Office, Department of Health. No Secrets: Guidance on developing and implementing multi- 14 agency policies and procedures to protect vulnerable adults from abuse. In: Health HOaDo, ed. 15 London, 2000. 16 7. Health Do. StatementFor of Governmentpeer Policy review on Adult Safeguarding. only In: Health Do, ed., 2013. 17 8. National Mental Health Working Group. National safety priorities in mental health: a national plan 18 for reducing harm. In: Health Priorities and Suicide Prevention Branch DoHaA, ed. Publications 19 approval number: 3725 (JN9187) ed. Canberra: Commonwealth of Australia, 2005. 20 9. Metropolitan Police. Inter-agency joint working protocol for the management of mental health: 21 22 Metropolitan Police, 2011. 23 10. Robinson M, Atkinson M, Downing D. Supporting Theory Building in Integrated Services Research: 24 ERIC 2008. 25 11. Oliver C, Mooney A, Statham J. Integrated working: a review of the evidence. 2010 26 12. Atkinson M, Jones M, Lamont E. Multi-agency working and its implications for practice. Reading: 27 CfBT Education Trust 2007 28 13. Darlington Y, Feeney JA, Rixon K. Interagency collaboration between child protection and mental 29 health services: Practices, attitudes and barriers. Child Abuse & Neglect 2005;29(10):1085-98. 30 doi: http://dx.doi.org/10.1016/j.chiabu.2005.04.005 31 14. Walter U, Petr C. A template for family-centered interagency collaboration. Families in Society: The 32 Journal of Contemporary Social Services 2000;81(5):494-503. http://bmjopen.bmj.com/ 33 15. Home Office. Multi-Agency Working and Information Sharing Project Early Findings. In: Office H, 34 ed., 2013. 35 16. Johnson P, Wistow G, Schulz R, et al. Interagency and interprofessional collaboration in community 36 care: the interdependence of structures and values. Journal of Interprofessional care 37 2003;17(1):70-83. 38 17. Paton FCW, Wright K, Ayre N, et al. Improving outcomes for people in mental health crisis: a rapid 39 synthesis of the evidence for available models of care. Health Technology Assessment 2016:1- 40 161. on September 26, 2021 by guest. Protected copyright. 41 42 18. House of Commons Home Affairs Committee. Policing and mental health: Eleventh Report of 43 Session 2014–15. London: The Stationery Office Limited 2015 44 19. Sainsbury Centre for Mental Health. Diversion: A better way for criminal justice and mental health. 45 London: Nuffield Press 2009. 46 20. Jenkins K. Information-sharing in mental health care provision: a review. 2014 47 21. Williams I. Offender health and social care: a review of the evidence on inter‐agency collaboration. 48 Health & social care in the community 2009;17(6):573-80. 49 22. Phillips C, Considine M, Lewis R. A review of audits and strategies produced by crime and disorder 50 partnerships in 1999: Home Office, Research, Development and Statistics Directorate, Policing 51 and Reducing Crime Unit 2000. 52 23. Mays N, Roberts E, Popay J. Synthesising research evidence. Studying the organisation and delivery 53 54 of health services: Research methods 2001:188-220. 55 24. Centre for R, Dissemination. Systematic Reviews: CRD’s Guidance for Undertaking Reviews in 56 Healthcare. York: University of York 2009. 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 22 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 23 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 25. Hughes-Morley A, Clarke A, MacBryde J, et al. What models or mechanisms for inter-agency 4 collaboration between the police or law enforcement and other statutory agencies for people 5 with mental problems have been evaluated, and what evidence is available on their 6 effectiveness? A systematic scoping review 2016 [Available from: http://connectebp.org/wp- 7 content/uploads/2016/09/Inter-Agency-Scoping-Review-Protocol-v1-05.09.2016.pdf accessed 8 17th March 2017. 9 26. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. International journal 10 of social research methodology 2005;8(1):19-32. 11 27. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta- 12 analyses: the PRISMA statement. PLoS Med 2009;6(7):e1000097. 13 28. Allen Consulting Group. Police, Ambulance and Clinical Early Response (PACER) Evaluation. April 14 2012;Final Report:1-66. 15 29. Boscarato K, Lee S, Kroschel J, et al. Consumer experience of formal crisis-response services and 16 preferredFor methods peer of crisis intervention. review International only Journal of Mental Health Nursing 17 2014;23(4):287-95. doi: http://dx.doi.org/10.1111/inm.12059 18 19 30. Herrington V, Clifford K, Lawrence P, et al. The impact of the NSW police force mental health 20 intervention team: final evaluation report. New South Wales: Charles Sturt University 2009 21 31. Herrington V. Inter-agency Cooperation and Joined-up Working in Police Responses to Persons with 22 a Mental Illness: Lessons from New South Wales. Policing: A Journal of Policy & Practice 23 2012;6(4):388-97. 24 32. Hollander Y, Lee SJ, Tahtalian S, et al. Challenges Relating to the Interface Between Crisis Mental 25 Health Clinicians and Police When Engaging with People with a Mental Illness. Psychiatry, 26 Psychology and Law 2012;19(3):402-11. doi: 27 http://dx.doi.org/10.1080/13218719.2011.585131 28 33. Huppert D, Griffiths M. Police Mental Health Partnership project: Police Ambulance Crisis 29 Emergency Response (PACER) model development. Australasian Psychiatry 2015;23(5):520-23. 30 doi: http://dx.doi.org/10.1177/1039856215597533 31 34. Laing R, Halsey R, Donohue D, et al. Application of a model for the development of a mental health 32
service delivery collaboration between police and the health service. Issues Ment Health Nurs http://bmjopen.bmj.com/ 33 2009;30(5):337-41. doi: http://dx.doi.org/10.1080/01612840902754644 34 35. McKenna B, Furness T, Oakes J, et al. Police and mental health clinician partnership in response to 35 mental health crisis: A qualitative study. International Journal of Mental Health Nursing 36 2015;24(5):386-93. 37 36. Meehan T, Stedman T. Trends in the use of Emergency Examination Orders in Queensland since the 38 39 implementation of the Mental Health Intervention Project. Australasian psychiatry : bulletin of 40 Royal Australian and New Zealand College of Psychiatrists 2012;20(4):287-90. on September 26, 2021 by guest. Protected copyright. 41 37. Ogloff JRP, Thomas SDM, Luebbers S, et al. Policing Services With Mentally Ill People: Developing 42 Greater Understanding and Best Practice. Australian Psychologist 2013;48(1):57-68. doi: 43 http://dx.doi.org/10.1111/j.1742-9544.2012.00088.x 44 38. Pathe MT, Haworth DJ, Lowry TJ, et al. A model for managing the mentally ill fixated person at 45 major events. Aust N Z J Psychiatry 2015;49(7):610-15. doi: 46 http://dx.doi.org/10.1177/0004867415581022 47 39. Pathe MT, Lowry T, Haworth DJ, et al. Assessing and managing the threat posed by fixated persons 48 in Australia. Journal of Forensic Psychiatry and Psychology 2015;26(4):425-38. doi: 49 http://dx.doi.org/10.1080/14789949.2015.1037332 50 40. Petrakis M, Penno S, Oxley J, et al. Early psychosis treatment in an integrated model within an adult 51 mental health service.[Erratum appears in Eur Psychiatry. 2013 Mar;28(3):197]. Eur Psychiatry 52 2012;27(7):483-8. doi: http://dx.doi.org/10.1016/j.eurpsy.2011.03.004 53 41. Victorian Auditor General’s Report. Responding to mental health crisis in the community. Victorian 54 Auditor General’s Report: Victorian Government Printer, 2009. 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 23 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 24 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 42. Webster S, Harrison L. The multidisciplinary approach to mental health crisis management: an 4 Australian example. J Psychiatr Ment Health Nurs 2004;11(1):21-29. doi: 10.1111/j.1365- 5 2850.2004.00647.x 6 43. Winters S, Magalhaes L, Kinsella EA. Interprofessional collaboration in mental health crisis response 7 systems: a scoping review. Disabil Rehabil 2015;37(23):2212-24. doi: 8 http://dx.doi.org/10.3109/09638288.2014.1002576 9 44. Baess E. Integrated Mobile Crisis Response Team (IMCRT): Review of pairing police with mental 10 health outreach services. Victoria, BC: Vancouver Island Health Authority 2005 11 45. Cant IR. The secondary family: the result of strong community partnering. Mental Health Review 12 Journal 2007;12(3):30-33. 13 46. Coleman TG, Cotton DH. Reducing Risk and Improving Outcomes of Police Interactions with People 14 with Mental Illness. Journal of Police Crisis Negotiations 2010;10(1/2):39-57. 15 47. De Caire G. A wrap-around social service solution. Blue Line Magazine 2013;25(8):14-14. 16 48. Forchuk C, JensenFor E, Martin peer M-L, et al.review Psychiatric Crisis Servicesonly in Three Communities. Can J 17 Commun Ment Health 2010;29(S5):73-86. doi: 10.7870/cjcmh-2010-0035 18 19 49. Kirst M, Francombe Pridham K, Narrandes R, et al. Examining implementation of mobile, police- 20 mental health crisis intervention teams in a large urban center. J Ment Health 2015;24(6):369- 21 74. doi: http://dx.doi.org/10.3109/09638237.2015.1036970 22 50. Kisely S, Campbell LA, Peddle S, et al. A controlled before-and-after evaluation of a mobile crisis 23 partnership between mental health and police services in Nova Scotia. Can J Psychiatry 24 2010;55(10):662-68. 25 51. Swaminath RS, Mendonca JD, Vidal C, et al. Experiments in change: Pretrial diversion of offenders 26 with mental illness. Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie 27 2002;47(5):450-58. 28 52. Sestoft D, Rasmussen MF, Vitus K, et al. The police, social services and psychiatry cooperation in 29 Denmark--a new model of working practice between governmental sectors. A description of 30 the concept, process, practice and experience. International Journal of Law & Psychiatry 31 2014;37(4):370-5. doi: http://dx.doi.org/10.1016/j.ijlp.2014.02.007 32
53. Girard V, Bonin J, Tinland A, et al. Mental health outreach and street policing in the downtown of a http://bmjopen.bmj.com/ 33 large French city. Int J Law Psychiatry 2014;37(4):376-82. 34 54. Mental Health Commission and An Garda Siochana. Report of joint working group on mental health 35 services and the police. . Mental Health Commission and An Garda Siochana (2009) 2009:1- 36 104. 37 55. Wierdsma AI, Poodt HD, Mulder CL. Effects of community-care networks on psychiatric emergency 38 39 contacts, hospitalisation and involuntary admission. J Epidemiol Community Health 40 2007;61(7):613-18. doi: http://dx.doi.org/10.1136/jech.2005.044974 on September 26, 2021 by guest. Protected copyright. 41 56. Bailey A, McAllister A, McAuley WJ. The development of a protocol for the joint investigation of 42 crimes committed against vulnerable adults. Tizard Learning Disability Review 2004;9(2):18-22. 43 57. Burton M, Evans R, Sanders A. Are special measures for vulnerable & intimidated witnesses 44 working? Evidence from the criminal justice agencies2006. 45 58. Cambridge P, Parkes T. The Management and Practice of Joint Adult Protection Investigations 46 between Health and Social Services: Issues Arising from a Training Intervention. Social Work 47 Education 2006;25(8):824-37. doi: http://dx.doi.org/10.1080/02615470600915886 48 59. Donnelly M, McGilloway S. Mental illness in the UK criminal justice system: a police liaison scheme 49 for mentally disordered offenders in Belfast. J Ment Health 2004;13(3):263-75. 50 60. Durcan D. Keys to diversion: Best practice for offenders with multiple needs. : Centre for Mental 51 Health, 2014. 52 61. Earl F, Cocksedge K, Rheeder B, et al. Neighbourhood outreach: a novel approach to Liaison and 53 Diversion. Journal of Forensic Psychiatry & Psychology 2015;26(5):573-85. 54 62. Edmondson D, Cummins I. Oldham Mental Health Phone Triage/RAID Pilot Project Evaluation 55 Report: Manchester Metropolitan University 2014. 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 24 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 25 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 63. Etherington D. The Police Liaison Community Psychiatric Nurse Project. Mental Health Review 4 Journal 1996;1(2):21-24. doi: 10.1108/13619322199600017 5 64. Exworthy T, Parrott J. Comparative evaluation of a diversion from custody scheme. The Journal of 6 Forensic Psychiatry 1997;8(2):406-16. doi: 10.1080/09585189708412020 7 65. Finn W, Hyslop J, Truman C. Mental health, multiple needs and the police: findings from the 8 Revolving Doors Agency link worker scheme. London: Revolving Doors 2000. 9 66. Fyson R. Young People with Learning Disabilities Who Sexually Harm Others: The Role of Criminal 10 Justice within a Multi-Agency Response. British Journal of Learning Disabilities 2007;35(3):181- 11 86. 12 67. Gibson S, Hamilton S, K J. Evaluation of the Crisis Care Concordat implementation Final Report: 13 McPin Foundation for Mind, 2016. 14 68. Great Britain Home Office. Alternative place of safety: the West Sussex pilot evaluation 2015. 15 London: Great Britain. Home Office 2015. 16 69. Heslin M, CallaghanFor L, Packwoodpeer M, etreview al. Decision analytic only model exploring the cost and cost- 17 offset implications of street triage. BMJ Open 2016;6 (2) (no pagination)(e009670) doi: 18 19 http://dx.doi.org/10.1136/bmjopen-2015-009670 20 70. Hollingsworth N. A fair hearing. Nurs Times 2000;96(50):41-42. 21 71. Irvine A, Allen L, Webber M. Evaluation of the Scarborough, Whitby and Ryedale Street Triage 22 Service. York: University of York 2015. 23 72. James DV, Harlow P. Increasing the power of psychiatric court diversion: a new model of supra- 24 district diversion centre. Medicine Science and the Law 2000;40(1):52-60. 25 73. James D, Cripps J, Gilluley P, et al. A court-focused model of forensic psychiatry provision to central 26 London: Abolishing remands to prison? The Journal of Forensic Psychiatry 1997;8(2):390-405. 27 doi: 10.1080/09585189708412019 28 74. James DV. Police station diversion schemes: Role and efficacy in central London. J Forensic 29 Psychiatry 2000;11(3):532-55. doi: http://dx.doi.org/10.1080/09585180010004801 30 75. James DV, Kerrigan TR, Forfar R, et al. The fixated threat assessment centre: Preventing harm and 31 facilitating care. Journal of Forensic Psychiatry and Psychology 2010;21(4):521-36. doi: 32
http://dx.doi.org/10.1080/14789941003596981 http://bmjopen.bmj.com/ 33 76. Kirkland J, Baron E. Using a cognitive analytic approach to formulate a complex sexual and violent 34 offender to inform multi-agency working: developing a shared understanding. Journal of 35 Sexual Aggression 2015;21(3):394-405. 36 77. Lennox C, Mason J, McDonnell S, et al. Information sharing between the National Health Service 37 and criminal justice system in the United Kingdom. Journal of Forensic Nursing 2012;8(3):131- 38 39 37. doi: http://dx.doi.org/10.1111/j.1939-3938.2012.01138.x 40 78. Mann A, Sugarman P, Rooney C, et al. Service innovation: Policing mental health - The St. Andrew's on September 26, 2021 by guest. Protected copyright. 41 scheme. Psychiatr Bull R Coll Psychiatr 2007;31(3):97-98. doi: 42 http://dx.doi.org/10.1192/pb.bp.106.011007 43 79. Marlow K. Achieving best evidence. Llais 2003(68):3-5. 44 80. McAllister A, Bailey A, Barr O. Training in joint investigation of alleged crimes against people with 45 learning disabilities in Northern Ireland. Journal of Adult Protection 2002;4(2):21-27. 46 81. McGilloway S, Donnelly M. Mental illness in the UK criminal justice system: A police liaison scheme 47 for Mentally Disordered Offenders in Belfast. J Ment Health 2004;13(3):263-75. doi: 48 10.1080/09638230410001700899 49 82. McLean N, Marshall LA. A front line police perspective of mental health issues and services. 50 Criminal Behaviour & Mental Health 2010;20(1):62-71. 51 83. Noga H, Foreman A, Walsh E, et al. Multi-agency action learning: Challenging institutional barriers 52 in policing and mental health services. Action Research 2016;14(2):132-50. doi: 53 10.1177/1476750315583315 54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 25 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 26 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 84. Pakes F, Winstone J. A site visit survey of 101 mental health liaison and diversion schemes in 4 England. The Journal of Forensic Psychiatry & Psychology 2010;21(6):873-86. doi: 5 http://dx.doi.org/10.1080/14789949.2010.511241 6 85. Penny C, Craissati J. Decisions on disclosure to third parties made at MAPP meetings: Opinions and 7 practice. Psychiatrist 2012;36(10):379-85. doi: http://dx.doi.org/10.1192/pb.bp.112.038786 8 86. Riordan S, Wix S, Kenney-Herbert J, et al. Diversion at the point of arrest: Mentally disordered 9 people and contact with the police. J Forensic Psychiatry 2000;11(3):683-90. doi: 10 http://dx.doi.org/10.1080/09585180010004937 11 87. Riordan S, Wix S, Haque MS, et al. Multiple contacts with diversion at the point of arrest. Medicine, 12 science, and the law 2003;43(2):105-10. 13 88. Rowlands R, Inch H, Rodger W, et al. Diverted to where? What happens to the diverted mentally 14 disordered offender. The Journal of Forensic Psychiatry 1996;7(2):284-96. doi: 15 10.1080/09585189608415013 16 89. Scott D, McGillowayFor S, peer Donnelly M. A review prospective comparative only evaluation of a Criminal Justice 17 Liaison and Diversion Service in Belfast. The Journal of Forensic Psychiatry & Psychology 18 19 2016;27(2):198. 20 90. Police TV. Thames Valley police (2015). Oxfordshire Mental Health Street Triage Pilot. . 2015 21 91. Vaughan PJ, Kelly M, Pullen N. The working practices of the police in relation to mentally 22 disordered offenders and diversion services. Medicine, science, and the law 2001;41(1):13-20. 23 92. Wain N. May the force be with you. Community Care 2000;31:22-23. 24 93. Barrett JG, Janopaul-Naylor E. Description of a collaborative community approach to impacting 25 juvenile arrests. Psychological Services 2016;13(2):133. 26 94. Bonkiewicz L, Green AM, Moyer K, et al. Left alone when the cops go home: evaluating a post- 27 mental health crisis assistance program. Policing-an International Journal of Police Strategies & 28 Management 2014;37(4):762-78. doi: 10.1108/pijpsm-04-2014-0035 29 95. Borum R, Deane MW, Steadman HJ, et al. Police perspectives on responding to mentally ill people 30 in crisis: perceptions of program effectiveness. Behav Sci Law 1998;16(4):393-405. 31 96. Bracey JR, Foley Geib C, Plant R, et al. Connecticut's Comprehensive Approach to Reducing In- 32
School Arrests: Changes in Statewide Policy, Systems Coordination and School Practices. Family http://bmjopen.bmj.com/ 33 Court Review 2013;51(3):427-34. 34 97. Clayfield JC, Grudzinskas JAJ, Fisher WH, et al. E pluribus unum: creating a multi-organizational 35 structure for serving arrestees with serious mental illness. Research in Social Problems & Public 36 Policy 2005;12:27-49. 37 98. Coggins MH, Pynchon MR. Mental health consultant to law enforcement: Secret Service 38 39 development of a Mental Health Liaison Program. Behav Sci Law 1998;16(4):407-22. 40 99. Compton MT, Broussard B, Hankerson-Dyson D, et al. System- and Policy-Level Challenges to Full on September 26, 2021 by guest. Protected copyright. 41 Implementation of the Crisis Intervention Team (CIT) Model. Journal of Police Crisis 42 Negotiations 2010;10(1/2):72-85. 43 100. Crutcher KD. The Early Notification Program. FBI Law Enforcement Bulletin 2011;80(7):12-15. 44 101. Deane MW, Steadman HJ, Borum R, et al. Emerging partnerships between mental health and law 45 enforcement. Psychiatr Serv 1999;50(1):99-101. 46 102. DeCuir W, Lamb R. Police response to the dangerous mentally ill. The Police Chief 1996:99-106. 47 103. Dupont R, Cochran S, Pillsbury S. Crisis Intervention Team core elements. The University of 48 Memphis School of Urban Affairs and Public Policy, Dept. of Criminology and Criminal Justice, 49 CIT Center2007 [Available from: 50 http://www.cit.memphis.edu/information_files/CoreElements.pdf accessed 2016 2016. 51 104. el-Mallakh RS, Wulfman G, Smock W, et al. Implementation of a crisis intervention program for 52 police response to mental health emergencies in Louisville. J Ky Med Assoc 2003;101(6):241-3. 53 [published Online First: 2003/07/04] 54 105. Frank J, Eck J, Ratansi S. Mobile crisis team/police collaboration evaluation2004. 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 26 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 27 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 106. Geller J, L., , Fisher W, H, , McDermet MA. A national survey of mobile crisis services and their 4 evaluation. Psychiatr Serv 1995;46(9):893-97. doi: 10.1176/ps.46.9.893 5 107. Gordon C, Chabot L. Jail diversion program shows power of teamwork. Behav Healthc Tomorrow 6 2004;13(4):31-35. 7 108. Grudzinskas AJ, Jr., Clayfield JC, Roy-Bujnowski K, et al. Integrating the criminal justice system into 8 mental health service delivery: the worcester diversion experience. Behav Sci Law 9 2005;23(2):277-93. 10 109. Hails J, Borum R. Police training and specialized approaches to respond to people with mental 11 illnesses. Crime & Delinquency 2003;49(1):52-61. doi: 10.1177/0011128702239235 12 110. Hamilton ZK, Sullivan CJ, Veysey BM, et al. Diverting Multi-Problem Youth from Juvenile Justice: 13 Investigating the Importance of Community Influence on Placement and Recidivism. Behav Sci 14 Law 2007;25(1):137-58. doi: http://dx.doi.org/10.1002/bsl.720 15 111. Hartford K, Carey R, Mendonca J. Pre-arrest Diversion of People with Mental Illness: Literature 16 Review For and International peer Survey.review Behav Sci only Law 2006;24(6):845-56. doi: 17 http://dx.doi.org/10.1002/bsl.738 18 19 112. Hatcher C, Mohandie K, Turner J, et al. The role of the psychologist in crisis/hostage negotiations. 20 Behav Sci Law 1998;16(4):455-72. 21 113. Helfgott JB, Hickman MJ, Labossiere AP. A descriptive evaluation of the Seattle Police 22 Department's crisis response team officer/mental health professional partnership pilot 23 program. Int J Law Psychiatry 2016;44:109-22. doi: 24 http://dx.doi.org/10.1016/j.ijlp.2015.08.038 25 114. Hill R, Quill G, Ellis K. The Montgomery County CIT model: Interacting with people with mental 26 illness. FBI Law Enforcement Bulletin 2004;73(7):18-25. 27 115. Hoff RA, Baranosky MV, Buchanan J, et al. The effects of a jail diversion program on incarceration: 28 A retrospective cohort study. Journal of the American Academy of Psychiatry and the Law 29 Online 1999;27(3):377-86. 30 116. James RK, Logan J, Davis SA. Including School Resource Officers in school-based crisis intervention: 31 Strengthening student support. School Psychology International 2011;32(2):210-24. 32
117. Janofsky Js, Tamburello AC. Diversion to the Mental Health System: Emergency Psychiatric http://bmjopen.bmj.com/ 33 Evaluations. J Am Acad Psychiatry Law 2006;34(3):283-91. 34 118. Klein M. Law Enforcement's Response to People with Mental Illness. FBI Law Enforcement Bulletin 35 2002;71(2):11. 36 119. Lacey CH. Collaborative Partnerships and School Change: Evaluating Project SOBEIT: Online 37 Submission, 2006. 38 39 120. Lamb HR, Shaner R, Elliott DM, et al. Outcome for psychiatric emergency patients seen by an 40 outreach police–mental health team. New Dir Ment Health Serv 1995;2001(90):67-76. doi: on September 26, 2021 by guest. Protected copyright. 41 10.1002/yd.23320019007 42 121. Lattimore PK, Broner N, Sherman R, et al. A Comparison of Prebooking and Postbooking Diversion 43 Programs for Mentally Ill Substance-Using Individuals With Justice Involvement. Journal of 44 Contemporary Criminal Justice 2003;19(1):30. 45 122. Lord VB, Bjerregaard B. Helping Persons with Mental Illness: Partnerships between Police and 46 Mobile Crisis Units. Victims & Offenders 2014;9(4):455-74. 47 123. Marans S, Berkowitz SJ, Cohen DJ. Police and mental health professionals: Collaborative responses 48 to the impact of violence on children and families. Child Adolesc Psychiatr Clin N Am 49 1998;7(3):635-51. 50 124. McGuire AB, Bond GR. Critical elements of the crisis intervention team model of jail diversion: an 51 expert survey. Behav Sci Law 2011;29(1):81-94. doi: http://dx.doi.org/10.1002/bsl.941 52 125. Murphy RA, Rosenheck RA, Berkowitz SJ. Acute service delivery in a police-mental health program 53 for children exposed to violence and trauma. Psychiatr Q 2005;76(2):107-21. 54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 27 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 28 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 126. Oliva JR, Compton MT. A statewide Crisis Intervention Team (CIT) initiative: evolution of the 4 Georgia CIT program. J Am Acad Psychiatry Law 2008;36(1):38-46. [published Online First: 5 2008/03/21] 6 127. Perez A, Leifman S, Estrada A. Reversing the criminalization of mental illness. Crime & Delinquency 7 2003;49(1):62-78. doi: 10.1177/0011128702239236 8 128. Project Link DoP, University of Rochester, Rochester New York. Gold Award: Prevention of Jail and 9 Hospital Recidivism Among Persons With Severe Mental Illness. Psychiatr Serv 10 1999;50(11):1477-80. 11 129. Rosenbaum N. Street-Level Psychiatry—A Psychiatrist's Role with the Albuquerque Police 12 Department's Crisis Outreach and Support Team. Journal of Police Crisis Negotiations 13 2010;10(1/2):175-81. 14 130. Saunders JEG. Missing and Wandering Children with Autism and Down Syndrome: The Project 15 Lifesaver Partnership Meets the Challenge. Sheriff 2006;58(5):26-28. 16 131. Scott RL. EvaluationFor peer of a Mobile Crisisreview Program: Effectiveness, only Efficiency, and Consumer 17 Satisfaction. Psychiatr Serv 2000;51(9):1153-56. doi: 10.1176/appi.ps.51.9.1153 18 19 132. Shafer MS, Arthur B, Franczak MJ. An analysis of post-booking jail diversion programming for 20 persons with co-occurring disorders. Behav Sci Law 2004;22(6):771-85. 21 133. Skubby D, Bonfine N, Novisky M, et al. Crisis Intervention Team (CIT) programs in rural 22 communities: A focus group study. Community Ment Health J 2013;49(6):756-64. 23 134. Steadman HJ, Deane MW, Morrissey JP, et al. A SAMHSA Research Initiative Assessing the 24 Effectiveness of Jail Diversion Programs for Mentally Ill Persons. Psychiatr Serv 25 1999;50(12):1620-23. doi: 10.1176/ps.50.12.1620 26 135. Steadman HJ, Naples M. Assessing the effectiveness of jail diversion programs for persons with 27 serious mental illness and co-occurring substance use disorders. Behav Sci Law 28 2005;23(2):163-70. doi: 10.1002/bsl.640 [published Online First: 2005/04/09] 29 136. Swartz MS, Swanson JW, Kim M, et al. Use of outpatient commitment or related civil court 30 treatment orders in five U.S. communities. Psychiatr Serv 2006;57(3):343-49. doi: 31 http://dx.doi.org/10.1176/appi.ps.57.3.343 32
137. Teske SC. A study of zero tolerance policies in schools: a multi-integrated systems approach to http://bmjopen.bmj.com/ 33 improve outcomes for adolescents. Journal of child and adolescent psychiatric nursing : official 34 publication of the Association of Child and Adolescent Psychiatric Nurses, Inc 2011;24(2):88-97. 35 doi: http://dx.doi.org/10.1111/j.1744-6171.2011.00273.x 36 138. Teller JL, Munetz MR, Gil KM, et al. Crisis intervention team training for police officers responding 37 to mental disturbance calls. Psychiatr Serv 2006;57(2):232-7. 38 39 139. Trupin EW, Selby PM, McCauley E, et al. The Prime Time Project: Developing an Intensive 40 Community-Based Intervention for Youth in the Juvenile Justice System, 1996. on September 26, 2021 by guest. Protected copyright. 41 140. Van Hasselt VB, Killam G, Schlessinger KM, et al. The Adolescent Drug Abuse Prevention and 42 Treatment (ADAPT) Program: A Mental Health-Law Enforcement Collaboration. J Child Adolesc 43 Subst Abuse 2005;15(2):87-104. 44 141. Wolff N. Interactions between mental health and law enforcement systems: problems and 45 prospects for cooperation. Journal of Health Politics, Policy & Law 1998;23(1):133-74. 46 142. Wood JD, Beierschmitt L. Beyond police crisis intervention: Moving "upstream" to manage cases 47 and places of behavioral health vulnerability. Int J Law Psychiatry 2014;37(5):439-47. doi: 48 http://dx.doi.org/10.1016/j.ijlp.2014.02.016 49 143. Meehan AJ. From conversion to coercion: The police role in medication compliance: Psychiatric 50 Quarterly 1995. 51 144. Sharp CR. Theoretical and Practical Application of Loose Coupling: A Study of Criminal Justice 52 Agencies in the State of Florida. Southwest Journal of Criminal Justice 2009;6(1):45-58. 53 145. Steadman HJ, Deane MW, Borum R, et al. Comparing outcomes of major models of police 54 responses to mental health emergencies. Psychiatr Serv 2000;51(5):645-49. doi: 55 http://dx.doi.org/10.1176/appi.ps.51.5.645 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 28 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 29 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 146. Wellborn. Responding to individuals with mental illness. FBI Law Enforcement Bulletin 4 1999;68(11):6. 5 147. Rollison J, Hill G, Yu P, et al. Evaluation of a complex, multisite, multilevel grants initiative. Eval 6 Program Plann 2012;35(2):273-79. 7 148. Wolff N, Frueh BC, Huening J, et al. Practice informs the next generation of behavioral health and 8 criminal justice interventions. Int J Law Psychiatry 2013;36(1):1-10. 9 149. Wolff N, Diamond RJ, Helminiak TW. A new look at an old issue: People with mental illness and 10 the law enforcement system. J Ment Health Adm 1997;24(2):152-65. 11 150. Crisp AP. Understanding Best Practice: The Emergency Response to Mental Illness-An Exploratory 12 Report. 2015 13 151. Steadman HJ, Cocozza JJ, Veysey BM. Comparing outcomes for diverted and nondiverted jail 14 detainees with mental illnesses. Law Hum Behav 1999;23(6):615-27. [published Online First: 15 2000/01/14] 16 152. Ligon JAN, For Thyer BA. peer CLIENT AND FAMILYreview SATISFACTION only WITH BRIEF COMMUNITY MENTAL 17 HEALTH, SUBSTANCE ABUSE, AND MOBILE CRISIS SERVICES IN AN URBAN SETTING. Crisis 18 19 Intervention and Time-Limited Treatment 2000;6(2):93-99. doi: 10.1080/10645130008951135 20 153. Durcan G, et a. The Bradley report five years on: an independent review of progress to date and 21 priorities for further development. London: Centre for Mental Health 2014. 22 154. Department of Health. Mental Health Act 1983: Code of Practice. In: Health Do, ed. Norwich: The 23 Stationery Office, 2015. 24 155. College of Policing. Statistical data: College of Policing; 2017 [The annual data requirement (ADR) 25 is a list of all requests for data made to all police forces in England and Wales under the Home 26 Secretary’s statutory powers and is used to report crime and policing related statistics. 27 28 29 30 A list of current data requirement publications can be found below:]. accessed 14th July 2017 2017. 31 156. O'Mara‐Eves A, Brunton G, McDaid D, et al. Techniques for identifying cross‐disciplinary and ‘ 32 hard to detect evidence for systematic review. Research synthesis methods 2014;5(1):50-59. http://bmjopen.bmj.com/ 33 ‐ ‐ ’ 34 157. Macvean M, Humphreys C, Healey L, et al. The PATRICIA Project: PAThways and Research in 35 Collaborative Inter-Agency working: State of knowledge paper Sydney: ANROWS Landscapes 36 14/2015, 2015. 37 158. Munetz MR, Griffin PA. Use of the sequential intercept model as an approach to decriminalization 38 of people with serious mental illness. Psychiatr Serv 2006;57(4):544-49. doi: 39 10.1176/appi.ps.57.4.544 40 159. Charette Y, Crocker AG, Billette I. Police encounters involving citizens with mental illness: use of on September 26, 2021 by guest. Protected copyright. 41 resources and outcomes. Psychiatr Serv 2014;65(4):511-16. 42 160. McManus S, Meltzer H, Brugha T, et al. Adult psychiatric morbidity in England, 2007: results of a 43 household survey: The NHS Information Centre for health and social care 2009. 44 161. Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: the new 45 Medical Research Council guidance. BMJ 2008;337:a1655. 46 162. Department of Health and Concordat signatories. Mental Health Crisis Care Concordat: Improving 47 outcomes for people experiencing mental health crisis. In: Health Do, ed.: HM Government, 48 2014. 49 163. UK Crown. Policing and Crime Act 2017. In: Office TS, ed., 2017. 50 164. Kane E, Evans E, Shokraneh F. Effectiveness of current policing-related mental health 51 52 interventions in England and Wales and Crisis Intervention Teams as a future potential model: 53 a systematic review. Systematic Reviews 2017;6(1):85. doi: 10.1186/s13643-017-0478-7 54 165. Innes M. A ‘Mirror’ and a ‘Motor’: Researching and Reforming Policing in an Age of Austerity1. 55 Policing: A Journal of Policy and Practice 2010;4(2):127-34. doi: 10.1093/police/pap058 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 29 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 30 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 166. Valentijn PP, Schepman SM, Opheij W, et al. Understanding integrated care: a comprehensive 4 conceptual framework based on the integrative functions of primary care. International 5 Journal of Integrated Care 2013;13:e010. 6 167. Moore GF, Audrey S, Barker M, et al. Process evaluation of complex interventions: Medical 7 Research Council guidance. BMJ : British Medical Journal 2015;350 doi: 10.1136/bmj.h1258 8 9 10 11 Figure legend 12 13 Figure 1: Flowchart of study selection process, adapted from PRISMA [27] 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v8 22/11/2017 Page 30 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 31 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 Figure 1: Flowchart of study selection process, adapted from PRISMA 43 44 301x333mm (300 x 300 DPI) 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 32 of 77
1 2 3 4 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 5 6 APPENDIX 1 7 The following eligibility criteria were applied: 8 9 10 Population 11 The police and collaborating organisations who deal with members of the public appearing to be 12 13 suffering from mental disorder, mental vulnerability or learning disability. We use the following 14 definitions to define our population of interest: 15 16 17 ‘Police’ refer to law enforcement agencies broadly, including regional and national police 18 For peer review only 19 forces as well as bodies with limited executive powers and their staff. Examples from the UK 20 include the British Transport Police and the UK Border Force. 21 22 ‘In line with the UK 1983 MHA [166], ‘mental disorder’ refers to ‘people who appear to be 23 24 suffering from mental disorder’ rather than people with a known diagnosis of mental illness. 25 The following additional definitions, based on the UK National Policing Improvement Agency 26 27 (NPIA) ‘Guidance on responding to people with mental ill health or learning disabilities’, are 28 29 used [167]: ‘Mental ill health’ is used broadly to encompass all other mental health terms, 30 including mental health disorders, mental illness, and mental health needs. ‘Mental disorder’ 31 32 refers to ‘any disorder or disability of the mind’ and includes conditions such as schizophrenia, 33 34 depression, bipolar disorder, anxiety disorder, obsessive-compulsive disorder, personality 35 disorders, eating disorders and dementia. Not all mental disorders meet the criteria for the 36 37 exercise of powers under the Mental Health Act. ‘Mentally vulnerable’ refers to people who http://bmjopen.bmj.com/ 38 39 ‘because of their mental state or capacity may not understand the significance of what is said 40 to them (for example in the form of questions) or of their replies’ [168]. 41 42 People with learning disabilities were also included: their needs and disability may not be 43 44 obvious but they may be extremely vulnerable and learning disabilities frequently co-occur 45 on September 26, 2021 by guest. Protected copyright. 46 with mental ill health. 47 We included children, adolescents and adults. Adolescence is defined as the period including 48 49 and between 10–19 years as defined by the World Health Organization [169]. 50 51 Intervention 52 53 We focused on models of inter-agency collaboration between the police and other organisations. 54 55 A number of different terms have been used to describe inter-agency and inter-professional 56 57 models These including: ‘multi-agency partnerships’, ‘inter-professional collaboration’, 58 59 ‘integrated care’, ‘inter-agency working’ and ‘joint working’ [12,170,171]. Although these 60
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terms are often used interchangeably, they can refer to distinctive forms of activity. The prefix BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 ‘multi-’ (e.g. multi-agency) is sometimes used to refer to specific collaborative activities around 6 7 an individual person [172]; while ‘inter-’ (e.g. inter-agency) tends to have a more inclusive 8 meaning, referring to collaborative activities across the wider network of professional 9 10 relationships and structures. ‘Inter-professional’ may vary from ‘inter-agency’ in that the 11 12 former refers to collaborative working across individuals (potentially at the same site), while 13 the latter refers to collaborative working across services. ‘Integration’ is sometimes used to 14 15 refer to the highest level of synthesis [173]. 16 17 ‘Inter-agency collaboration’ refers to a broad range of collaborative activities and models 18 across professionalFor relationshipspeer review and structures, whichonly include the core principles of 19 20 information sharing, joint decision making and coordinated intervention. 21 22 Organisations collaborating with the police refer to any agency or organisation, professional 23 agencies statutory or otherwise, involved in the care of people perceived to be suffering from 24 25 mental health problems. This can include other emergency services such as the ambulance 26 27 service, accident and emergency, crisis resolution and home treatment teams, etc.; other 28 29 health care providers such as mental health early intervention services; or third sector 30 organisations [174]. Third sector organisations are patient and carer organisations which 31 32 represent and support patients and the family, friends and significant others of people with 33 34 mental health problems. 35 We included models that focus, either exclusively or predominantly, on close collaboration 36 37 between the police and at least one other organisation that offers help to people with mental http://bmjopen.bmj.com/ 38 39 health problems. This included models that focus on multi-agency working at a single site; 40 models that focus on collaboration across child and adult mental health services; and models 41 42 where inter-agency collaboration was one of several other components, provided there is a 43 44 clear reporting of the inter-agency collaboration component. 45 on September 26, 2021 by guest. Protected copyright. 46 Comparator(s) 47 Any comparators were included, as were studies with no comparator. 48 49 50 Outcomes 51 All outcomes were eligible as the purpose of this review was to map the available evidence. Outcomes 52 53 measured could include perceived benefits such as enhanced effectiveness of services; impact on 54 service users, such as improved access to services, through speedier and more appropriate referral; 55 56 mental health outcomes; and early intervention. 57 58 59 Context 60
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Inter-agency collaboration models could be in the context of: the national level; county or state wide; BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 cities or rural setting; private or public services or settings; or in homes, police stations, on the street, 6 7 safe havens, schools, accident and emergency, etc. We included police working at the interface with 8 the criminal justice system, for instance at the court level or as part of a rehabilitation service; 9 10 however we did not include prisons since separate arrangements exist for prisons. 11 12 UK-based evidence and international literature from Organisation for Economic Co-operation and 13 14 Development (OECD) countries were included. We hypothesised that OECD countries would have 15 16 sufficiently similar health and criminal justice systems to allow lessons learned to be potentially 17 transferable. 18 For peer review only 19 20 Study Design 21 Eligible studies included empirical evaluations or descriptions of models of inter-agency collaboration. 22 23 Other relevant legislation and good practice guidance were included, where these were subject to 24 25 empirical evaluation. 26 27 Evidence from empirically-based research and evaluation, both qualitative and quantitative, 28 29 provided there was systematic data collection and analysis. We included systematic reviews; 30 31 Randomised Controlled Trials (RCTs); non-randomised controlled trials; observational studies 32 such as cohort, interrupted time series and case studies describing or evaluating an 33 34 intervention to determine the range of approaches that have been tried and described, and 35 36 ideally, potentially promising or unacceptable approaches http://bmjopen.bmj.com/ 37 We included qualitative studies exploring issues around inter-agency collaboration, such as 38 39 barriers or facilitators around implementing inter-agency models 40 41 42 Exclusion criteria 43 The following were excluded: 44 45 on September 26, 2021 by guest. Protected copyright. 46 Studies where the interagency collaboration was focused solely on substance abuse, without 47 48 including individuals with co-occurring mental health problems 49 Diagrammatical and mathematical modelling of inter-agency collaboration models for 50 51 organisations 52 53 Patient-doctor or patient-clinician shared decision-making 54 Inter-agency collaboration without the involvement of the police 55 56 Studies published in languages other than English 57 58 Opinion pieces and editorial articles 59 60 Due to changing context of data protection legislation, studies published before 1995
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BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 For peer review only 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 http://bmjopen.bmj.com/ 38 39 40 41 42 43 44 45 on September 26, 2021 by guest. Protected copyright. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
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1 2 3 4 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 5 6 APPENDIX 2: SEARCH STRATEGY USED IN ASSIA 7 ASSIA 8 9 10 Via Proquest 11 12 Search date=25th July 2016 13 14 15 Records retrieved=138 records 16 17 18 Set# Searched for For peer review only Databases Results 19 20 21 S1 SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 10841 22 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing) Sciences Index &° 23 24 Abstracts 25 26 (ASSIA) 27 28 29 S2 police OR policing Applied Social 10762 30 Sciences Index &° 31 32 Abstracts 33 34 (ASSIA) 35 36 37 S3 (SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 10841 http://bmjopen.bmj.com/ 38 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) Sciences Index &° 39 40 OR (police OR policing) Abstracts 41 42 (ASSIA) 43 44 45 S4 SU.EXACT("Service integration") Applied Social 78° on September 26, 2021 by guest. Protected copyright. 46 Sciences Index & 47 48 Abstracts 49 50 (ASSIA) 51 52 53 S5 SU.EXACT("Interagency collaboration") Applied Social 757° 54 Sciences Index & 55 56 Abstracts 57 58 (ASSIA) 59 60
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S6 (multi-agency NEAR/2 (approach* or collaborat* or cooperat* or coordinat* Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 264° 5 or department* or model* or team* or partner* or program* or working)) ORSciences Index & 6 7 (multiagency NEAR/2 (approach* or collaborat* or cooperat* or coordinat* Abstracts 8 9 or department* or model* or team* or partner* or program* or working)) (ASSIA) 10 11 (multi-professional NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 12 S7 182° 13 coordinat* OR department* OR model* OR team* OR partner* OR program*S ciences Index & 14 15 OR working)) OR (multiprofessional NEAR/2 (approach* OR collaborat* OR Abstracts 16 17 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 18 OR program* ORFor working)) peer review only 19 20 21 S8 (multi-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 2159° 22 23 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 24 25 OR working)) OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 26 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 27 28 OR program* OR working)) 29 30 31 S9 (inter-agency NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 1025° 32 33 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 34 OR working)) OR (interagency NEAR/2 (approach* OR collaborat* OR Abstracts 35 36 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 37 http://bmjopen.bmj.com/ 38 OR program* OR working)) 39 40 41 S10 (inter-professional NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 131° 42 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 43 44 OR working)) OR (interprofesional NEAR/2 (approach* OR collaborat* OR Abstracts 45 on September 26, 2021 by guest. Protected copyright. 46 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 47 OR program* OR working)) 48 49 50 S11 (inter-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social ° 51 4128 52 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 53 54 OR working)) OR (interdisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 55 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 56 57 OR program* OR working)) 58 59 60
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S12 (trans-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 119° 5 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 6 7 OR working)) OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 8 9 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 10 OR program* OR working)) 11 12 13 S13 "joint agency" or "joint approach" or "joint collaborat*" or "joint cooperat*" Applied Social 450° 14 15 or "joint coordinat*" or "joint department*" or "joint team*" or "joint Sciences Index & 16 17 partner*" or "joint program*" or "joint working" Abstracts 18 For peer review only (ASSIA) 19 20 21 S14 integrat* NEAR/2 (agency or approach* or department* or model* or team* Applied Social 4279° 22 23 or partner* or program* or working) Sciences Index & 24 25 Abstracts 26 (ASSIA) 27 28 29 S15 "cross agency" or "cross department*" or "cross team*" or "cross partner*" Applied Social 54° 30 31 or "cross program*" Sciences Index & 32 33 Abstracts 34 (ASSIA) 35 36 37 http://bmjopen.bmj.com/ S16 "across agency" or "across department*" or "across team*" or "across Applied Social 116° 38 39 partner*" or "across program*" Sciences Index & 40 41 Abstracts 42 (ASSIA) 43 44 45 on September 26, 2021 by guest. Protected copyright. S19 information NEAR/1 (integrat* or governance or share* or sharing or Applied Social ° 46 1765 47 transfer*) Sciences Index & 48 49 Abstracts 50 (ASSIA) 51 52 53 S20 knowledge NEAR/1 (integrat* or governance or share* or sharing or Applied Social ° 54 913 55 transfer*) Sciences Index & 56 57 Abstracts 58 (ASSIA) 59 60
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S21 data NEAR/1 (integrat* OR governance OR share* OR sharing OR transfer*) Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 391° 5 Sciences Index & 6 7 Abstracts 8 9 (ASSIA) 10 11 technology NEAR/1 (integrat* OR governance OR share* OR sharing OR Applied Social 12 S22 398° 13 transfer*) Sciences Index & 14 15 Abstracts 16 17 (ASSIA) 18 For peer review only 19 20 S23 "communities of practice" Applied Social 208° 21 Sciences Index & 22 23 Abstracts 24 25 (ASSIA) 26 27 28 S24 SU.EXACT("Clinical risk management" OR "Risk management") Applied Social 866° 29 Sciences Index & 30 31 Abstracts 32 33 (ASSIA) 34 35 36 S25 "single assessment process" Applied Social 18° http://bmjopen.bmj.com/ 37 Sciences Index & 38 39 Abstracts 40 41 (ASSIA) 42 43 44 S26 SU.EXACT("Service integration") OR SU.EXACT("Interagency collaboration") Applied Social 15367 45 on September 26, 2021 by guest. Protected copyright. OR ((multi-agency NEAR/2 (approach* or collaborat* or cooperat* or Sciences Index &° 46 47 coordinat* or department* or model* or team* or partner* or program* or Abstracts 48 49 working)) OR (multiagency NEAR/2 (approach* or collaborat* or cooperat* or(ASSIA) 50 coordinat* or department* or model* or team* or partner* or program* or 51 52 working))) OR ((multi-professional NEAR/2 (approach* OR collaborat* OR 53 54 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 55 OR program* OR working)) OR (multiprofessional NEAR/2 (approach* OR 56 57 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 58 59 team* OR partner* OR program* OR working))) OR ((multi-disciplinary 60
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NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 department* OR model* OR team* OR partner* OR program* OR working)) 6 7 OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 8 9 coordinat* OR department* OR model* OR team* OR partner* OR program* 10 OR working))) OR ((inter-agency NEAR/2 (approach* OR collaborat* OR 11 12 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 13 14 OR program* OR working)) OR (interagency NEAR/2 (approach* OR 15 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 16 17 team* OR partner* OR program* OR working))) OR ((inter-professional 18 For peer review only 19 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 20 department* OR model* OR team* OR partner* OR program* OR working)) 21 22 OR (interprofesional NEAR/2 (approach* OR collaborat* OR cooperat* OR 23 24 coordinat* OR department* OR model* OR team* OR partner* OR program* 25 OR working))) OR ((inter-disciplinary NEAR/2 (approach* OR collaborat* OR 26 27 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 28 29 OR program* OR working)) OR (interdisciplinary NEAR/2 (approach* OR 30 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 31 32 team* OR partner* OR program* OR working))) OR ((trans-disciplinary 33 34 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 35 department* OR model* OR team* OR partner* OR program* OR working)) 36 37 OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR http://bmjopen.bmj.com/ 38 39 coordinat* OR department* OR model* OR team* OR partner* OR program* 40 OR working))) OR ("joint agency" or "joint approach" or "joint collaborat*" or 41 42 "joint cooperat*" or "joint coordinat*" or "joint department*" or "joint 43 44 team*" or "joint partner*" or "joint program*" or "joint working") OR 45 on September 26, 2021 by guest. Protected copyright. (integrat* NEAR/2 (agency or approach* or department* or model* or team* 46 47 or partner* or program* or working)) OR ("cross agency" or "cross 48 49 department*" or "cross team*" or "cross partner*" or "cross program*") OR 50 ("across agency" or "across department*" or "across team*" or "across 51 52 partner*" or "across program*") OR (information NEAR/1 (integrat* or 53 54 governance or share* or sharing or transfer*)) OR (knowledge NEAR/1 55 56 (integrat* or governance or share* or sharing or transfer*)) OR (data NEAR/1 57 (integrat* OR governance OR share* OR sharing OR transfer*)) OR 58 59 (technology NEAR/1 (integrat* OR governance OR share* OR sharing OR 60
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transfer*)) OR "communities of practice" OR SU.EXACT("Clinical risk BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 management" OR "Risk management") OR "single assessment process" 6 7 8 S27 "criminal justice" or "youth justice" or" juvenile justice" Applied Social 7998° 9 10 Sciences Index & 11 Abstracts 12 13 (ASSIA) 14 15 16 S28 (probation or parole or court* or justice) NEAR/2 (personnel or staff or Applied Social 993° 17 18 worker* or caseworker*For peer or office* or reviewofficial* or employee*) only Sciences Index & 19 20 Abstracts 21 (ASSIA) 22 23 24 S29 SU.EXACT("Probation service") Applied Social 727° 25 26 Sciences Index & 27 28 Abstracts 29 (ASSIA) 30 31 32 S30 paramedic* or para-medic* Applied Social 267° 33 34 Sciences Index & 35 36 Abstracts http://bmjopen.bmj.com/ 37 (ASSIA) 38 39 40 S31 (emergency or ambulance or casualty) NEAR/2 (personnel or staff or worker*Applied Social 363° 41 42 or office* or official* or employee*) Sciences Index & 43 44 Abstracts on September 26, 2021 by guest. Protected copyright. 45 (ASSIA) 46 47 48 S32 SU.EXACT("Presentence reports" OR "Social services departments") OR Applied Social 8979° 49 50 SU.EXACT("Befriending" OR "Care assistants" OR "Child care centres" OR Sciences Index & 51 52 "Child contact centres" OR "Community care" OR "Consumer operated drop Abstracts 53 in centres" OR "Day care" OR "Day care centres" OR "Day centres" OR (ASSIA) 54 55 "Deinstitutionalization" OR "Drop in centres" OR "Family centres" OR 56 57 "Halfway houses" OR "Home care" OR "Home health aides" OR "Home helps" 58 OR "Home ventilation" OR "Hospital at home schemes" OR "Local health and 59 60
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social service centres" OR "Long term community care" OR "Long term home BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 care" OR "Meals on wheels" OR "Out of school care" OR "Probation day 6 7 centres" OR "Psychiatric day centres" OR "Social services" OR "Welfare 8 9 services") OR SU.EXACT("Jewish Association for Services for the Aged" OR 10 "Social services agencies") 11 12 13 S33 SU.EXACT("Analytical social work" OR "Behavioural social work" OR "Care Applied Social 15597 14 15 orders" OR "Child care" OR "Child protection" OR "Childminding" OR "Clinical Sciences Index &° 16 17 social work" OR "Community nurseries" OR "Community work" OR "Creches" Abstracts 18 OR "Critical socialFor work" peerOR "Day foster review care" OR "Day nurseries" only OR (ASSIA) 19 20 "Detached youth work" OR "Educational social work" OR "Family child care" 21 22 OR "Family preservation services" OR "Family social work" OR "Feminist 23 community work" OR "Feminist people" OR "Feminist social work" OR "Foster 24 25 care" OR "Geriatric social work" OR "Guardians ad litem" OR "Guardianship" 26 27 OR "Hospital social work" OR "In care" OR "Kinship foster care" OR "Leaving 28 care" OR "Long term foster care" OR "Medical social work" OR 29 30 "Neighbourhood work" OR "Nurseries" OR "Occupational social work" OR 31 32 "Parent aide services" OR "Political social work" OR "Postadoption services" 33 OR "Private foster care" OR "Psychiatric social work" OR "Quality child care" 34 35 OR "Radical community work" OR "Radical social work" OR "Residential social 36 37 work" OR "Social casework" OR "Social work" OR "Temporary foster care" OR http://bmjopen.bmj.com/ 38 "Therapeutic child care" OR "Voluntary social work" OR "Wardship" OR 39 40 "Youth work") 41 42 43 S34 "social services" or "social work" Applied Social 32896 44 45 Sciences Index &° on September 26, 2021 by guest. Protected copyright. 46 Abstracts 47 48 (ASSIA) 49 50 51 S35 "voluntary group*" or "voluntary work" Applied Social 236° 52 53 Sciences Index & 54 Abstracts 55 56 (ASSIA) 57 58 59 60
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S36 SU.EXACT("Voluntary work") Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 139° 5 Sciences Index & 6 7 Abstracts 8 9 (ASSIA) 10 11 "community group*" or "self help group*" or "third sector" or "social Applied Social 12 S37 1005° 13 enterprise*" Sciences Index & 14 15 Abstracts 16 17 (ASSIA) 18 For peer review only 19 20 S38 SU.EXACT("Community groups") Applied Social 119° 21 Sciences Index & 22 23 Abstracts 24 25 (ASSIA) 26 27 28 S39 SU.EXACT("Selfhelp groups") Applied Social 439° 29 Sciences Index & 30 31 Abstracts 32 33 (ASSIA) 34 35 36 S40 SU.EXACT("Social enterprises") Applied Social 47° http://bmjopen.bmj.com/ 37 Sciences Index & 38 39 Abstracts 40 41 (ASSIA) 42 43 44 S41 ("criminal justice" or "youth justice" or" juvenile justice") OR ((probation or Applied Social 51930 45 on September 26, 2021 by guest. Protected copyright. parole or court* or justice) NEAR/2 (personnel or staff or worker* or Sciences Index &° 46 47 caseworker* or office* or official* or employee*)) OR SU.EXACT("Probation Abstracts 48 49 service") OR (paramedic* or para-medic*) OR ((emergency or ambulance or (ASSIA) 50 casualty) NEAR/2 (personnel or staff or worker* or office* or official* or 51 These databases 52 employee*)) OR (SU.EXACT("Presentence reports" OR "Social services 53 are searched for 54 departments") OR SU.EXACT("Befriending" OR "Care assistants" OR "Child part of your 55 care centres" OR "Child contact centres" OR "Community care" OR 56 query. 57 "Consumer operated drop in centres" OR "Day care" OR "Day care centres" 58 59 OR "Day centres" OR "Deinstitutionalization" OR "Drop in centres" OR "Family 60
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centres" OR "Halfway houses" OR "Home care" OR "Home health aides" OR BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 "Home helps" OR "Home ventilation" OR "Hospital at home schemes" OR 6 7 "Local health and social service centres" OR "Long term community care" OR 8 9 "Long term home care" OR "Meals on wheels" OR "Out of school care" OR 10 "Probation day centres" OR "Psychiatric day centres" OR "Social services" OR 11 12 "Welfare services") OR SU.EXACT("Jewish Association for Services for the 13 14 Aged" OR "Social services agencies")) OR SU.EXACT("Analytical social work" 15 OR "Behavioural social work" OR "Care orders" OR "Child care" OR "Child 16 17 protection" OR "Childminding" OR "Clinical social work" OR "Community 18 For peer review only 19 nurseries" OR "Community work" OR "Creches" OR "Critical social work" OR 20 "Day foster care" OR "Day nurseries" OR "Detached youth work" OR 21 22 "Educational social work" OR "Family child care" OR "Family preservation 23 24 services" OR "Family social work" OR "Feminist community work" OR 25 "Feminist people" OR "Feminist social work" OR "Foster care" OR "Geriatric 26 27 social work" OR "Guardians ad litem" OR "Guardianship" OR "Hospital social 28 29 work" OR "In care" OR "Kinship foster care" OR "Leaving care" OR "Long term 30 foster care" OR "Medical social work" OR "Neighbourhood work" OR 31 32 "Nurseries" OR "Occupational social work" OR "Parent aide services" OR 33 34 "Political social work" OR "Postadoption services" OR "Private foster care" OR 35 "Psychiatric social work" OR "Quality child care" OR "Radical community 36 37 work" OR "Radical social work" OR "Residential social work" OR "Social http://bmjopen.bmj.com/ 38 39 casework" OR "Social work" OR "Temporary foster care" OR "Therapeutic 40 child care" OR "Voluntary social work" OR "Wardship" OR "Youth work") OR 41 42 ("social services" or "social work") OR ("voluntary group*" or "voluntary 43 44 work") OR SU.EXACT("Voluntary work") OR ("community group*" or "self help 45 on September 26, 2021 by guest. Protected copyright. group*" or "third sector" or "social enterprise*") OR SU.EXACT("Community 46 47 groups") OR SU.EXACT("Selfhelp groups") OR SU.EXACT("Social enterprises") 48 49 50 S43 SU.EXACT("Suicide") Applied Social 3383° 51 52 Sciences Index & 53 Abstracts 54 55 (ASSIA) 56 57 58 59 60
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S44 SU.EXACT("Vulnerable people") Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 389° 5 Sciences Index & 6 7 Abstracts 8 9 (ASSIA) 10 11 Applied Social 12 S45 SU.EXACT("Stigmatization") 2448° 13 Sciences Index & 14 15 Abstracts 16 17 (ASSIA) 18 For peer review only 19 20 S46 SU.EXACT("Learning disabilities") Applied Social 2054° 21 Sciences Index & 22 23 Abstracts 24 25 (ASSIA) 26 27 28 S47 "learning disabilit*" or "learning difficult*" or "learning disorder*" or Applied Social 11637 29 "intellectual disabilit*" or "mental retard*" or "special need*" Sciences Index &° 30 31 Abstracts 32 33 (ASSIA) 34 35 36 S48 mental* NEAR/2 (ill* or vulnerab*) Applied Social 11374 37 http://bmjopen.bmj.com/ Sciences Index &° 38 39 Abstracts 40 41 (ASSIA) 42 43 44 S49 SU.EXACT("Mental health") Applied Social 8565° on September 26, 2021 by guest. Protected copyright. 45 Sciences Index & 46 47 Abstracts 48 49 (ASSIA) 50 51 52 S50 SU.EXACT("Psychiatric disorders") Applied Social 6061° 53 Sciences Index & 54 55 Abstracts 56 57 (ASSIA) 58 59 60
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S51 "mental disorder*" Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 4204° 5 Sciences Index & 6 7 Abstracts 8 9 (ASSIA) 10 11 Applied Social 12 S52 SU.EXACT("Schizophrenia") 4882° 13 Sciences Index & 14 15 Abstracts 16 17 (ASSIA) 18 For peer review only 19 20 S53 SU.EXACT("Bipolar affective disorder") Applied Social 2330° 21 Sciences Index & 22 23 Abstracts 24 25 (ASSIA) 26 27 28 S54 SU.EXACT("Depression") Applied Social 18305 29 Sciences Index &° 30 31 Abstracts 32 33 (ASSIA) 34 35 36 S55 SU.EXACT("Suicide") OR SU.EXACT("Vulnerable people") OR Applied Social 62157 37 http://bmjopen.bmj.com/ SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") OR Sciences Index &° 38 39 ("learning disabilit*" or "learning difficult*" or "learning disorder*" or Abstracts 40 41 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* (ASSIA) 42 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 43 These databases 44 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 45 are searched for on September 26, 2021 by guest. Protected copyright. 46 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR part of your 47 SU.EXACT("Depression") 48 query. 49 50 51 S56 ((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 409° 52 53 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) Sciences Index & 54 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable Abstracts 55 56 people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities")(ASSIA) 57 58 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 59 These databases "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 60
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NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR are searched for BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR part of your 6 7 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR query. 8 9 SU.EXACT("Depression")) 10 11 (SU.EXACT("Service integration") OR SU.EXACT("Interagency collaboration") Applied Social 12 S57 21° 13 OR ((multi-agency NEAR/2 (approach* or collaborat* or cooperat* or Sciences Index & 14 15 coordinat* or department* or model* or team* or partner* or program* or Abstracts 16 17 working)) OR (multiagency NEAR/2 (approach* or collaborat* or cooperat* or(ASSIA) 18 coordinat* or department*For peer or model* review or team* or partner* only or program* or 19 These databases 20 working))) OR ((multi-professional NEAR/2 (approach* OR collaborat* OR 21 are searched for cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 22 part of your 23 OR program* OR working)) OR (multiprofessional NEAR/2 (approach* OR 24 query. 25 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 26 27 team* OR partner* OR program* OR working))) OR ((multi-disciplinary 28 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 29 30 department* OR model* OR team* OR partner* OR program* OR working)) 31 32 OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 33 coordinat* OR department* OR model* OR team* OR partner* OR program* 34 35 OR working))) OR ((inter-agency NEAR/2 (approach* OR collaborat* OR 36 37 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* http://bmjopen.bmj.com/ 38 OR program* OR working)) OR (interagency NEAR/2 (approach* OR 39 40 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 41 42 team* OR partner* OR program* OR working))) OR ((inter-professional 43 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 44 45 department* OR model* OR team* OR partner* OR program* OR working)) on September 26, 2021 by guest. Protected copyright. 46 47 OR (interprofesional NEAR/2 (approach* OR collaborat* OR cooperat* OR 48 coordinat* OR department* OR model* OR team* OR partner* OR program* 49 50 OR working))) OR ((inter-disciplinary NEAR/2 (approach* OR collaborat* OR 51 52 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 53 OR program* OR working)) OR (interdisciplinary NEAR/2 (approach* OR 54 55 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 56 57 team* OR partner* OR program* OR working))) OR ((trans-disciplinary 58 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 59 60
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department* OR model* OR team* OR partner* OR program* OR working)) BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 6 7 coordinat* OR department* OR model* OR team* OR partner* OR program* 8 9 OR working))) OR ("joint agency" or "joint approach" or "joint collaborat*" or 10 "joint cooperat*" or "joint coordinat*" or "joint department*" or "joint 11 12 team*" or "joint partner*" or "joint program*" or "joint working") OR 13 14 (integrat* NEAR/2 (agency or approach* or department* or model* or team* 15 or partner* or program* or working)) OR ("cross agency" or "cross 16 17 department*" or "cross team*" or "cross partner*" or "cross program*") OR 18 For peer review only 19 ("across agency" or "across department*" or "across team*" or "across 20 partner*" or "across program*") OR (information NEAR/1 (integrat* or 21 22 governance or share* or sharing or transfer*)) OR (knowledge NEAR/1 23 24 (integrat* or governance or share* or sharing or transfer*)) OR (data NEAR/1 25 (integrat* OR governance OR share* OR sharing OR transfer*)) OR 26 27 (technology NEAR/1 (integrat* OR governance OR share* OR sharing OR 28 29 transfer*)) OR "communities of practice" OR SU.EXACT("Clinical risk 30 management" OR "Risk management") OR "single assessment process") AND 31 32 (((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR 33 34 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) 35 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable 36 37 people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") http://bmjopen.bmj.com/ 38 39 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 40 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 41 42 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 43 44 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 45 on September 26, 2021 by guest. Protected copyright. SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR 46 47 SU.EXACT("Depression"))) 48 49 50 S58 (("criminal justice" or "youth justice" or" juvenile justice") OR ((probation or Applied Social 130° 51 52 parole or court* or justice) NEAR/2 (personnel or staff or worker* or Sciences Index & 53 caseworker* or office* or official* or employee*)) OR SU.EXACT("Probation Abstracts 54 55 service") OR (paramedic* or para-medic*) OR ((emergency or ambulance or (ASSIA) 56 57 casualty) NEAR/2 (personnel or staff or worker* or office* or official* or 58 These databases employee*)) OR (SU.EXACT("Presentence reports" OR "Social services 59 are searched for 60
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departments") OR SU.EXACT("Befriending" OR "Care assistants" OR "Child part of your BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 care centres" OR "Child contact centres" OR "Community care" OR query. 6 7 "Consumer operated drop in centres" OR "Day care" OR "Day care centres" 8 9 OR "Day centres" OR "Deinstitutionalization" OR "Drop in centres" OR "Family 10 centres" OR "Halfway houses" OR "Home care" OR "Home health aides" OR 11 12 "Home helps" OR "Home ventilation" OR "Hospital at home schemes" OR 13 14 "Local health and social service centres" OR "Long term community care" OR 15 "Long term home care" OR "Meals on wheels" OR "Out of school care" OR 16 17 "Probation day centres" OR "Psychiatric day centres" OR "Social services" OR 18 For peer review only 19 "Welfare services") OR SU.EXACT("Jewish Association for Services for the 20 Aged" OR "Social services agencies")) OR SU.EXACT("Analytical social work" 21 22 OR "Behavioural social work" OR "Care orders" OR "Child care" OR "Child 23 24 protection" OR "Childminding" OR "Clinical social work" OR "Community 25 nurseries" OR "Community work" OR "Creches" OR "Critical social work" OR 26 27 "Day foster care" OR "Day nurseries" OR "Detached youth work" OR 28 29 "Educational social work" OR "Family child care" OR "Family preservation 30 services" OR "Family social work" OR "Feminist community work" OR 31 32 "Feminist people" OR "Feminist social work" OR "Foster care" OR "Geriatric 33 34 social work" OR "Guardians ad litem" OR "Guardianship" OR "Hospital social 35 work" OR "In care" OR "Kinship foster care" OR "Leaving care" OR "Long term 36 37 foster care" OR "Medical social work" OR "Neighbourhood work" OR http://bmjopen.bmj.com/ 38 39 "Nurseries" OR "Occupational social work" OR "Parent aide services" OR 40 "Political social work" OR "Postadoption services" OR "Private foster care" OR 41 42 "Psychiatric social work" OR "Quality child care" OR "Radical community 43 44 work" OR "Radical social work" OR "Residential social work" OR "Social 45 on September 26, 2021 by guest. Protected copyright. casework" OR "Social work" OR "Temporary foster care" OR "Therapeutic 46 47 child care" OR "Voluntary social work" OR "Wardship" OR "Youth work") OR 48 49 ("social services" or "social work") OR ("voluntary group*" or "voluntary 50 work") OR SU.EXACT("Voluntary work") OR ("community group*" or "self help 51 52 group*" or "third sector" or "social enterprise*") OR SU.EXACT("Community 53 54 groups") OR SU.EXACT("Selfhelp groups") OR SU.EXACT("Social enterprises")) 55 56 AND (((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR 57 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) 58 59 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable 60
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people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 6 7 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 8 9 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 10 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 11 12 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR 13 14 SU.EXACT("Depression"))) 15 16 17 18 For peer review only 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 http://bmjopen.bmj.com/ 38 39 40 41 42 43 44 45 on September 26, 2021 by guest. Protected copyright. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
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BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 For peer review only 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 http://bmjopen.bmj.com/ 38 39 40 41 42 43 44 45 on September 26, 2021 by guest. Protected copyright. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
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1 2 3 4 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 5 6 APPENDIX 3: DESCRIPTION OF STUDY DESIGNS 7 Study Design Description 8 Audit An assessment of current practice within a specific setting or context, in 9 10 line with best practice or to inform best practice, using for instance an 11 audit checklist [84] 12 Case study Description of policy or model within a specific context or setting, along 13 with presentation of routinely collected data pre- and post- 14 introduction, such as Teske et al. (2011) [137] 15 Qualitative Qualitative research concerns itself with aspects of research such as 16 experience and understanding. Techniques used include in-depth semi- 17 structured interviews and focus groups, and data can take any form 18 For peer review only 19 including audio recordings or words, such as Boscarto et al. (2014) [29] 20 Scoping review “A scoping review or scoping study is a form of 21 knowledge synthesis that addresses an exploratory research question 22 aimed at mapping key concepts, types of evidence, and gaps in research 23 related to a defined area or field by systematically searching, selecting, 24 and synthesising existing knowledge” [175] 25 Mixed methods Involves quantitative components such as a national survey involving 26 27 the police; and qualitative components such as focus groups and 28 interviews [57]. 29 Controlled before and A controlled before and after study compares one group receiving an 30 after study intervention with another (control) group that typically does not 31 receive the intervention. This can be a parallel group where the 32 comparison is made at the same time that the intervention group 33 receives the intervention, or a retrospective comparison can be made 34 where for example those referred to court diversion schemes are 35 36 compared with a retrospective group of defendants referred for 37 psychiatric reports by the same courts in the 1-2 year period http://bmjopen.bmj.com/ 38 immediately prior to the introduction of the diversion scheme [64]. 39 Service evaluation This describes and evaluates a service or model to examine practicality, 40 feasibility or pilot of a model within its’ initial stages. For example, to 41 examine the practicability of a recommendation to abolish or amend 42 Magistrates’ power to remand people perceived to have mental health 43 problems in custody for psychiatric reports and report the first 12 44 45 months of the service [33]. on September 26, 2021 by guest. Protected copyright. 46 Survey Typically using questionnaire to gather information within a specific 47 time point. For example, using a questionnaire distributed to health 48 and criminal justice staff to explore factors that impede or facilitate 49 information exchange between criminal justice and health agencies 50 [77]. 51 Description of model Description of the development and implementation of a model of 52 interagency collaboration, for example of a joint protocol for the 53 54 investigation of crimes against vulnerable adults [56] 55 Prospective An observational study, often longitudinal in nature, for which the 56 observational study consequential outcomes of interest occur after study commencement 57 (including creation of a study protocol and analysis plan, and study 58 initiation) [176]. 59 60
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1 2 3 4 !∞∞•Æ§©∏ 4: $•¥°©¨•§ §•≥£≤©∞¥©ØÆ Ø¶ ¥®• ≠ا•¨≥ 5 !rranged in the order of the most frequently occurring models. 6 7 bame 5efinition bo of Çype of model 8 9 studies 10 11 tolice-based specialised tolice-based specialised police response. Çhese 2 tre-arrest 12 police response [95,145] models involve sworn diversion 13 14 officers who have special mental health training, 15 serving as the first-line 16 For peer review only 17 police response to mental health crises in the 18 community and acting as liaisons 19 20 to the formal mental health system. 21 22 aental health training tolice officer receive training by mental health 3 tre-arrest 23 [101,118,143] professional to increase awareness and diversion 24 25 sensitivity to mental health issues and crisis and 26 facilitate access to services. Ürban and rural 27 population. íhen receive a call police officer 28 who has been trained is assigned wherever 29 30 possible. {ite also implemented pilot project 31 where psychiatric nurse who could admit people 32 directly to ward was paired with trained police http://bmjopen.bmj.com/ 33 officer to attend crisis calls and conduct follow- 34 up assessments on people in recent contact with 35 36 police. 37 38 39 40 !nother example is the aulti-agency training on September 26, 2021 by guest. Protected copyright. 41 initiative. Çhe half day course included reception 42 of patients at the hospital, legal requirements 43 (use of {ections 135 and 136 of the aI! 1983), 44 missing patients, restraint of patients, police use 45 46 of /{ spray and liaison with other professionals. 47 48 tost-crisis !ssistance tost-crisis !ssistance trogram (t/!t). tolice 1 tre-arrest 49 trogram (t/!t) [94] officers can refer individuals (via email) to diversion 50 aental Iealth !ssociation after incidents and 51 v ul Œ ( ŒŒo• (}Œ vÇ Z}v•µu Œ•[ ]v Œ]•]•X 52 5ata sharing between police and mental health 53 54 is primarily via email referrals. Collowing referral 55 šZ u všo Z ošZ ••}]š]}v • v• Z‰ Œ 56 •‰ ]o]•š[ }všš• šZ }v•µu Œ ]v ‰ Œ•}vX t Œ 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 54 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialists are consumers with long term mental 4 health plans. Çhey make consumers aware of 5 services relevant to their needs. 6 7 Çhe alternative place of Çhe alternative place of safety (!to{) legislation, 1 tre-arrest jail 8 safety (!to{) [68] which held adults under the aental Iealth !ct 5iversion 9 10 outside of a custody suite or traditional health- 11 based place of safety (I.to{), to give people a 12 better experience whilst they await a mental 13 health assessment 14 15 9mergency 9xamination 9mergency 9xamination hrders, which 1 tre-arrest jail 16 For peer review only 17 hrders [36] empowers police and ambulance officers (and 5iversion 18 psychiatrists) to transport patients to an 19 9mergency 5epartment or other authorised 20 mental health service for assessment 21 22 Çhe {econdary Camily {ZÇ }vŒÇZ Cu]oÇ[U }uuµv]šÇ Œ]•]• 1 tre-arrest jail 23 [45] response model which provides support for 5iversion 24 25 people with mental illness in times of crisis. Çhis 26 is as partnership of hospitals, tolice and a 27 /ommunity /risis wesponse programme who 28 provide a collective approach to support 29 provision. Çhe aim was to help individuals in 30 31 mental health crisis experience supportive 32 relationships in order to help them build http://bmjopen.bmj.com/ 33 resilience, to direct them in the right direction 34 35 Çhe {ubstance Çhe {ubstance !buse and aental Iealth 1 tre-arrest jail 36 {ervices !dministration ({!aI{!) jail 5iversion 37 !buse and aental Iealth 38 {ervices diversion initiative, which are pre-booking and 39 40 post-booking programmes !dministration ({!aI{!) on September 26, 2021 by guest. Protected copyright. 41 42 jail 43 44 diversion initiative [134] 45 46 aassachusetts aental aassachusetts aental Iealth 5iversion and 1 tre-arrest jail 47 Iealth 5iversion and Lvš PŒš]}v tŒ}PŒuu U Za u‰Z]•-like /LÇ- 5iversion 48 Lntegration trogramme ‰Œ}PŒuu [ šZš o•} ]voµ šZ o}o ‰}o] 49 [97] department and community care 50 representatives. Çhe aim was to develop 51 52 integrated treatment alternatives for people 53 with mental health, substance abuse, and/or 54 homelessness issues who become involved with 55 law enforcement 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 55 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Çhe aontgomery /LÇ Çhe aontgomery /LÇ. !imed to provide law 1 tre-arrest jail 4 [114] enforcement officers with the skills they need to 5iversion 5 safely deescalate situations with people with 6 mental illness in crisis 7 8 aobile /ommunity .ased on the Çraining in /ommunity [iving 1 tre-arrest jail 9 10 Çreatment program trogram. 5iversion 11 (a/Ç) [149] 12 13 14 thilosophy based on outreach efforts, with staff 15 }(š v P}]vP š} o] vš•[ Z}u v Á}Œl]vP š} 16 For connectpeer in any wayreview possible from providing only rids 17 to the grocery store to crisis intervention to help 18 19 with specific skill training. [inkages developed 20 with other community agencies including 21 hospital emergency rooms, police and county 22 jail. 23 24 ZLš ]• šÇ‰]o }( PŒ}Á]vP vµu Œ }( !/Ç 25 programs that are all based on similar operating 26 27 ‰Œ]v]‰o • ]v •]u]oŒ ‰}‰µoš]}vX[ !/Ç ‰Œ}À] • 28 mental health and other support on an on-going 29 basis, using community-based outreach 30 treatment teams. 31 32 /risis hutreach !nd /risis hutreach !nd {upport Çeam (/h!{Ç) 1 tre-arrest jail http://bmjopen.bmj.com/ 33 {upport Çeam (/h!{Ç) 5iversion 34 9xpanded /LÇ program involving civilians in crisis 35 [129] }µšŒ ZX ÇZ (]À ^Œ]•]• •‰ ]o]•š•_ ]v šZ 36 37 civilian unit are employees of and supervised by 38 the police. /h!{Ç workers are college graduates 39 with a background in case management, social 40 work, or psychology and includes a psychiatrist. on September 26, 2021 by guest. Protected copyright. 41 Çhey respond on-site in the field; conduct non- 42 43 urgent follow-ups; and make proactive visits to 44 homeless people to engage them with services 45 46 /risis Lntervention Çeam tre-booking, police-based programs that provide 17 tre-arrest jail 47 (/LÇ) mental health treatment in lieu of arrests. tre- 5iversion 48 [29,34,43,99,103,104,111 arrest diversion generally involves collaboration 49 50 ,114,116,118,124,126,12 between state and local law enforcement, 51 7,133,138,145,150] emergency services (e.g., dispatchers and 52 ambulatory services), and community 53 behavioural health treatment providers such as 54 clinical staff from local behavioural health 55 56 departments, hospital emergency departments, 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 56 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialised psychiatric centres. 4 5 6 7 Çhe most common pre-arrest diversion model is 8 the aemphis /risis Lntervention Çeam (/LÇ), 9 which is a police based first responder program 10 of pre-arrest jail diversion for those in a mental 11 12 illness crisis. Çhis provides law enforcement 13 based crisis intervention training for helping 14 those individuals with mental illness. Ln addition, 15 /LÇ works in partnership with mental health 16 For professionalspeer to review provide a system of servicesonly to 17 18 assist to the individuals with mental illness, 19 family members, and the police officers. 20 21 Çhe /ommunity /risis Çhe /ommunity /risis Lntervention Çeam (//LÇ); 1 tre-arrest jail 22 Lntervention Çeam (//LÇ) an innovative program utilizing crisis 5iversion 23 [43] intervention services and mobile crisis outreach 24 25 within an emergency room (9w) setting 26 27 /ivil commitment law /ivil commitment law, which allows for the 1 tre-arrest jail 28 [117] forced hospitalization 5iversion 29 30 of mentally ill individuals who are in need of 31 care, who are dangerous to themselves or 32 others, and http://bmjopen.bmj.com/ 33 34 who are either unwilling or unable to consent to 35 hospitalisation. Çhe aim was to allow people 36 37 who are mentally ill and exhibit problematic 38 behaviour in the community to be diverted, 39 before booking, from the criminal justice system 40 into the mental health system without the on September 26, 2021 by guest. Protected copyright. 41 necessity of arrest or criminal court involvement 42 43 44 {chool wesource {chool wesource 1 tre-arrest jail 45 5iversion 46 hfficers ({whs) [116] hfficers ({whs), school-based police officers with 47 /LÇ mental health training 48 49 who are trained to deal with a wide variety of 50 both instrumental and 51 52 expressive criminal acts 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 57 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Çhe Cixated Çhreat Çhe Cixated Çhreat !ssessment /entre (CÇ!/), a 1 tre-arrest jail 4 !ssessment /entre joint police/ 5iversion 5 (CÇ!/) [75] 6 bational Iealth {ervice unit in the Ünited 7 Yingdom, which was set up 8 9 to assess and manage risks in people with 10 intense pathological fixation with public figures 11 12 vueensland Cixated vueensland Cixated Çhreat !ssessment /entre. 1 tre-arrest jail 13 14 Çhreat !ssessment Lnvolves intelligence gathering, risk assessment, 5iversion 15 /entre [38] alerting and awareness training for police and 16 For healthpeer professionals. review vCÇ!/ staff have only specialist 17 skills in the evaluation of the fixated, particularly 18 19 risks of violence, and from persistence, 20 disruption and escalation, which minimises 21 uncertainty and unmet security needs. 22 23 Çhe /ommunity {ervice Çhe /ommunity {ervice hfficer (/{h) model. ! 1 tre-arrest jail 24 hfficer (/{h) model [111] /ommunity {ervice hfficer (/{h), provides 5iversion 25 support in crime prevention, investigation, and 26 27 response where full police powers are 28 unnecessary and assists police officers in 29 upholding law and order 30 31 tre-arrest jail 5iversion ! separate but collaborative approach between 3 tre-arrest jail 32 [135] mental health and police teams. tolice bring 5iversion http://bmjopen.bmj.com/ 33 individuals in mental health crisis to emergency 34 35 department where mental health nurse is on 36 duty to assist. 37 38 aental Iealth aental Iealth Lntervention Çeam (aILÇ). Cront 2 tre-arrest jail 39 Lntervention Çeam line police officers receive enhanced mental 5iversion 40 (aILÇ) [30,31] health. Yey aims are: on September 26, 2021 by guest. Protected copyright. 41 42 1. weduce the risk of injury to police and mental 43 44 health consumers during mental health crisis 45 events; 46 47 2. Lmprove awareness by frontline police of risks 48 involved in dealing with mental health 49 consumers and strategies to reduce injuries to 50 police and consumers; 51 52 3. Lmprove collaboration with other government 53 54 and non-government agencies in the response 55 to and management of mental health crisis 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 58 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 events; and 4 5 4. weduce the time taken by police in the 6 handover of mental health consumers into the 7 health care system. 8 9 Çhe /ornwall ! pilot beighbourhood hutreach scheme to 1 tre-arrest jail 10 support police with vulnerable individuals with diversion 11 /riminal Wustice [iaison 12 suspected mental illness but not necessarily and 5iversion {ervice 13 criminal involvement. 14 (/W[5{) [61] 15 16 ëictoria model of For ëictoriapeer model ofreview wesponding to aental only Iealth 1 /o-response 17 wesponding to aental /rises in the /ommunity. !ims to provide 18 Iealth /rises in the assistance to people in mental health crises and 19 maintain their safety and that of others, and to 20 /ommunity [41] 21 receive assessment and treatment 22 23 Çhe tsychiatric Çhe tsychiatric 9mergency wesponse Çeam 2 /o-response 24 9mergency wesponse (t9wÇ) model. Çhe tsychiatric 9mergency 25 Çeam (t9wÇ) model wesponse Çeams (t9wÇ) consist of specially 26 trained officers and deputies who are paired 27 [33,111] with licensed mental health professionals. 28 29 Çogether, they respond on-scene to situations 30 involving people who are experiencing a mental 31 health related crisis and have come to the 32 attention of law enforcement. Çhe goal is to http://bmjopen.bmj.com/ 33 provide the most appropriate resolution to the 34 35 crisis by linking people to the least restrictive 36 level of care and to help prevent the 37 unnecessary incarceration or hospitalization of 38 those seen. 39 40 aental-health-based aental-health-based specialized mental health 1 /o-response on September 26, 2021 by guest. Protected copyright. 41 42 specialised mental health response. Ln this more traditional model, 43 response [95] partnerships or cooperative agreements are 44 developed 45 46 between police and mobile mental health crisis 47 teams (a/Çs) that exist as 48 49 part of the local community mental health 50 services system and operate independently of 51 52 the police department. 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 59 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 aobile /risis Çeams aobile /risis Çeams. Ln this instance, when 9 /o-response 4 [101,105,111] necessary, calls involving mentally disordered 5 [43,48,50,106,131] [152] individuals are handled by community health 6 [122] [146] based crisis teams in coordination with the 7 8 police department. !imed to improve the 9 handling of calls involving mentally impaired 10 individuals, and provide benefit to the 11 /incinnati tolice 5ivision and the local criminal 12 justice system generally. 13 14
15 16 For aobilepeer psychiatric review crisis assessment andonly 17 18 treatment teams, independently of but 19 responsive to requests from police. {hared 20 protocols providing guidelines for police and 21 mental health staff in handling situations 22 23 requiring a joint response have also been 24 implemented. 25 26 /o-responding tolice- aobile /risis Lntervention Çeams (a/LÇs), a 3 /o-response 27 aental Iealth programs police and mental health system co-response 28 (police and mental health partnership to assist police in responding to 29 professional) [29,43,49] people experiencing mental 30 31 health crises 32 http://bmjopen.bmj.com/ 33 {treet triage [69,71,90] {treet triage, this model involved a psychiatric 3 /o-response 34 35 nurse attending incidents with a police 36 constable. Çhe model of street triage 37 implemented contains the following 38 39 key elements: 40 on September 26, 2021 by guest. Protected copyright. 41 ¾ Çhe street triage team consists of one 42 dedicated police constable and one psychiatric 43 44 nurse; 45 ¾ 46 Çhe team physically attends the scene of 47 incidents reported, unless they are already 48 attending another 49 50 incident, in which case telephone support is 51 provided; 52 53 ¾ /all handlers filter calls to {ussex tolice and 54 55 allocate incidents to the street triage team if 56 there is an indication that the incident requires 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 60 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 support for mental health needs or crises; 4 5 ¾ Çhe street triage team are not the initial 6 response to emergency or life-threatening 7 events; 8 9 Çhe .irmingham Çhe .irmingham /ommunity {ervice hfficers- 1 /o-response 10 11 /ommunity {ervice police-based specialised mental health response: 12 hfficers [95] mental health professionals are employed by 13 police department to provide on-site telephone 14 consultations to officers in the field. 15 16 For peer review only 17 18 Çhe Ynoxville trogram Çhe Ynoxville trogram: aental-health-based 1 /o-response 19 [95] specialised mental health response: partnerships 20 21 or cooperative agreements are developed 22 between police and mobile mental health crisis 23 teams that exist as part of the local community 24 mental health service system and operate 25 independently to police department 26 27 aental 9valuation Ünit aental 9valuation Ünit (a9Ü), consisting of a 28 1 /o-response 29 (a9Ü) [150] {ystemíide aental !ssessment wesponse 30 Çeam, /ase !ssessment aanagement 31 trogramme, and aental Iealth Lntervention 32 Çraining. Çhe aim was to provide response to http://bmjopen.bmj.com/ 33 34 people in mental health crisis 35 36 Çhe {ystemwide aental Çhe {ystemwide aental !ssessment wesponse 3 /o-response 37 !ssessment wesponse Çeam, which allows mental health clinicians to 38 Çeam ({a!wÇ) [102] be present at incidents to employ and explore 39 non judicial alternatives such as diversion to a 40 private hospital, substance abuse centre or on September 26, 2021 by guest. Protected copyright. 41 42 outpatient mental health programme. Ço 43 provide a more effective and reliable way for 44 police to handle acutely mentally ill in the field 45 46 tolice !mbulance /risis t!/9w (tolice !mbulance /risis 9mergency 1 /o-response 47 9mergency wesponse) model. t!/9w was a dual secondary 48 49 wesponse(t!/9w) model service to aIC! for new police recruits, with 50 [28] mental health personnel travelling with police 51 and working together to manage individuals in 52 crisis in the community. 53 54 borthern tolice and borthern tolice and /linician 9mergency 1 /o-response 55 /linician 9mergency wesponse (bt!/9w) team. {econd response 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 61 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 wesponse (bt!/9w) [35] model consisting of police officer and mental 4 health professional attending mental health 5 crisis in the community, after initial police 6 response requires the person to be assessed by 7 8 mental health practitioner. 9 10 aental Iealth aental Iealth 9mergency {ervice, where police 1 /o-response 11 9mergency {ervice [150] officer and mental health nurse respond to 12 mental health calls. Çhe aim was to provide 13 response to people in mental health crisis 14 15 !ssertive hutreach Çeam !ssertive hutreach Çeam, a multi-professional 1 /o-response 16 For peer review only 17 [150] approach placing police officers as part of a 18 mental health team that addresses problematic 19 clients. Çhe aim was to provide response to 20 people in mental health crisis 21 22 .ehavioural Iealth .ehavioural Iealth {pecialised /o-wesponse 1 /o-response 23 {pecialised /o-wesponse Çeam builds on /LÇ model to have a full time 24 25 Çeam [150] aental Iealth /oordinator, a clinician. Çhe aim 26 was to provide response to people in mental 27 health crisis 28 29 /o-response aodel [150] ! /o-response aodel, which partners a police 1 /o-response 30 officer and mental health practitioner as a police 31 32 response team. Çhe aim was to provide http://bmjopen.bmj.com/ 33 response to people in mental health crisis 34 35 Iostage/barricade crisis /risis negotiation co-response. tsychologist or 2 /o-response 36 negotiation co-response. mental health professional as an integrated
37 [112] team member 38 39 tolice, !mbulance and t!/9w was a joint crisis response from police 1 /o-response 40 /linical 9arly wesponse and mental health clinicians to people on September 26, 2021 by guest. Protected copyright. 41 42 (t!/9w) [33] experiencing a behavioural disturbance in the 43 community. aental health clinician and police 44 operating together in an 8 hour shift. t!/9w unit 45 is a secondary unit that can be requested by a 46 primary responder police unit attending an 47 48 incident in the community. t!/9w can also be 49 requested by ambulance via police 50 communications 51 52 Çhe Lntegrated aobile Çhe Lntegrated aobile /risis wesponse Çeam , 1 /o-response 53 /risis wesponse [44] which aims to combine varied front-line crisis 54 55 responder elements into 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 62 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 a more efficient, responsive, and 4 interdisciplinary crisis response team that can 5 attend to the full continuum of community 6 crises 7 8 /risis wesponse Çeam /risis wesponse Çeam (/wÇ) consisting of 1 /o-response 9 10 (/wÇ) [113] dedicated /risis Lntervention Çeam (/LÇ) officers 11 (hC/) paired with a aental Iealth trofessional 12 (aIt). !ims to improve the police response in 13 situations involving mentally ill and chemically 14 15 dependent 16 For peer review only 17 individuals through specialized mental health 18 provider response 19 20 in the field 21 22 ! multi-agency police ! multi-agency police liaison scheme comprising 1 tost booking 23 liaison scheme [59] a rapid screening and mental health assessment jail diversion 24 at the earliest point of contact with the criminal 25 justice system, plus a mechanism for 26 27 appropriate referral or diversion to health and 28 social services 29 30 Çhe !dolescent 5rug ! multi-component, cognitive-behavioural 1 tost booking 31 !buse trevention and outpatient intervention serving children and jail diversion 32 Çreatment (!5!tÇ) youths referred directly from local police http://bmjopen.bmj.com/ 33 trogram [140] agencies 34 35 36 aental Iealth/Wuvenile aental Iealth/Wuvenile Wustice 5iversion troject 1 tost booking 37 Wustice 5iversion troject (aI/WW) jail diversion 38 (aI/WW) [110] 39 Lnvolves diverting youth out of the juvenile 40 justice system and linking them to appropriate on September 26, 2021 by guest. Protected copyright. 41 treatments in their counties. !ims to (1) to 42 reduce out-of-community placement, (2) to 43 44 prevent recidivism, and (3) to increase the 45 general functioning of youth and their families 46 47 tolvuest [83] 5eveloped a manual and training package for 1 tost-booking 48 tolvuest, a new police custody questionnaire. jail diversion 49 50 51 52 tolvuest-police and mental health screening 53 questionnaire which aimed to bridge the gap 54 between mental health services and police by 55 56 helping with the identification and referral of 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 63 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 individuals with mental health problems. 4 5 Çhe aassachusetts Çhe aassachusetts aental Iealth 5iversion and 1 tost-booking 6 aental Iealth 5iversion Lntegration jail diversion 7 and Lntegration 8 trogram (aaI5Lt), identify service strengths 9 trogram (aaI5Lt) [108] and gaps in delivering effective, integrated 10 services to persons suffering with mental illness, 11 12 substance abuse, and/or homelessness issues. 13 Çhis aimed to address the current needs for our 14 target population and facilitate better 15 interagency communication, cooperation, and 16 For peer review only 17 resource sharing. 18 19 òouth offending team òouth offending team-multi-disciplinary teams 1 tost-booking 20 [66] that work with young people who have jail diversion 21 committed crimes or who are believed to be at 22 risk of committing crimes. 23 24 !ssertive community Çhe !ssertive community treatment is a post- 3 tost-booking 25 treatment (!/Ç). !n booking, jail-based diversion program diverting jail diversion 26 27 Lntensive case individuals into psychiatric treatment in lieu of 28 management incarceration or reduced incarceration (with 29 [141,143,149] possible reductions in charges) 30 31 Çhe tolice [iaison Çhe tolice [iaison /ommunity tsychiatric burse 1 tost-booking 32 /ommunity tsychiatric troject. Çhree aims: 1) Ldentify and assess jail diversion http://bmjopen.bmj.com/ 33 34 burse troject [63] mentally disordered offenders; 2) direct these 35 cases into the healthcare system; 3) provide a 36 quantitative indication of the size of the 37 problem, in order to make recommendations for 38 future services. Çhe aim was to identify and 39 40 assess mentally disordered offenders and direct on September 26, 2021 by guest. Protected copyright. 41 these cases into the healthcare system 42 43 ÇZ Z[]vl í}Œl Œ ÇZ Z[]vl í}Œl Œ {Z u [U ]u š •šo]•Z]vP 1 tost-booking 44 {Z u [ [65] relationships with people with mental health jail diversion 45 and multiple problems in contact with the police 46 in order to improve the ways in which the full 47 48 range of their needs can be understood and met 49 50 /ourt diversion scheme /ourt diversion scheme. 5efendants are 2 tost-booking 51 [72,74] screened prior to their appearance in court, by jail diversion 52 forensic community psychiatric nurses. Çhey 53 look at charge sheets and previous convictions, 54 55 for any unusual aspects such as multiple drug or 56 alcohol related offences or and possible serious 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 64 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 mental illness. /ustody or probation officers may 4 refer a prisoner they have concerns about. 5 6 .elfast screening, Çhe police station provides a setting for the 1 tost-booking 7 assessment and referral treatment, questioning and identification of jail diversion 8 service for mentally mentally disordered suspects. {ervice based on 9 10 disordered offenders [89] the 5iversion at the point of arrest model, 11 providing mental health assessment at the 12 earliest point of contact with the criminal justice 13 system and guidance and referrals to local 14 15 health and social services. trovided by 16 For /ommunitypeer mental review health nurses and only supported 17 by forensic psychiatry. burses screen custody 18 record forms of all detainees. Lndividuals may 19 also be referred by an Corensic aedical officer, 20 21 custody sergeant or magistrate. Collowing 22 assessment make recommendations for 23 treatment and support. 24 25 5iversion at the point of 5iversion at the point of arrest (5!t!) 2 tost-booking 26 arrest (5!t!) [86,87] jail diversion 27 28 aulti-agency police aulti-agency police liaison scheme. Çhe service 1 tost-booking 29 liaison scheme [59] comprises a rapid screening of custody records jail diversion 30 31 for all detainees and mental health assessment 32 where needed at the earliest point of contact http://bmjopen.bmj.com/ 33 with the /W{, plus a mechanism for appropriate 34 referral or diversion to health and social 35 36 services. Çhe nurses also co-ordinate follow-up 37 care and provide ongoing advice and support to 38 offenders, the police and health care 39 professionals. !imed to identify offenders with 40 psychiatric illness and/or learning disabilities on September 26, 2021 by guest. Protected copyright. 41 42 within the integrated health and social care 43 system 44 45 Wail diversion programme Wail diversion programme, a process where 13 tost-booking 46 [59,70,74,81,84,107,115, alternatives to criminal sanctions are made jail diversion 47 121,127,132,133,134, available to persons with mental illness (taL) 48 135] who have come into contact with the law. Ço 49 50 identify detainees who have {aL and/or
51 substance misuse problems and establish mental 52 health treatment programs that meet their 53 needs in the least restrictive environment. 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 65 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 hutreach team and hutreach team and police department. Çhe 1 Lnformation 4 police department [53] team contact police for help in finding missing sharing 5 persons and the police contact the team when agreements 6 they observed strange behaviour in a homeless 7 8 person that suggests the need for mental health 9 information. .y establishing ongoing 10 communication with the police, outreach team 11 hoped it could foster better relations with the 12 police and between the police and the target 13 14 population, leading to fewer arrests and 15 incarcerations of people with mental health 16 For problemspeer and arereview homeless. !lso helped only the 17 police would help them find hard-to-find at risk 18 19 people with mental health problems that are 20 living on the streets. 21 22 /risis /are concordat [67] Çhe /risis /are /oncordat, a national agreement 1 Lnformation 23 between the different agencies and services sharing 24 involved in the care of people experiencing, or at agreements 25 risk of experiencing, a mental health crisis in the 26 27 ÜY. Çwenty-seven national bodies have signed 28 up to the /oncordat, representing health, the 29 police, social care, housing, national and local 30 government (including the Iome hffice, 31 5epartment of Iealth and the ainistry of 32 http://bmjopen.bmj.com/ 33 5efence) and voluntary and community sector 34 organisations. !ims to improve the quality and 35 availability of help and support, with a focus on 36 acute mental health crises, although it also 37 38 recognises the importance of prevention and 39 recovery. Çhe four main aims of the /oncordat 40 are to improve: access to support before crisis on September 26, 2021 by guest. Protected copyright. 41 point; urgent and emergency access to crisis 42 care; vuality of treatment and care when in 43 44 crisis; wecovery and staying well 45 46 Çhe tsychiatry/ aental Cormally organised at two levels: managerial and 1 Lnformation 47 Iealth {ervices operational level. aanagerial level has one sharing 48 cooperation model [52] representative from each sector and the agreements 49 operational level has one representative at mid- 50 level from each of the three sectors and a 51 52 coordinator who is also a member at managerial 53 o À oX ZÇZ u}•š ]u‰}Œšvš š•l[ ]• š} }}Œ]nate 54 the information about vulnerable citizens and 55 their situation to designate the most appropriate 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 66 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 sector to deal with their issues. 4 5 6 7 9arly botification 9arly botification trogram (9bt) 1 Lnformation 8 trogram (9bt) sharing ! system where people with mental illnesses 9 agreements 10 [100] and special needs can voluntarily provide the 11 police with their medical information to aid 12 interaction. Çhe aim was to provide officers with 13 14 medical information to enable them to resolve 15 situations while protecting themselves and 16 For maintainingpeer the review safety of the individual only and the 17 community. 18 19 Lnformation sharing aulti-!gency tublic trotection !rrangements 1 Lnformation 20 agreements,(e.g. with (a!tt!) is a legal requirement in the ÜY under sharing 21 22 /W{; part of risk the /riminal Wustice !ct 2003. Çhe aim of a!tt! agreements 23 management (aulti- is to protect the public, including previous 24 !gency tublic trotection victims of crime, from serious harm by sexual 25 !rrangements - a!tt!); and violent offenders. a!tt! requires the local 26 safeguarding) [85] criminal justice agencies and other bodies 27 28 dealing with offenders to work together in 29 partnership in dealing with these offenders, by 30 identifying individuals who should be under 31 a!tt!; management of such individuals; multi- 32 http://bmjopen.bmj.com/ 33 agency storing and sharing information about 34 offenders; disclosure of information to the 35 public about individual offenders in particular 36 circumstances; risk assessment and 37 management; multiagency meetings and case 38 39 reviews: 40 on September 26, 2021 by guest. Protected copyright. 41 Z[}}• }µ‰o]vP[ [144] Z[}}• }µ‰o]vP[ ]• }v ‰š šZš •µPP •š• 1 Lnformation 42 43 resilient system of independent agencies that sharing 44 work harmoniously in an exchange relationship agreements 45 while the different parts retain physical and 46 professional autonomy. 47 48 49 50 Çhe flexibility of loose coupling allows for 51 systems such as criminal justice and mental 52 53 health that seem ideologically incompatible to 54 join when a need arises and create composite 55 services. 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 67 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 [earning 5isabled [earning 5isabled hffenders' Corum. Lnitially a 1 Lnformation 4 hffenders' Corum [70] support group for sharing issues; membership sharing 5 expanded to enable not only interagency agreements 6 communication but to be instrumental in 7 8 improving services and their delivery. !imed to 9 improve communication between professionals 10 and agencies 11 12 Lnformation sharing [egislation and good practice guidance 3 Lnformation 13 agreements [56] [54] documents. sharing 14 agreements 15 16 For peer review only 17 Cor example: Lnformation sharing between bI{ 18 19 and criminal justice system. Çhe study explored 20 factors that enable or impede information 21 sharing and determined what information is 22 received and needed for bI{ and criminal 23 justice system agencies as well as attitudes and 24 25 practises about information sharing rather than 26 one model. 27 28 29 30 9xample: wecommendations made: 31 32 aove to community-based mental health http://bmjopen.bmj.com/ 33 services. Lmplement the trimary /are {trategy. 34 trovide social work services 24hrs, 7 days a 35 week. 36 37 aental health training for !n Darda {íochána. 38 39 9xamine the feasibility of /LÇs. 5evelop joint 40 protocol and formal liaison systems. Ço examine on September 26, 2021 by guest. Protected copyright. 41 the introduction of 5istrict court diversion 42 programme 43 44 Z/}vš u‰}ŒŒÇ t}o]]vP Z/}vš u‰}ŒŒÇ t}o]]vP Dµ] o]v • (}Œ í}Œl]vP 1 Lnformation 45 Duidelines for íorking with the aental Iealth {ysš u[X Z]• }µšo]v • sharing 46 Ç 47 with the aental Iealth proactive police approach to interactions with agreements 48 {Ç•š u[ [46] people with mental illness and with the mental 49 health system and identifies principles that can 50 be used by police organisations. Çhe aim was to 51 52 maximize the likelihood that crisis interactions 53 between police and people with mental illnesses 54 are prevented when possible and resolved safely 55 and respectfully when they do occur 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 68 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 .est practice model of Çhe program of work is culminating in the 1 Lnformation 4 policing people with development of a best practice model of policing sharing 5 mental illness [37] people with mental illness. agreements 6 7 trotocol for the Woint Çhis aims to strengthen communication and 1 Lnformation 8 collaboration between agencies in order to sharing 9 Lnvestigation of /rimes 10 protect vulnerable adults; to provide a agreements 11 /ommitted against framework for early cross-referral of /ases; to 12 ensure police involvement in the referral process 13 ëulnerable !dults [56] to ascertain whether a crime has been 14 15 committed; to minimise the number of 16 For interviewspeer conducted review with the victim; only to ensure 17 through good planning that criminal enquiries 18 run parallel to other lines of enquiry; to allow 19 accurate data to be collected on the incidence of 20 21 crimes against vulnerable adults. 22 23 tsychiatric assessment tsychiatric assessment scheme. weferred from 1 /ourt 24 scheme [64] court or other agencies for assessment. diversion 25 26 /ognitive !nalytic /ognitive !nalytic Çherapy (/!Ç) is a 1 /ourt 27 Çherapy (/!Ç) [76] collaborative time-limited psychotherapy. Çhe diversion 28 approach aims to formulate how early 29 experiences influence the development 30 31 }( µvZ o‰(µo ‰šš Œv• šZš u]vš]v ‰ Œ•}v[• 32 http://bmjopen.bmj.com/ 33 current difficult experiences. Çhis is represented 34 diagrammatically in a map. 35 36 /ourt diversion 5iversion includes all community-based 5 /ourt 37 [54,72,74,88,110] alternatives to standard prosecution that occur diversion 38 before an offender has 39 40 entered a plea or goes to trial; thus, the offender on September 26, 2021 by guest. Protected copyright. 41 42 ]• Z]À Œš [ (Œ}u •švŒ 43 44 prosecution and into specialised community- 45 based services that are better able to meet their 46 needs. /ourt diversion programmes occur 47 following arrest whilst the individual is 48 49 in initial detention, during initial hearings, or 50 while being assisted by 51 52 pre-trial services offer community based 53 54 alternatives to standard prosecution 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 69 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 hutpatient commitment hutpatient commitment- a civil court procedure 1 /ourt 4 [136] mandating adherence to outpatient mental diversion 5 health treatment. {tatutorily defined outpatient 6 commitment requires compliance with 7 8 recommended outpatient treatment but does 9 not permit forced medication of legally 10 competent individuals. Lf fail to comply with 11 treatment, outpatient statutes permit the 12 clinician to request law enforcement officers 13 14 transport the individual to an outpatient facility, 15 where clinicians will attempt to persuade them 16 For topeer accept treatment review or undertake an onlyevaluation 17 for inpatient commitment. 18 19 20 21 !dditionally, a number of related civil judicial 22 23 mechanisms may be used to compel outpatient 24 treatment. 25 26 [iaison and diversion [iaison and diversion services aim to identify and 2 /ourt 27 services [61,153] support people with mental health problems, diversion 28 learning difficulties and other vulnerabilities in 29 police stations and courts. Çhe aim is to identify 30 31 and support people with mental health 32 problems, learning difficulties and other http://bmjopen.bmj.com/ 33 vulnerabilities in police stations and courts 34 35 {ocial bavigator troject. {ocial bavigator troject. ({bt) 1 /ourt 36 ({bt) [47] diversion 37 Çhe social navigator is a full time paramedic who 38 works closely with !/ÇLhb (anti-violence) 39 officers to help repeat offenders Çhe bavigator 40 on September 26, 2021 by guest. Protected copyright. 41 works with social agencies to provide care that 42 serves the need. Çhe aim is to reduce contacts 43 with repeat offenders and get them the 44 appropriate care 45 46 tolice-based specialised tolice-based specialised mental health response. 1 /o-location 47 48 mental health response Ln this model, mental 49 [101] 50 health professionals (not sworn officers) are 51 employed by the police department to provide 52 on-site and telephone consultations to officers 53 in the field. hf the departments, 12% had this 54 type of program. 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 70 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 !labama, police-based /ommunity services officers provide crisis 1 /o-location 4 specialised mental health intervention and some follow-up assistance. 5 response [145] /ommunity service officers receive 6 weeks 6 training. !lso attend social service calls 7 8 (domestic violence) where required. 9 10 9mbedded model [78] tolice [iaison Corum. 1 /o-location 11 12 /ommunity police officer dedicated to charity 13 funded hospital facilities for mental health, 14 learning disability or acquired brain injury. 15 hfficer is managed as police officer but has 16 For peer review only 17 office at the hospital. !imed to improve 18 communications, consistency of decision- 19 making, police response, and reduce number of 20 violent incidents. and have a common approach 21 to referral to criminal justice system 22 23 9mbedded model [29,95] 9mbedded model where police employ mental 2 /o-location 24 25 health professionals who assess consumers 26 brought into police stations by frontline officers. 27 28 a [ v I}•‰]šo[• a [ v I}•‰]šo[• /}oo P a všo I oth 1 {ervice 29 /ollege aental Iealth trogram was established as an institutional integration 30 trogram [43] response to escalating, national college mental model 31 health concerns. ac[ean Iospital is the first 32 http://bmjopen.bmj.com/ 33 psychiatric hospital to develop a comprehensive 34 college student program that bridges the gap 35 between a psychiatric hospital and multiple 36 campus settings as an attempt to address the 37 38 specific needs of college student-patients across 39 levels of psychiatric care and diagnostic 40 areas/programs. Üsing a bioecological systems on September 26, 2021 by guest. Protected copyright. 41 framework, this review examines (1) the 42 strategic clinical, education/outreach, and 43 44 research efforts that collectively represent a 45 paradigm shift to extend responsibility for 46 addressing serious college mental health 47 challenges beyond college and university 48 campuses, (2) the challenges and benefits of 49 50 creating stronger multi-campus/hospital 51 collaborations in order to improve our 52 understanding of college students with serious 53 mental illness, and (3) the progress in addressing 54 these needs more effectively and in establishing 55 56 documented best practices and policies through 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 71 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 effective and innovative partnerships. 4 5 /ommunity-care betwork coordinator (often community 1 {ervice 6 networks[55] psychiatric nurse). tatient reported by one of integration 7 the network partners who gather relevant model 8 information and if necessary the coordinator 9 10 starts intensive outreach to contact the person. 11 ! plan of action is established and the 12 coordinator monitors implementation. !s soon 13 as possible community care involvement is 14 15 reduced and responsibility is transferred to the 16 For mostpeer appropriate review agency e.g. mental only health. 17 18 Çhe {afety bet Çhis is a multiagency integrated model of 1 {ervice 19 /ollaborative [93] preventive services for at-risk youth involving integration 20 mental health providers, police officers, schools, model 21 and the department of youth and families. Çhe 22 23 aim of the service was to decrease youth arrest, 24 decrease youth violence, improve school 25 attendance and completion, and reduce 26 symptoms of mental illness and psychological 27 distress. botably in this program, youth police 28 29 officers are actively involved in the follow-up 30 and outreach to at-risk youth. 31 32 Wuvenile justice policy /omprehensive three-pronged approach to 1 /omprehensiv http://bmjopen.bmj.com/ 33 reform, advocacy and reducing in-school arrests through reforms to e systems 34 systems coordination juvenile justice policy, advocacy and systems organisation 35 36 efforts, and changes to coordination efforts, and changes to school 37 school practice and practice and policy 38 policy from an 39 interdisciplinary 40 collaborative approach on September 26, 2021 by guest. Protected copyright. 41 42 [96] 43 44 troject {h.9LÇ [119] troject {h.9LÇ, which included six elements: (1) 1 /omprehensiv 45 safe school environment, e systems 46 organisation 47 (2) alcohol and other drug and violence 48 prevention and early intervention programs, (3) 49 school and community mental health preventive 50 and treatment intervention services, (4) early 51 52 childhood psychosocial and emotional 53 development programs, (5) educational reform, 54 and (6) safe school policies. !imed to provide 55 students and their families with enhanced 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 72 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 comprehensive educational, mental health, 4 social service, law enforcements and juvenile 5 justice services that promote healthy childhood 6 development and prevent violence and alcohol 7 8 and other drug abuse. Ln this model, school 9 police officers worked with other agencies to 10 encourage pro-social behaviour and reduce drug 11 use 12 13 {chool weferral {chool weferral weduction trotocol 1 /omprehensiv 14 weduction trotocol [137] e systems 15 Lntegrates community systems to reduce 16 For peer review only organisation 17 reliance on punitive measures while at the same 18 time providing additional resources for school 19 systems to assess and treat disruptive students. 20 21 tolice agencies use tolice agencies use mental health professional 1 /onsultation 22 mental health consultants working with police negotiation model 23 professional consultants teams in hostage and barricade situations. Çhe 24 25 to the negotiation team aim of the model is to preserve life, apprehend 26 the perpetrator and protect property 27 [98] 28 29 30 31 Çhe multidisciplinary Çhe multidisciplinary 1 /onsultation 32 model http://bmjopen.bmj.com/ 33 mental health care team mental health care team, provides a backup of 34 [42] skilled mental health workers to the general 35 hospital and community support services such as 36 the police, and contributes to the skill 37 development of staff, and maximizes the 38 39 resources provided by a specialist team 40 on September 26, 2021 by guest. Protected copyright. 41 hldham thone hldham thone Çriage/w!L5 tilot troject, 1 /onsultation 42 Çriage/w!L5 tilot troject consists of a 24-hour telephone number for model 43 [62] professional advice and assistance from w!L5 44 (wapid !ssessment Lnterface and 5ischarge), the 45 46 ÇŒµ•š[• ‰•ÇZ]šŒ] o]]•}v • ŒÀ] X ÇZ ]u Á• š} 47 provide a service available to local police officers 48 who attend incidents where an individual 49 appears to be experiencing mental health 50 problems. 51 52 ZW}]vš µoš tŒ}š š]}v ZW}]vš µoš tŒ}š š]}v LvÀ •š]Pš]}v•[ šŒ]v]vPU ]v 1 Woint 53 54 LvÀ •š]Pš]}v•[ šŒ]v]vPU o]v Á]šZ šZ ÜY P}À Œvu vš ‰}o]ÇU Zb} { Œ š•[X investigation 55 in line with the ÜY Çhe aim was to improve the conduct of joint or training 56 P}À Œvu vš ‰}o]ÇU Zb} multi-agency adult protection investigations by 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 73 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 {X Œ š•[ [80] social care and health professionals and to 4 promote collaborative working in order to 5 achieve best practice in joint investigations and 6 in supporting the vulnerable adults involved. 7 8 Woint investigation tilot scheme of joint training for the police and 1 Woint 9 10 training [58] Iomefirst community trust-focussing on inter- investigation 11 agency reporting and investigation of crimes training 12 committed against vulnerable adults. Çraining 13 aimed to provide opportunities for police 14 15 officers and social workers to explore issues 16 For aroundpeer joint investigation review of crimes committedonly 17 against vulnerable adults. 18 19 trime Çime troject [139] Çhe project makes contact with youths and their 1 we-entry 20 families while the youths are detained and then 21 follows them into the community upon release. trogrammes 22 23 !ctivities include:(1) structured activities in a 24 local community center;(2) vocational training, 25 including hands-on job skills training; (3) training 26 such as social skills, affect management, 27 interpersonal problem-solving, and drug and 28 29 alcohol abuse; and (4) a youth and parent group 30 meeting 31 32 troject [ink [128] troject [ink 1 we-entry http://bmjopen.bmj.com/ 33 34 ! consortium of community service agencies trogrammes 35 based on assertive community treatment and 36 intensive case management. Çhere is a mobile 37 38 treatment team and case advocates in each of 39 five agencies who link consumers to psychiatric, 40 medical, residential and social services in the on September 26, 2021 by guest. Protected copyright. 41 community 42 43 Z{‰ l]vP µ‰ (}Œ iµ•š] [U {pecial measures throughout the criminal justice 1 {pecial 44 {pecial measures to system to protect vulnerable and intimidated protective 45 46 protect vulnerable witnesses. {pecial measures were brought under measures 47 witnesses [57] the 1999 /riminal Wustice !ct. Çhis aimed to 48 improve how vulnerable and intimidated 49 witnesses are treated. Çhis included the 50 identification and support of vulnerable 51 52 witnesses. 53 54 /hild 5evelopment- /hild 5evelopment-/ommunity tolicing troject. 1 {pecial 55 /ommunity tolicing /omprises: training; police exposure to social protective 56 and clinical services and clinician exposure to 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 74 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 troject [123] police practice; 24 hour access to clinician; case measures 4 conferences. 5 6 7 troject [ifesaver [130] teople enrolled in the project wear a 1 {pecial 8 personalised wristband tracking device. Çeams protective
9 are specially trained to use electronic tracking measures 10 equipment and how to approach a person who 11 12 has special needs and gain their trust. 13 14 Lntegrated model [93] 9arly tsychosis trogram, an integrated model of 1 Lntegrated 15 enhanced management within an adult mental model 16 For healthpeer service. Çhereview aim is to provide onlycontinuity, 17 familiarity and 18 19 support at an early stage throughout all settings 20 21 in the health service in order to facilitate trust, 22 reduce distress and trauma 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
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1 PRISMA 2009 Checklist 2 3 Reported 4 Section/topic # Checklist item 5 on page # 6 7 TITLE 8 Title 1 Identify the report as a systematic review, meta-analysis, or both. 1 9 10 ABSTRACT 11 Structured summary 2 Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, 2 12 participants,For and interventions; peer study appraisal review and synthesis methods; only results; limitations; conclusions and 13 implications of key findings; systematic review registration number. 14 15 INTRODUCTION 16 Rationale 3 Describe the rationale for the review in the context of what is already known. 4 17 Objectives 4 Provide an explicit statement of questions being addressed with reference to participants, interventions,http://bmjopen.bmj.com/ 18 5 comparisons, outcomes, and study design (PICOS). 19 20 METHODS 21 Protocol and registration 5 Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide 22 5 registration information including registration number. 23 24 Eligibility criteria 6 Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, 5 25 language, publication status) used as criteria for eligibility, giving rationale. on September 26, 2021 by guest. Protected copyright. 26 Information sources 7 Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify 6 27 additional studies) in the search and date last searched. 28 29 Search 8 Present full electronic search strategy for at least one database, including any limits used, such that it could be Appendix 30 repeated. 2 31 32 Study selection 9 State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, 6 included in the meta analysis). 33 - 34 Data collection process 10 Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes 6 35 for obtaining and confirming data from investigators. 36 Data items 11 List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and 37 6 simplifications made. 38 39 Risk of bias in individual 12 Describe methods used for assessing risk of bias of individual studies (including specification of whether this was Not 40 studies done at the study or outcome level), and how this information is to be used in any data synthesis. applicable 41 as 42 43 scoping 44 review 45 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
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1 PRISMA 2009 Checklist 2 3 Summary measures 13 State the principal summary measures (e.g., risk ratio, difference in means). 4 N/A 5 Synthesis of results 14 Describe the methods of handling data and combining results of studies, if done, including measures of consistency 6 2 6 (e.g., I ) for each meta-analysis. 7 8 Page 1 of 2 9 Reported Section/topic # Checklist item 10 on page # 11 12 Risk of bias across studies 15 Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective N/A reportingFor within studies). peer review only 13 14 Additional analyses 16 Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating 6 15 which were pre-specified. 16 17 RESULTS http://bmjopen.bmj.com/ 18 Study selection 17 Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at 7 19 each stage, ideally with a flow diagram. 20 21 Study characteristics 18 For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and 8-11 provide the citations. 22 23 Risk of bias within studies 19 Present data on risk of bias of each study and, if available, any outcome level assessment (see item 12). N/A 24 25 Results of individual studies 20 For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each N/A intervention group (b) effect estimates and confidence intervals, ideally with a forest plot. on September 26, 2021 by guest. Protected copyright. 26 27 Synthesis of results 21 Present results of each meta-analysis done, including confidence intervals and measures of consistency. N/A 28 29 Risk of bias across studies 22 Present results of any assessment of risk of bias across studies (see Item 15). N/A 30 Additional analysis 23 Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item 16]). 11-16 31 32 DISCUSSION 33 Summary of evidence 24 Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to 16 34 key groups (e.g., healthcare providers, users, and policy makers). 35 36 Limitations 25 Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of 17 37 identified research, reporting bias). 38 Conclusions 26 Provide a general interpretation of the results in the context of other evidence, and implications for future research. 19 39 40 FUNDING 41 42 Funding 27 Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the 20 systematic review. 43 44 45 From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMAFor peer Group review (2009). only Preferred - http://bmjopen.bmj.com/site/about/guidelines.xhtml Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
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1 PRISMA 2009 Checklist 2 3 doi:10.1371/journal.pmed1000097 4 For more information, visit: www.prisma-statement.org. 5 Page 2 of 2 6 7 8 9 10 11 12 For peer review only 13 14 15 16 17 http://bmjopen.bmj.com/ 18 19 20 21 22 23 24 25 on September 26, 2021 by guest. Protected copyright. 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
Inter-agency collaboration models for people with mental ill-health in contact with the police: a systematic scoping review
ForJournal: peerBMJ Open review only Manuscript ID bmjopen-2017-019312.R2
Article Type: Research
Date Submitted by the Author: 13-Feb-2018
Complete List of Authors: Parker, Adwoa; University of York, York Trials Unit, Department of Health Sciences Scantlebury, Arabella; Newcastle University Institute for Health and Society Booth, Alison; York University, University of York, York Trials Unit, Department of Health Sciences ARRC Building Department of health Sciences, Faculty of Sciences Macbryde, Jillian; University of York, York Management School Scott, William; North Yorkshire Police Wright, Kath; University of York, Centre for Reviews & Dissemination McDaid, Catriona; University of York, York Trials Unit
Primary Subject Mental health Heading: http://bmjopen.bmj.com/
Health services research, Legal and forensic medicine, Mental health, Public Secondary Subject Heading: health
police, MENTAL HEALTH, systematic scoping review, inter-agency Keywords: collaboration
on September 26, 2021 by guest. Protected copyright.
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1 2 3 4 5 INTER-AGENCY COLLABORATION MODELS FOR PEOPLE WITH MENTAL 6 7 ILL-HEALTH IN CONTACT WITH THE POLICE: A SYSTEMATIC SCOPING 8 9 REVIEW 10
11 12 1* 2 1 3 4 13 Adwoa Parker , Arabella Scantlebury , Alison Booth , Jillian Catherine MacBryde , William J Scott , 14 5 1 Kath Wright , Catriona McDaid 15 16 For peer review only 17 18 AUTHOR AFFILIATIONS 19 1 20 York Trials Unit, Department of Health Sciences, University of York, YO10 5DD, UK 21 22 2University of Newcastle, Institute of Health and Society, Baddiley-Clark Building, NE2 4AX, UK 23 24 3The York Management School, University of York, YO10 5DD, UK 25 26 27 4North Yorkshire Police, Newby Wiske Hall, Northallerton, North Yorkshire, DL7 9HA, UK 28 29 5Centre for Reviews and Dissemination, University of York, YO10 5DD, UK 30 31 32 http://bmjopen.bmj.com/ 33 CORRESPONDING AUTHOR 34 35 *Adwoa Parker, Email: [email protected] 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 WORD COUNT: 3794 42 43 44 45 Key Words: Police, mental health, systematic scoping review, inter-agency-collaboration 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 1 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 2 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 ABSTRACT 4 5 6 Objective: To identify existing evidence on inter-agency collaboration between law enforcement, 7 emergency services, statutory services and third sector agencies regarding people with mental ill- 8 9 health. 10 11 Design: Systematic scoping review. Scoping reviews map particular research areas to identify 12 13 research gaps. 14 15 Data sources and eligibility: ASSIA, CENTRAL, the Cochrane Library databases, Criminal Justice 16 Abstracts, ERIC, Embase,For MEDLINE, peer PsycINFO, review PROSPERO and Socialonly Care Online and Social Sciences 17 18 Citation Index, were searched up to 2017, as were grey literature and hand searches. Eligible articles 19 20 were empirical evaluations or descriptions of models of inter-agency collaboration between the police 21 and other agencies. 22 23 24 Study appraisal and synthesis: Screening and data extraction were undertaken 25 independently by two researchers. Arksey’s framework was used to collate and map included studies. 26 27 28 Results: One hundred and twenty-five studies were included. The majority of articles were of 29 descriptions of models (28%), mixed methods evaluations of models (18%) and single service 30 31 evaluations (14%). The most frequently reported outcomes (52%) were ‘organisational or service level 32 http://bmjopen.bmj.com/ 33 outcomes’ (e.g. arrest rates). Most articles (53%) focused on adults with mental ill-health, whilst others 34 focused on adult offenders with mental ill-health (17.4%). Thirteen models of inter-agency 35 36 collaboration were described, each involving between 2-13 agencies. Frequently reported models were 37 ‘pre-arrest diversion’ of people with mental ill-health (34%), ‘co-response’ involving joint response by 38 39 police officers paired with mental health professionals (28.6%) and ‘jail diversion’ following arrest 40 on September 26, 2021 by guest. Protected copyright. 41 (23.8%). 42 43 Conclusions: We identified 13 different inter-agency collaboration models catering for a range of 44 45 mental health related interactions. All but one of these models involved the police and mental health 46 services or professionals. Several models have sufficient literature to warrant full systematic reviews of 47 48 their effectiveness, while others need robust evaluation, by RCT where appropriate. Future evaluations 49 should focus on health related outcomes and the impact on key stakeholders. 50 51 52 53
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1 2 3 Strengths and limitations of this study 4 5 • This is the first, broad scoping review to map the evidence available for inter-agency 6 collaboration models between the police and other agencies, for people with apparent mental 7 8 ill-health. 9 • We undertook rigorous searches for the available literature, including grey literature, led by an 10 11 information specialist with input from the team, including a police officer. 12 13 • Two reviewers independently undertook study selection and the data extraction and study 14 coding was checked by a second researcher to ensure robustness in these processes. 15 16 • The lack ofFor an assessment peer of study qualityreview and synthesis onlyof the findings means we were unable 17 to make conclusions about the effectiveness of individual models. 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 3 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 4 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 BACKGROUND 4 5 Globally, there has been increasing policy and legislative focus on inter-agency collaboration for people 6 with mental ill-health coming into contact with the police and other statutory agencies such as 7 8 healthcare providers.[1-7] In recent decades in the UK and elsewhere, mental health legislation has 9 required health departments to establish jointly agreed policies with other statutory agencies to 10 11 manage people with a range of mental ill-health.[3,4,8,9] 12 13 Inter-agency collaboration, also known as ‘integrated’, ‘multi-agency’ or ‘inter-professional’ 14 15 collaboration,[10,11] takes many forms [12] ranging from a low level of joint decision-making with 16 For peer review only 17 limited shared resources to multifaceted, fully-integrated services.[13,14] Regardless of the form, 18 inter-agency collaboration generally involves three core principles of information sharing, joint 19 20 decision-making and coordinated intervention.[2,15] Inter-agency collaborations involving the police 21 aim to improve health and social care outcomes for individuals with mental ill-health and the cost and 22 23 effectiveness of services.[16,17] 24 25 A disproportionate number of people with mental ill-health come into contact with police, who are 26 27 often the first public service to interact with such individuals. Between 20-45% of police time is spent 28 engaging with people experiencing mental ill-health, as victims, witnesses or offenders.[18] However, 29 30 mental ill-health is often unrecognised and poorly handled by the police, meaning that many people 31 end up incarcerated rather than receiving appropriate treatment.[19] 32 http://bmjopen.bmj.com/ 33 34 There have been few systematic reviews of inter-agency collaboration models involving the police, 35 with no current registered ongoing review; so the impacts, particularly health-related, of such models 36 37 remain unclear. One review focused on guidance and research in the UK related to information-sharing 38 39 practices within mental health services and the organisations they work in partnership with.[20] Other 40
reviews have focused on inter-agency working in general rather than law enforcement on September 26, 2021 by guest. Protected copyright. 41 42 agencies.[11,12,21,22] The extent, range and nature of the available literature on inter-agency 43 collaboration between the police and other agencies are unclear. 44 45 46 We therefore undertook a systematic scoping review of inter-agency collaboration models involving 47 the police or other law enforcement organisations and emergency services, health and social care and 48 49 third sector organisations, aimed at supporting people with mental ill-health. Scoping reviews are used 50 in complex areas or where there is no existing systematic review. They provide a map of ‘the key 51 52 concepts underpinning a research area and the main sources and types of evidence available’.[23] It is 53 54 then possible to identify areas where a full systematic review would be feasible and worthwhile, such 55 as to capture the effectiveness of certain interventions on health outcomes. 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 4 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 5 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 AIMS AND OBJECTIVES 4 5 We aimed to identify and map the existing research evidence evaluating and describing inter-agency 6 collaboration between the police or law enforcement and emergency services, health service, social 7 8 care, education and third sector agencies for people who appear to be suffering from mental health 9 disorder. 10 11 12 Our specific objectives were to identify and map the evidence available on: 13 14 1. Models or mechanisms for inter-agency collaboration that have been described and/or 15 16 evaluatedFor peer review only 17 2. The broad areas and issues covered 18 19 3. Views and experiences of the collaborative models 20 21 22 23 METHODS 24 We undertook a systematic scoping review of the published evidence. This followed systematic review 25 26 methodology, except for quality assessment of studies and the evidence identified is mapped rather 27 than the findings synthesised.[24] The protocol was made publicly available a priori via our project 28 29 website.[25] 30 31 32 Inclusion and exclusion criteria http://bmjopen.bmj.com/ 33 Eligible studies were empirical evaluations or descriptions of models of inter-agency collaboration 34 35 between the police and other organisations dealing with members of the public of any age appearing 36 to suffer from mental disorder, mental vulnerability or learning disability. We include all terms used to 37 38 describe inter-agency working, ranging from active collaboration (e.g. ‘inter-agency’ or inter- 39 professional collaboration) to professionals or services working in parallel with limited collaboration 40 on September 26, 2021 by guest. Protected copyright. 41 between them (e.g. ‘multiagency’ or ‘multiprofessional’ working) (see Appendix 1). In this manuscript 42 43 we predominantly use the term ‘inter-agency’; however ‘multi-agency’ is used where this is the term 44 used in the original papers. Evidence and international literature from Organisation for Economic Co- 45 46 operation and Development (OECD) countries were included. Studies with any or no comparator were 47 included. All outcomes measured were eligible for inclusion. 48 49 50 We excluded: studies undertaken in the prison setting since separate arrangements exist for prisons; 51 non-English language studies; studies where the inter-agency collaboration was focused solely on 52 53 substance abuse; and Inter-agency collaboration without the involvement of the police. Appendix 1 54 lists the full inclusion and exclusion criteria. 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 5 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 6 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Search strategy 4 5 The following electronic databases were searched from inception to March 2017 by an information 6 specialist: ASSIA, CENTRAL, Cochrane Database of Systematic Reviews, Database of Abstracts of 7 8 Reviews of Effects (DARE), Criminal Justice Abstracts, ERIC, MEDLINE, Embase, PsycINFO, Social Care 9 Online and Social Sciences Citation Index. The Cochrane Effective Practice and Organisation of Care 10 11 and PROSPERO were searched for relevant reviews. 12 13 The search strategy for ASSIA is provided in Appendix 2; the complete search strategies are available 14 15 from the authors on request. Searches were comprehensive and broadly combined domain terms and 16 their associationsFor for ‘inter-agency’ peer and ‘police’ review and ‘mental health’. only ‘Google Advanced Search’ was 17 18 used to identify documents and the websites of organisations such as the Centre for Mental Health, 19 20 Crisis Care Concordat, NHS England and the Society for Evidence Based Policing. We contacted the UK 21 College of Policing for relevant evaluations. The reference lists of eligible studies were hand searched. 22 23 24 Study selection and data extraction 25 Search results were downloaded into Endnote and duplicate references removed before titles and 26 27 abstracts were screened. Study selection was undertaken independently by two researchers. 28 Discrepancies were resolved by discussion or by recourse to a third researcher. Data extraction forms 29 30 were developed and piloted. One researcher extracted data and classified the included studies and this 31 32 was checked by a second researcher. Discrepancies were resolved by discussion or by recourse to a http://bmjopen.bmj.com/ 33 third researcher. Data extraction forms were developed for primary/descriptive studies and for 34 35 reviews. Information extracted included: type of study; model of inter-agency collaboration; target 36 audience; agencies involved; study setting and context; purpose of inter-agency collaboration; 37 38 outcomes evaluated; and whether stakeholder perspectives were evaluated. 39 40 Strategy for collating, summarising and reporting the data on September 26, 2021 by guest. Protected copyright. 41 42 We mapped the literature, following Arksey’s [26] framework. This involved developing a chart which 43 44 outlined key variables of data to be extracted. Data was extracted from the original papers into the 45 relevant sections of the chart; and were subsequently sorted and shifted according to key issues and 46 47 themes. This process is akin to a ‘narrative review’ in a standard systematic review. We firstly present 48 basic numerical analysis of the extent, nature and distribution of the studies. We collated: the 49 50 geographic and chronological distribution of studies, agencies involved and the care recipient groups; 51 52 research methods adopted; outcome measures reported; and inter-agency models. We grouped 53 studies according to the name of the inter-agency collaboration model and the definition of the model, 54 55 as provided by the authors. We then used the terminology reported in the primary papers to code and 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 6 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 7 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 categorise the different models. We present the studies grouped by the different models of inter- 4 agency collaboration. 5 6 7 8 RESULTS 9 10 11 Overview of included studies 12 After deduplication there were 2802 records; 340 full text articles were reviewed independently by 13 14 two authors and 125 were included (Figure 1). 15 16 Figure 1: FlowchartFor of study selectionpeer process, review adapted from PRISMA only [27] 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 7 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 8 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 The studies were from 8 countries: Australia,[28-42] Canada,[43-51] Denmark 4 5 ,[52] France,[53] Ireland,[54] Netherlands,[55] UK,[56-92] and USA;[93-149] two multinational studies 6 7 were undertaken in Australia, Canada and the USA.[111,150] The majority of studies were from the 8 USA (45%) and the UK (29%). 9 10 11 Study Design 12 The study designs of the 125 included articles are given in Table 1. Definitions for our classification of 13 14 study designs are in Appendix 3. 15 16 Table 1: ResearchFor methods adoptedpeer review only 17 18 19 Study Design Number of Reference number 20 studies (%) 21 Audit 3 (2.4%) [41,42,84] 22 Case study 6 (4.8%) [58,70,76,97,137,141] 23 Scoping review 1 (0.8%) [43] 24 25 Qualitative 11 (8.8%) [29,35,48,49,60,82,83,91,133,150,151] 26 27 Mixed methods 23 (18.4%) [28,30-32,37,50,52-54,57,62,66- 28 68,71,90,105,110,119,142,143,147,148] 29 Controlled before and 15 (12%) [40,55,64,65,69,74,80,89,115,121,131,132,135,145,149] 30 after study 31 Service evaluation 18 (14.4%) [36,39,44,73,75,81,86- 32 88,92,94,95,113,117,120,122,125,138] http://bmjopen.bmj.com/ 33 Survey 12 (9.6%) [59,61,77,85,101,106,109,111,124,136,144,152] 34 35 Description of model 35 (28%) [33,34,38,45-47,51,56,63,78,79,93,96,98-100,102- 36 104,107,108,112,114,116,118,123,126- 37 130,134,139,140,146] 38 Prospective 1 (0.8%) [72] 39 observational study 40
on September 26, 2021 by guest. Protected copyright. 41 42 43 Outcomes assessed 44 There was a wide range of outcomes assessed, with some studies reporting multiple outcomes. Where 45 46 this occurred we report outcomes in all relevant categories (Table 2); therefore some studies are 47 presented in multiple categories. The most frequently occurring outcomes (66 studies) were 48 49 ‘organisational or service level outcomes’. The views and experiences of agency staff were investigated 50 51 in 28 studies. 52 53 Table 2: Outcomes assessed 54 55 Outcomes assessed Number of Reference number 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 8 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 9 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 studies (%) 4 Organisational/service level 66 (52%) [30-33,36,39,40,42,44,47,50,51,54,55,59,62-65,69,71- 5 6 outcomes (e.g. arrest rates, 77,81,84-89,93,94,96,97,101,106,108-111,113,115,117,119- 7 8 diversion rates, mental health 122,124,125,128,131,132,134-138,140,141,144,145,147,148] 9 referrals, court referrals and 10 11 numbers of people under 12 emergency protective custody) 13 14 Views and experiences of agency 28 (22%) [29-32,35,37,48- 15 staff (e.g. police officers) 50,52,53,57,66,67,71,83,90,95,105,110,119,124,133,142,143,1 16 For peer review only 17 47,151] 18 19 Views and experiences of people 18 (14.2%) [30,31,44,48-50,53,54,57,59,60,66,67,90,91,110,119,152] 20 in community (e.g. service users, 21 22 families and carers) 23 Service user mental health 7 (5.5%) [59,61,63,81,102,119,140] 24 25 outcomes (e.g. improvement in 26 27 mood) 28 Cost effectiveness or wider 3 (2.4%) [28,61,65] 29 30 economic costs 31 Staff learning outcomes (e.g. staff 3 (2.4%) [58,80,92] 32 http://bmjopen.bmj.com/ 33 knowledge about mental health 34 35 following mental health training) 36 No outcomes reported 28 (22%) [34,38,43,45,46,56,70,78,79,98- 37 38 100,103,104,107,112,114,116,118,123,126,127,129,130,139,1 39 46,150] 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 Study population 45 The majority of articles (n=67) focused on adults, either diagnosed with or perceived to have a mental 46 47 health problem, such as psychoses or severe mental illness (Table 3). A number of articles focused on 48 adult offenders with mental ill-health (n=22) or adults with mental health and/or substance misuse 49 50 problems (n=7). Articles including children and youth generally focused on those who had been 51 exposed to or victimised by violence (n=4); child offenders with mental health and/or substance abuse 52 53 problems (n=3); or those with behavioural problems (n=2). Three articles included children and adults. 54 55 Table 3: Care recipient group 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 9 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 10 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Care recipient group Number of Reference number 4 studies (%) 5 6 Adults Mental ill-health 67 (53.2%) [28-37,40-43,45,46,48- 7 8 50,54,55,64,65,67- 9 69,71,72,74,77,82,83,88,90,92,94,95,97, 10 11 99,101- 12 106,109,114,117,118,120,122,124,126- 13 14 128,131,133,136,138,141,143,145,146,1 15 48-150] 16 For peer review only 17 Mental health and/or substance misuse dual 7 (5.6%) [44,52,62,113,134,135,152] 18 19 diagnosis 20 Mental health, substance misuse dual 3 (2.4%) [108,129,142] 21 22 diagnosis and/or homelessness 23 Learning disabilities 3 (2.4%) [56,79,80] 24 25 Mental ill-health and homelessness 1 (0.8%) [53] 26 27 Offenders with mental illness 22 [32,47,51,59,63,73,76,81,84- 28 87,89,91,107,111,112,115,121,132,144, 29 30 151] 31 Offenders with learning disabilities 1 (0.8%) [70] 32 http://bmjopen.bmj.com/ 33 Individuals with pathological fixations, 4 (3.2%) [38,39,75,98] 34 35 deemed to be mentally ill 36 Vulnerable adults, including mental health, 5 (4%) [57,58,60,61,100] 37 38 learning disabilities and other special needs 39 Children At risk children and youth 4 (3.2%) [93,116,119,147] 40 on September 26, 2021 by guest. Protected copyright. 41 and young Offenders with learning disabilities 1 (0.8%) [66] 42 43 people Offenders with mental health and/or 3 (2.4%) [110,139,140] 44 substance abuse problems 45 46 Behavioural problems 2 (1.6%) [96,137] 47 48 Children and adolescents who have been 1 (0.8%) [123] 49 exposed to or victimized by violence 50 51 Men, women, adolescents and older people 1 (0.8%) [78] 52 with mental health, learning disability or 53 54 acquired brain injury. 55 Mixed Children and families exposed to violence 1 (0.8%) [125] 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 10 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 11 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 adults and and trauma 4 children People with Alzheimer’s, children with autism 1 (0.8%) [130] 5 6 and Down syndrome 7 8 Men, women, adolescents and older people 1 (0.8%) [78] 9 with mental health, learning disability or 10 11 acquired brain injury 12
13 14 15 Models of inter-agency collaboration and agency composition 16 For peer review only 17 Thirteen different models of inter-agency collaboration were described in the included articles; 18 although there were often overlaps in agency composition. A number of articles reported on more 19 20 than one model; therefore papers are represented in each relevant section. The terminologies used to 21 describe the different models of inter-agency collaboration were directly derived from the primary 22 23 papers. Detailed descriptions of the models are provided in Appendix 4. 24 25 The models identified involved collaborations between the police and a wide range of other services 26 27 (Table 4). The ‘consultation model’ and ‘joint investigation training’ only involved the police and 28 mental health services; the remaining models were highly multi-disciplinary involving a range of 29 30 organisations. Information sharing agreements and court diversion models involved the widest 31 32 combination of agencies. Across all collaborations with the police, mental health clinicians, mental http://bmjopen.bmj.com/ 33 health services and criminal justice agencies were the most frequently occurring partners. 34 35
36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 11 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml
Witness services Witness BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
Welfare services Welfare
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services workers/social Social
Schools/Colleges
Probation services Probation
Primary care Primary
Policy makers Policy
Police
Nurses
Mental health services health Mental
Mental health clinicians health Mental
Housing services Housing
Hospitals (acute general) (acute Hospitals
30
of of
Employment support Employment Agency composition composition Agency
12
Emergency services Emergency
Page Page
Courts/criminal justice Courts/criminal
Community organisations Community
BMJ Open Children and family family and Children services services
http://bmjopen.bmj.com/
Ambulance
Advocacy
Adult protection services protection Adult
Addiction services Addiction
on September 26, 2021 by guest. Protected copyright.
24 hour crisis services crisis hour 24
For peer review only For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml
Type of model (number of studies) of studies) (number model of Type Integrated model (n=1) (n=1) model Integrated Re-entry programmes (n=2) (n=2) programmes Re-entry Joint investigation training (n=2) (n=2) training investigation Joint Consultation model (n=3) (n=3) model Consultation Special protective measures (n=3) (n=3) measures protective Special Comprehensive systems organisation organisation systems Comprehensive (n=3) Service integration model (n=3) (n=3) model integration Service Co-location (n=5) (n=5) Co-location Court Diversion (n=11) (n=11) Diversion Court Information sharing agreement models models agreement sharing Information (n=13) Post-booking jail diversion (n=30) (n=30) diversion jail Post-booking Co-response (n=36) (n=36) Co-response Pre-arrest diversion (n=43) (n=43) diversion Pre-arrest
Table 4: Overview of models and agency composition composition agency and models of Overview 4: Table
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1 2 3 4 Pre-arrest diversion 5 The most frequently reported model (43 articles), was pre-arrest diversion, from 6 7 Australia;[30,31,33,34,36,38] Canada;[43,45] the UK;[61,68,75] 8 USA;[29,94,95,97,99,101,103,104,114,116-118,124,126,127,129,133-135,138,143,145,149]; and two 9 10 multi-national articles involving Australia, Canada and the US.[111,150] Pre-arrest diversion models are 11 12 described as involving police officers who had special mental health training, serving as the first-line 13 police response to mental health crises in the community and acting as liaisons to the formal mental 14 15 health system. The reported purpose of pre-arrest diversion models was to equip police officers to 16 better manage situationsFor involving peer people withreview mental health, substanceonly abuse, and/or homelessness 17 18 problems who became involved with the police, and to offer treatment as an alternative to arrest. The 19 20 most widely reported pre-arrest diversion model was the US-based Crisis Intervention Team (CIT) 21 model.[29,34,43,99,103,104,111,114,116,118,124,126,127,133,138,145,150] CIT is a police-based first- 22 23 responder programme for people in mental health crisis who come into contact with the police and 24 provides police-based crisis intervention training. This model involved collaboration between police, 25 26 emergency services, and treatment providers such as clinical staff from local health departments, 27 hospital emergency departments, and specialised mental health services. CIT trained officers worked in 28 29 partnership with mental health professionals to assist people with mental illness, family members, and 30 31 other police officers. 32 http://bmjopen.bmj.com/ 33 Co-response 34 35 Co-response models were reported in 36 articles, from Australia;[28,29,32,33,35,41] 36 Canada;[33,43,44,48-50] UK;[43,69,71,90] USA;[95,101,102,105,106,111-113,122,131,146,152] and 37 38 multinational studies involving Australia, Canada and the UK.[111,150] In this model, a shared protocol 39 paired specially trained police officers with mental health professionals to attend police call outs 40 on September 26, 2021 by guest. Protected copyright. 41 involving people with mental ill-health. The reported aims were to provide assistance to people in 42 43 mental health crisis and prevent their unnecessary incarceration or hospitalisation. An example of this 44 model is the UK based ‘Street Triage’,[69,71,90] where a dedicated police officer and psychiatric nurse 45 46 together attend the scene of incidents requiring support for mental health needs. In Street Triage, the 47 team did not provide the initial response to events. Rather, police call handlers allocated incidents to 48 49 the Street Triage team if the incident required additional mental health support. Telephone support to 50 51 police colleagues attending a new incident was provided if the team were already busy. 52 53 Post-booking jail diversion 54 55 Thirty articles reported post-booking jail diversion programmes, from the UK 56 [59,63,65,66,70,72,74,81,83,84,86,87,89] and USA.[107,108,110,115,121,127,132- 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 13 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 14 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 134,140,141,143,149] This is a multi-agency liaison scheme, comprising of a rapid screening and 4 mental health assessment of people arrested at the earliest point of contact with the criminal justice 5 6 system, plus a mechanism for appropriate referral or diversion to health, treatment, social and 7 community services. An example is Diversion at the Point of Arrest (DAPA),[86,87] a UK based model in 8 9 which people arrested and detained at police stations were assessed by a community psychiatric 10 11 nurse, who then acted as the co-ordinator for the involvement of other mental health care workers 12 and services as needed. 13 14 15 Information sharing agreement models 16 Information sharingFor agreement peer models were review reported in 13 papersonly from Australia;[37] Canada;[46] 17 18 Denmark;[52] France;[53] the UK;[56,67,70,85] and USA.[100,144] In this model information about 19 20 people with mental ill-health were shared between police and other agencies; or between the 21 individual with mental ill-health and the police and other agencies. The reported aims of information 22 23 models were to improve support to people with mental ill-health; foster better relations between 24 agencies and between the police and people with mental ill-health; identify hard-to-find at risk people 25 26 with mental ill-health; and protect the public from offenders with mental ill-health. An example is the 27 Multi-Agency Public Protection Arrangements (MAPPA) which aims to protect the public from harm by 28 29 sexual and violent offenders, who may have mental ill-health.[85] Agency composition includes the 30 31 police, other law enforcement agencies and mental health services. MAPPA agencies work together by: 32
identifying individuals who should be under MAPPA; managing such individuals; multi-agency storing http://bmjopen.bmj.com/ 33 34 and sharing information about offenders; disclosure of information to the public about individual 35 offenders in particular circumstances; risk assessment and management; multiagency meetings and 36 37 case reviews. 38 39 Court diversion models 40 on September 26, 2021 by guest. Protected copyright. 41 Eleven articles reported court diversion models from Canada;[47] the UK;[61,64,72,76,88,153] 42 43 Ireland;[54] and USA.[74,110,136] Offenders were ‘diverted’ from prosecution and into a specialised 44 community-based service. Court diversion occurred following arrest whilst the individual was initially 45 46 detained, during initial hearings, or while being assisted by pre-trial services to offer community based 47 alternatives to standard prosecution. An example of such a service is ‘Liaison and diversion’, which 48 49 identifies and supports people with mental ill-health, learning difficulties and other vulnerabilities in 50 51 police stations and courts.[61,153] 52 53 Co-location 54 55 Co-location was a model reported in five articles from Australia;[29] the UK;[78] and USA.[95,101,145] 56 In this model, mental health professionals were employed by police departments to provide on-site 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 14 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 15 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 and telephone consultations to officers in the field. Another variant of the co-location model involved 4 a dedicated police officer being based in an office within a mental health hospital; an example of this is 5 6 the ‘Police Liaison Forum’.[78] 7 8 Comprehensive systems model 9 10 Three papers from the USA reported a ‘comprehensive systems’ approach to reducing crime and 11 12 arrests, three of which focused on reducing in school arrests.[96,119,137] Comprehensive systems 13 models typically include policy reform, multi-systems coordination and changes to practice at multiple 14 15 levels. An example was Project SOBEIT,[119] which included six elements: 1) safe school environment, 16 2) alcohol and otherFor drug andpeer violence preventionreview and early interventiononly programs, 3) school and 17 18 community mental health preventive and treatment intervention services, 4) early childhood 19 20 psychosocial and emotional development programs, 5) educational reform, and 6) safe school policies. 21 In this model school-based police officers worked with children, staff and external agencies to 22 23 encourage pro-social behaviour and reduce drug use and criminalisation. 24 25 Consultation model 26 27 Three papers from Australia;[42] the UK;[62] and USA [98] reported on a ‘consultation’ model. In this 28 model police agencies accessed advice from mental health professionals when working with people 29 30 with mental ill-health. Typically the advice was delivered over the telephone and generally aimed to 31 32 maximise the resources provided by a specialist team and to assess and prevent criminal behaviour, http://bmjopen.bmj.com/ 33 protect life, arrest the perpetrator and protect property. An example is the Oldham Phone 34 35 Triage/Rapid Assessment Interface,[62] which consisted of a dedicated 24-hour telephone number for 36 professional advice and assistance from, the local health service’s psychiatric liaison service for local 37 38 police officers. 39 40 Service integration models on September 26, 2021 by guest. Protected copyright. 41 42 Three articles from Canada;[43] the Netherlands;[55] and the USA [93] reported on ‘service 43 44 integration’ models. The agencies involved were mental health providers, police officers, educational 45 institutions, and the children and family services (see Table 4). The aims of these models were to 46 47 integrate services by creating a network to bridge gaps between services, decrease arrest, decrease 48 violence, improve educational attendance and completion, and reduce symptoms of mental illness and 49 50 psychological distress. Such models typically involve a network coordinator who provides active follow- 51 52 up. An example of a service integration model is the ‘Community-care networks’.[55] A Network 53 coordinator (often community psychiatric nurse), received reports from network partners about any 54 55 person of concern and gathered relevant information, established a plan of action and monitored 56 implementation. Responsibility was transferred to the most appropriate agency as soon as possible. 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 15 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 16 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Special protective measures 4 5 Three articles from the UK [57] and USA [123,130] focused on ‘special protective measures’, with the 6 reported aim of identifying and protecting people with mental ill-health, learning disabilities and other 7 8 vulnerable people. An example of this was ‘Speaking up for justice’,[57] a collaboration between the 9 police, the courts, hospitals and other agencies aimed at improving how vulnerable and intimidated 10 11 witnesses were treated. 12 13 Joint investigation training 14 15 Two papers from the UK reported on a ‘joint investigation training’ model,[58,80] which focused on 16 For peer review only 17 adults with mental ill-health, learning disabilities or other vulnerable adults who had crimes committed 18 against them. This model involved joint mental health training for the police, social workers, mental 19 20 health and adult protection services aimed at improving multi-agency adult protection investigations, 21 and promoting collaborative working to support vulnerable adults. An example of such training is the 22 23 ‘Joint adult Protection Investigations’ training. [58] 24 25 Re-entry programmes 26 27 Two articles from the USA [128,139] reported on ‘re-entry’ programmes, which aimed to assist 28 29 individuals with mental illness to re-integrate into the community. This included institutional and 30 community-based programmes serving individuals with mental illness following release from prison or 31 32 hospitalisation. The ‘Prime Time Project’,[139] involves a collaborative alliance with local police officers http://bmjopen.bmj.com/ 33 to involve young people with mental ill-health who have been detained by the police and involves 34 35 activities in the community training in job skills and other aspects of managing daily life. 36 37 Integrated model 38 39 One article reported an Early Psychosis Program from Australia.[40] In this model police could become 40 on September 26, 2021 by guest. Protected copyright. 41 involved in the voluntary or involuntary admission process of people with mental ill-health into the 42 Early Psychosis Programme. The aim was to provide continuity, familiarity and support at an early 43 44 stage throughout the health service to facilitate trust and reduce distress. 45 46 47 48 DISCUSSION 49 50 Overview of main findings 51 52 The scoping review identified thirteen distinctive inter-agency collaboration models for people with 53 mental ill-health in contact with the police, mainly from the US, UK and Australia. Although the 54 55 majority of articles focused on adults with mental ill-health, a substantial body of the literature 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 16 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 17 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 focused on offenders with mental illness. The area most commonly covered was the relationship 4 between the police and mental health services; unsurprising as this is a critical interface for the police 5 6 service. However, it is noteworthy that several key agencies were not identified as agency 7 collaborators. For example, the ambulance service was a named agency in only three models; yet in 8 9 countries like the UK, the legal frameworks and guidance stipulate that people with mental ill-health 10 11 taken to a health-based place of safety should ideally be transported by ambulance.[18,154] 12 Additionally, ten articles included people with dual diagnoses of mental health and substance abuse 13 14 problems, yet addiction services featured as an agency in only one of the models. This may be 15 indicative of conflicting priorities for services; however there is potential for mutual benefit through 16 For peer review only 17 greater inter-agency working. 18 19 Our review did not evaluate the risk of bias in the included studies, but in general the study designs 20 21 used are unlikely to provide robust evidence about effectiveness: there were no RCTs. The main focus 22 in the articles was the impact of the model on organisational level outcomes routinely collected by the 23 24 police such as arrest and diversion rates, which they are required to collect.[155] Several articles 25 26 reported the views and experiences of members of the public coming into contact with the service as 27 well as the different agencies involved. There are sufficient studies identified to justify development of 28 29 focussed questions for systematic review. These should include study designs relevant to the specific 30 research question, such as qualitative studies if the focus of the review is to explore stakeholder 31 32 perspectives; and experimental designs if the aim is to explore effectiveness. http://bmjopen.bmj.com/ 33 34 35 Strengths and limitations 36 A strength of our review is that the broad scope has facilitated mapping of the evidence available on 37 38 inter-agency collaboration models between the police and other agencies, to appropriately manage 39 people with apparent mental problems who come into contact with the police. The lack of an 40 on September 26, 2021 by guest. Protected copyright. 41 assessment of study quality and synthesis of the findings means we were unable to make conclusions 42 about the effectiveness of individual models. However, this scoping review provides an overview of the 43 44 literature not previously available.[26] 45 46 Identifying all available evidence on complex topics can be difficult as the relevant studies can be 47 48 spread across numerous databases covering a range of disciplines. Furthermore, the key concepts may 49 also be described using different terminology in each database so the search strategies need significant 50 51 adaptation.[156] Additionally, ‘inter-agency’ is a nebulous concept which has multiple definitions; and 52 53 is often interchanged with other terms, making studies on the topic difficult to identify. To address 54 these issues, the search strategy was extensive and thorough, and developed by an information 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 17 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 18 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialist with input from members of the team including a police officer. We also undertook grey 4 literature searches and hand searching to maximise retrieval. 5 6 7 Mapping focussed on identifying distinctive models.Two reviewers independently undertook study 8 selection and the data extraction and study coding was also checked by a second researcher to ensure 9 10 robustness in these processes. However, the identification of the models inevitably has a subjective 11 component. We have mitigated against this as far as possible through involvement of two researchers 12 13 in the mapping as well as a providing examples and descriptions of each model. We assigned each 14 15 study to a methodological grouping based on the description of the methods used, which may or may 16 not have matchedFor with the author’speer categorisation review of the study. only 17 18 19 Comparison with existing literature 20 To our knowledge this is the first systematic scoping review to focus on inter-agency collaboration 21 22 models for people with mental ill-health in contact with the police. We identified no robust evaluations 23 of models of inter-agency collaboration such as RCTs. Such a lack of evidence has been found in other 24 25 fields assessing the evidence for inter-agency models.[157] Our categorisation of the various inter- 26 27 agency models, such as ‘pre-arrest diversion’, ‘post booking diversion’ and ‘court diversion’ fits with 28 the Sequential Intercept Model.[158] The Sequential Intercept Model is a framework for 29 30 conceptualising the range of community-based alternatives for people with mental ill-health in contact 31 with the criminal justice system. The model suggests a series of ‘points of interception’ at which 32 http://bmjopen.bmj.com/ 33 interventions can be targeted to prevent individuals from entering or penetrating deeper into the 34 35 criminal justice system. Our review is broader and considers inter-agency collaboration models outside 36 the criminal justice system. For example, we highlight ‘joint investigation training’ or ‘special 37 38 protective’ models as efforts that focus on people with mental illness as victims of crime or as 39 vulnerable witnesses. 40 on September 26, 2021 by guest. Protected copyright. 41 42 Although the majority of articles focused on adults with mental ill-health, a number focused on 43 offenders with mental illness; possibly because individuals with mental ill-health are disproportionally 44 45 more likely to be arrested and enter the criminal justice system.[159,160] 46 47 Knowledge gaps and implications for research, policy and professional 48 49 practice 50 51 While not all the models may be distinctive enough to make an RCT appropriate or feasible, there are a 52 number of models where this approach would be appropriate. We identified an absence of high quality 53 54 evidence on effectiveness, despite the fact that models such as Street Triage and CIT are now routinely 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 18 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 19 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 implemented within policing. Few evaluations considered the views of people with mental ill-health, or 4 indeed the views and experiences of staff in the collaborating agencies. 5 6 7 Inter-agency collaboration models are complex interventions involving several interactive components 8 and agencies. Existing guidance on the development and evaluation of theoretically informed, complex 9 10 interventions may be useful in informing future development and evaluation of inter-agency models 11 [161]. More research is required to examine the effectiveness, cost effectiveness, barriers and 12 13 benefits of inter-agency collaboration models. The latter is important for designing ‘effective’ models 14 15 which might have significant benefit for healthcare. Whilst there is significant political pressure on 16 agencies to collaborate,[18,154,162]For peer at present review there is no clear understandingonly of the most effective or 17 18 cost-effective ways of developing, implementing and delivering such models. Future models may 19 require a more fundamental reassessment of the roles and functions of each agency and how they 20 21 work together. Furthermore, legislative and policy changes, and the speed with which they are 22 implemented over time and in different jurisdictions can influence the availability and even 23 24 preferences for certain models. For example, in the UK changes in legislation such as the 2017 Police 25 26 and Crime Act,[163] which extends Police powers under the Mental Health Act, is likely to impact on 27 the adoption of certain models. Studies in this area should move from simple descriptions of models of 28 29 care to prospective exploratory and experimental evaluations that include primary and secondary 30 outcomes. We identified sufficient literature for some models such as pre-arrest diversion, co- 31 32 response and post-booking diversion which warrant more in-depth evaluation in a systematic review; http://bmjopen.bmj.com/ 33 34 some of this research is already underway with an upcoming systematic review focusing on the 35 effectiveness of liaison and diversion, Street Triage and specialist staff embedded in police control 36 37 rooms [164]. Evaluations of the cost-effectiveness of such models would be important from a policy 38 perspective, since one of the key drivers for inter-agency collaboration is to streamline services and 39 40 improve efficiency [162] particularly in the current UK context of austerity.[165] on September 26, 2021 by guest. Protected copyright. 41 42 Health services played a significant role in many of these models; however only 5.5% of the articles 43 44 assessed patient health outcomes, pointing to a need to identify the health related benefits of inter- 45 agency collaboration for patients and carers using robust methods. More work is also needed to 46 47 develop conceptual clarity and frameworks around collaboration models encompassing people with 48 mental ill-health in contact with the police as suspects or perpetrators, as well as victims or vulnerable 49 50 witnesses. Existing work in related areas could inform such work, such as a conceptual framework 51 52 combining the concepts of primary care and integrated care to understand the complexity of 53 integrated care.[166] Future studies could include the views of people with mental ill-health in the 54 55 development and evaluation of models. Ideally, researchers should specify the influence of the 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 19 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 20 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 research context on their findings and explain any discrepancies between their findings and the 4 findings of other studies, given the differences in context. This could involve the adoption of process 5 6 evaluation methods, where guidance already exists to inform such work.[167] 7 8 9 10 CONCLUSIONS 11 We identified 13 different inter-agency collaboration models aimed at supporting people with mental 12 13 ill-health; including adults, children and different severities of condition and comorbidities. There were 14 wide variations in the number of agencies involved within the models. All but one of these models 15 16 included collaborationFor between peer the police andreview mental health professionals only and/or services; and many 17 18 of the identified models included other organisations relevant to the purpose of the collaboration. We 19 have identified models where sufficient literature exists to warrant full systematic reviews to assess 20 21 their effectiveness. We have also identified other areas which have highlighted the need for robust 22 evaluation by RCT where appropriate. Important outcomes for future evaluations should include the 23 24 impact on and experiences of the people the collaborations aim to assist, on staff from the agencies 25 26 involved, as well as health related outcomes for patients. 27 28 29 ACKNOWLEDGEMENTS 30 31 We thank Kat Chatterton for assistance with sourcing inter-library loans. 32 http://bmjopen.bmj.com/ 33 34 35 FUNDING STATEMENT 36 This work was supported by the Higher Education Funding Council for England (HEFCE) and the Home 37 38 Office through the College of Policing, grant number J05. This review is part of Connect, the Co- 39 production of policing evidence, research and training: focus mental health project 40 on September 26, 2021 by guest. Protected copyright. 41 (http://connectebp.org/). 42 43 44 45 COMPETING INTERESTS 46 The authors declare that they have no competing interests. 47 48 49 50 AUTHORS’ CONTRIBUTIONS 51 52 AP lead the review and was responsible for writing the protocol, study selection, data extraction, grey 53 literature and hand searches and writing the final report. KW devised the search strategies and carried 54 55 out the literature searches and wrote the search methodology section of the paper. AP, AB, and AS 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 20 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 21 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 undertook study selection and data extraction. AP, AB, AS, CM, JCM and WJS inputted into the study 4 conception and design. All the authors commented on the draft protocol and the final report. CM 5 6 provided input at all stages, commented on all draft documents and had overall responsibility for the 7 8 review. All authors read and approved the final manuscript. 9 10 11 DATA SHARING STATEMENT 12 13 The data extraction tables will be made available by placing a reasonable request with the lead author. 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 21 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 22 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 REFERENCE LIST 4 5 1. Department of Health and Concordat signatories. Mental Health Crisis Care Concordat Improving 6 outcomes for people experiencing mental health crisis. February 2014 7 2. Home Office. Multi-Agency Working and Information Sharing Project: Final Report. In: Office H, ed., 8 2014. 9 3. UK Crown. Mental Health Act 1983. The Stationery Office. UK, 1983. 10 4. UK Crown. Mental Health Act 2007. The Stationery Office. UK, 2007. 11 5. Home Office. Supporting vulnerable people who encounter the police: A strategic guide for police 12 forces and their partners. 2015 13 6. Home Office, Department of Health. No Secrets: Guidance on developing and implementing multi- 14 agency policies and procedures to protect vulnerable adults from abuse. In: Health HOaDo, ed. 15 London, 2000. 16 7. Health Do. StatementFor of Governmentpeer Policy review on Adult Safeguarding. only In: Health Do, ed., 2013. 17 8. National Mental Health Working Group. National safety priorities in mental health: a national plan 18 for reducing harm. In: Health Priorities and Suicide Prevention Branch DoHaA, ed. Publications 19 approval number: 3725 (JN9187) ed. Canberra: Commonwealth of Australia, 2005. 20 9. Metropolitan Police. Inter-agency joint working protocol for the management of mental health: 21 22 Metropolitan Police, 2011. 23 10. Robinson M, Atkinson M, Downing D. Supporting Theory Building in Integrated Services Research: 24 ERIC 2008. 25 11. Oliver C, Mooney A, Statham J. Integrated working: a review of the evidence. 2010 26 12. Atkinson M, Jones M, Lamont E. Multi-agency working and its implications for practice. Reading: 27 CfBT Education Trust 2007 28 13. Darlington Y, Feeney JA, Rixon K. Interagency collaboration between child protection and mental 29 health services: Practices, attitudes and barriers. Child Abuse & Neglect 2005;29(10):1085-98. 30 doi: http://dx.doi.org/10.1016/j.chiabu.2005.04.005 31 14. Walter U, Petr C. A template for family-centered interagency collaboration. Families in Society: The 32 Journal of Contemporary Social Services 2000;81(5):494-503. http://bmjopen.bmj.com/ 33 15. Home Office. Multi-Agency Working and Information Sharing Project Early Findings. In: Office H, 34 ed., 2013. 35 16. Johnson P, Wistow G, Schulz R, et al. Interagency and interprofessional collaboration in community 36 care: the interdependence of structures and values. Journal of Interprofessional care 37 2003;17(1):70-83. 38 17. Paton FCW, Wright K, Ayre N, et al. Improving outcomes for people in mental health crisis: a rapid 39 synthesis of the evidence for available models of care. Health Technology Assessment 2016:1- 40 161. on September 26, 2021 by guest. Protected copyright. 41 42 18. House of Commons Home Affairs Committee. Policing and mental health: Eleventh Report of 43 Session 2014–15. London: The Stationery Office Limited 2015 44 19. Sainsbury Centre for Mental Health. Diversion: A better way for criminal justice and mental health. 45 London: Nuffield Press 2009. 46 20. Jenkins K. Information-sharing in mental health care provision: a review. 2014 47 21. Williams I. Offender health and social care: a review of the evidence on inter‐agency collaboration. 48 Health & social care in the community 2009;17(6):573-80. 49 22. Phillips C, Considine M, Lewis R. A review of audits and strategies produced by crime and disorder 50 partnerships in 1999: Home Office, Research, Development and Statistics Directorate, Policing 51 and Reducing Crime Unit 2000. 52 23. Mays N, Roberts E, Popay J. Synthesising research evidence. Studying the organisation and delivery 53 54 of health services: Research methods 2001:188-220. 55 24. Centre for R, Dissemination. Systematic Reviews: CRD’s Guidance for Undertaking Reviews in 56 Healthcare. York: University of York 2009. 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 22 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 23 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 25. Hughes-Morley A, Clarke A, MacBryde J, et al. What models or mechanisms for inter-agency 4 collaboration between the police or law enforcement and other statutory agencies for people 5 with mental problems have been evaluated, and what evidence is available on their 6 effectiveness? A systematic scoping review 2016 [Available from: http://connectebp.org/wp- 7 content/uploads/2016/09/Inter-Agency-Scoping-Review-Protocol-v1-05.09.2016.pdf accessed 8 17th March 2017. 9 26. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. International journal 10 of social research methodology 2005;8(1):19-32. 11 27. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta- 12 analyses: the PRISMA statement. PLoS Med 2009;6(7):e1000097. 13 28. Allen Consulting Group. Police, Ambulance and Clinical Early Response (PACER) Evaluation. April 14 2012;Final Report:1-66. 15 29. Boscarato K, Lee S, Kroschel J, et al. Consumer experience of formal crisis-response services and 16 preferredFor methods peer of crisis intervention. review International only Journal of Mental Health Nursing 17 2014;23(4):287-95. doi: http://dx.doi.org/10.1111/inm.12059 18 19 30. Herrington V, Clifford K, Lawrence P, et al. The impact of the NSW police force mental health 20 intervention team: final evaluation report. New South Wales: Charles Sturt University 2009 21 31. Herrington V. Inter-agency Cooperation and Joined-up Working in Police Responses to Persons with 22 a Mental Illness: Lessons from New South Wales. Policing: A Journal of Policy & Practice 23 2012;6(4):388-97. 24 32. Hollander Y, Lee SJ, Tahtalian S, et al. Challenges Relating to the Interface Between Crisis Mental 25 Health Clinicians and Police When Engaging with People with a Mental Illness. Psychiatry, 26 Psychology and Law 2012;19(3):402-11. doi: 27 http://dx.doi.org/10.1080/13218719.2011.585131 28 33. Huppert D, Griffiths M. Police Mental Health Partnership project: Police Ambulance Crisis 29 Emergency Response (PACER) model development. Australasian Psychiatry 2015;23(5):520-23. 30 doi: http://dx.doi.org/10.1177/1039856215597533 31 34. Laing R, Halsey R, Donohue D, et al. Application of a model for the development of a mental health 32
service delivery collaboration between police and the health service. Issues Ment Health Nurs http://bmjopen.bmj.com/ 33 2009;30(5):337-41. doi: http://dx.doi.org/10.1080/01612840902754644 34 35. McKenna B, Furness T, Oakes J, et al. Police and mental health clinician partnership in response to 35 mental health crisis: A qualitative study. International Journal of Mental Health Nursing 36 2015;24(5):386-93. 37 36. Meehan T, Stedman T. Trends in the use of Emergency Examination Orders in Queensland since the 38 39 implementation of the Mental Health Intervention Project. Australasian psychiatry : bulletin of 40 Royal Australian and New Zealand College of Psychiatrists 2012;20(4):287-90. on September 26, 2021 by guest. Protected copyright. 41 37. Ogloff JRP, Thomas SDM, Luebbers S, et al. Policing Services With Mentally Ill People: Developing 42 Greater Understanding and Best Practice. Australian Psychologist 2013;48(1):57-68. doi: 43 http://dx.doi.org/10.1111/j.1742-9544.2012.00088.x 44 38. Pathe MT, Haworth DJ, Lowry TJ, et al. A model for managing the mentally ill fixated person at 45 major events. Aust N Z J Psychiatry 2015;49(7):610-15. doi: 46 http://dx.doi.org/10.1177/0004867415581022 47 39. Pathe MT, Lowry T, Haworth DJ, et al. Assessing and managing the threat posed by fixated persons 48 in Australia. Journal of Forensic Psychiatry and Psychology 2015;26(4):425-38. doi: 49 http://dx.doi.org/10.1080/14789949.2015.1037332 50 40. Petrakis M, Penno S, Oxley J, et al. Early psychosis treatment in an integrated model within an adult 51 mental health service.[Erratum appears in Eur Psychiatry. 2013 Mar;28(3):197]. Eur Psychiatry 52 2012;27(7):483-8. doi: http://dx.doi.org/10.1016/j.eurpsy.2011.03.004 53 41. Victorian Auditor General’s Report. Responding to mental health crisis in the community. Victorian 54 Auditor General’s Report: Victorian Government Printer, 2009. 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 23 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 24 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 42. Webster S, Harrison L. The multidisciplinary approach to mental health crisis management: an 4 Australian example. J Psychiatr Ment Health Nurs 2004;11(1):21-29. doi: 10.1111/j.1365- 5 2850.2004.00647.x 6 43. Winters S, Magalhaes L, Kinsella EA. Interprofessional collaboration in mental health crisis response 7 systems: a scoping review. Disabil Rehabil 2015;37(23):2212-24. doi: 8 http://dx.doi.org/10.3109/09638288.2014.1002576 9 44. Baess E. Integrated Mobile Crisis Response Team (IMCRT): Review of pairing police with mental 10 health outreach services. Victoria, BC: Vancouver Island Health Authority 2005 11 45. Cant IR. The secondary family: the result of strong community partnering. Mental Health Review 12 Journal 2007;12(3):30-33. 13 46. Coleman TG, Cotton DH. Reducing Risk and Improving Outcomes of Police Interactions with People 14 with Mental Illness. Journal of Police Crisis Negotiations 2010;10(1/2):39-57. 15 47. De Caire G. A wrap-around social service solution. Blue Line Magazine 2013;25(8):14-14. 16 48. Forchuk C, JensenFor E, Martin peer M-L, et al.review Psychiatric Crisis Servicesonly in Three Communities. Can J 17 Commun Ment Health 2010;29(S5):73-86. doi: 10.7870/cjcmh-2010-0035 18 19 49. Kirst M, Francombe Pridham K, Narrandes R, et al. Examining implementation of mobile, police- 20 mental health crisis intervention teams in a large urban center. J Ment Health 2015;24(6):369- 21 74. doi: http://dx.doi.org/10.3109/09638237.2015.1036970 22 50. Kisely S, Campbell LA, Peddle S, et al. A controlled before-and-after evaluation of a mobile crisis 23 partnership between mental health and police services in Nova Scotia. Can J Psychiatry 24 2010;55(10):662-68. 25 51. Swaminath RS, Mendonca JD, Vidal C, et al. Experiments in change: Pretrial diversion of offenders 26 with mental illness. Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie 27 2002;47(5):450-58. 28 52. Sestoft D, Rasmussen MF, Vitus K, et al. The police, social services and psychiatry cooperation in 29 Denmark--a new model of working practice between governmental sectors. A description of 30 the concept, process, practice and experience. International Journal of Law & Psychiatry 31 2014;37(4):370-5. doi: http://dx.doi.org/10.1016/j.ijlp.2014.02.007 32
53. Girard V, Bonin J, Tinland A, et al. Mental health outreach and street policing in the downtown of a http://bmjopen.bmj.com/ 33 large French city. Int J Law Psychiatry 2014;37(4):376-82. 34 54. Mental Health Commission and An Garda Siochana. Report of joint working group on mental health 35 services and the police. . Mental Health Commission and An Garda Siochana (2009) 2009:1- 36 104. 37 55. Wierdsma AI, Poodt HD, Mulder CL. Effects of community-care networks on psychiatric emergency 38 39 contacts, hospitalisation and involuntary admission. J Epidemiol Community Health 40 2007;61(7):613-18. doi: http://dx.doi.org/10.1136/jech.2005.044974 on September 26, 2021 by guest. Protected copyright. 41 56. Bailey A, McAllister A, McAuley WJ. The development of a protocol for the joint investigation of 42 crimes committed against vulnerable adults. Tizard Learning Disability Review 2004;9(2):18-22. 43 57. Burton M, Evans R, Sanders A. Are special measures for vulnerable & intimidated witnesses 44 working? Evidence from the criminal justice agencies2006. 45 58. Cambridge P, Parkes T. The Management and Practice of Joint Adult Protection Investigations 46 between Health and Social Services: Issues Arising from a Training Intervention. Social Work 47 Education 2006;25(8):824-37. doi: http://dx.doi.org/10.1080/02615470600915886 48 59. Donnelly M, McGilloway S. Mental illness in the UK criminal justice system: a police liaison scheme 49 for mentally disordered offenders in Belfast. J Ment Health 2004;13(3):263-75. 50 60. Durcan D. Keys to diversion: Best practice for offenders with multiple needs. : Centre for Mental 51 Health, 2014. 52 61. Earl F, Cocksedge K, Rheeder B, et al. Neighbourhood outreach: a novel approach to Liaison and 53 Diversion. Journal of Forensic Psychiatry & Psychology 2015;26(5):573-85. 54 62. Edmondson D, Cummins I. Oldham Mental Health Phone Triage/RAID Pilot Project Evaluation 55 Report: Manchester Metropolitan University 2014. 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 24 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 25 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 63. Etherington D. The Police Liaison Community Psychiatric Nurse Project. Mental Health Review 4 Journal 1996;1(2):21-24. doi: 10.1108/13619322199600017 5 64. Exworthy T, Parrott J. Comparative evaluation of a diversion from custody scheme. The Journal of 6 Forensic Psychiatry 1997;8(2):406-16. doi: 10.1080/09585189708412020 7 65. Finn W, Hyslop J, Truman C. Mental health, multiple needs and the police: findings from the 8 Revolving Doors Agency link worker scheme. London: Revolving Doors 2000. 9 66. Fyson R. Young People with Learning Disabilities Who Sexually Harm Others: The Role of Criminal 10 Justice within a Multi-Agency Response. British Journal of Learning Disabilities 2007;35(3):181- 11 86. 12 67. Gibson S, Hamilton S, K J. Evaluation of the Crisis Care Concordat implementation Final Report: 13 McPin Foundation for Mind, 2016. 14 68. Great Britain Home Office. Alternative place of safety: the West Sussex pilot evaluation 2015. 15 London: Great Britain. Home Office 2015. 16 69. Heslin M, CallaghanFor L, Packwoodpeer M, etreview al. Decision analytic only model exploring the cost and cost- 17 offset implications of street triage. BMJ Open 2016;6 (2) (no pagination)(e009670) doi: 18 19 http://dx.doi.org/10.1136/bmjopen-2015-009670 20 70. Hollingsworth N. A fair hearing. Nurs Times 2000;96(50):41-42. 21 71. Irvine A, Allen L, Webber M. Evaluation of the Scarborough, Whitby and Ryedale Street Triage 22 Service. York: University of York 2015. 23 72. James DV, Harlow P. Increasing the power of psychiatric court diversion: a new model of supra- 24 district diversion centre. Medicine Science and the Law 2000;40(1):52-60. 25 73. James D, Cripps J, Gilluley P, et al. A court-focused model of forensic psychiatry provision to central 26 London: Abolishing remands to prison? The Journal of Forensic Psychiatry 1997;8(2):390-405. 27 doi: 10.1080/09585189708412019 28 74. James DV. Police station diversion schemes: Role and efficacy in central London. J Forensic 29 Psychiatry 2000;11(3):532-55. doi: http://dx.doi.org/10.1080/09585180010004801 30 75. James DV, Kerrigan TR, Forfar R, et al. The fixated threat assessment centre: Preventing harm and 31 facilitating care. Journal of Forensic Psychiatry and Psychology 2010;21(4):521-36. doi: 32
http://dx.doi.org/10.1080/14789941003596981 http://bmjopen.bmj.com/ 33 76. Kirkland J, Baron E. Using a cognitive analytic approach to formulate a complex sexual and violent 34 offender to inform multi-agency working: developing a shared understanding. Journal of 35 Sexual Aggression 2015;21(3):394-405. 36 77. Lennox C, Mason J, McDonnell S, et al. Information sharing between the National Health Service 37 and criminal justice system in the United Kingdom. Journal of Forensic Nursing 2012;8(3):131- 38 39 37. doi: http://dx.doi.org/10.1111/j.1939-3938.2012.01138.x 40 78. Mann A, Sugarman P, Rooney C, et al. Service innovation: Policing mental health - The St. Andrew's on September 26, 2021 by guest. Protected copyright. 41 scheme. Psychiatr Bull R Coll Psychiatr 2007;31(3):97-98. doi: 42 http://dx.doi.org/10.1192/pb.bp.106.011007 43 79. Marlow K. Achieving best evidence. Llais 2003(68):3-5. 44 80. McAllister A, Bailey A, Barr O. Training in joint investigation of alleged crimes against people with 45 learning disabilities in Northern Ireland. Journal of Adult Protection 2002;4(2):21-27. 46 81. McGilloway S, Donnelly M. Mental illness in the UK criminal justice system: A police liaison scheme 47 for Mentally Disordered Offenders in Belfast. J Ment Health 2004;13(3):263-75. doi: 48 10.1080/09638230410001700899 49 82. McLean N, Marshall LA. A front line police perspective of mental health issues and services. 50 Criminal Behaviour & Mental Health 2010;20(1):62-71. 51 83. Noga H, Foreman A, Walsh E, et al. Multi-agency action learning: Challenging institutional barriers 52 in policing and mental health services. Action Research 2016;14(2):132-50. doi: 53 10.1177/1476750315583315 54 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 25 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 26 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 84. Pakes F, Winstone J. A site visit survey of 101 mental health liaison and diversion schemes in 4 England. The Journal of Forensic Psychiatry & Psychology 2010;21(6):873-86. doi: 5 http://dx.doi.org/10.1080/14789949.2010.511241 6 85. Penny C, Craissati J. Decisions on disclosure to third parties made at MAPP meetings: Opinions and 7 practice. Psychiatrist 2012;36(10):379-85. doi: http://dx.doi.org/10.1192/pb.bp.112.038786 8 86. Riordan S, Wix S, Kenney-Herbert J, et al. Diversion at the point of arrest: Mentally disordered 9 people and contact with the police. J Forensic Psychiatry 2000;11(3):683-90. doi: 10 http://dx.doi.org/10.1080/09585180010004937 11 87. Riordan S, Wix S, Haque MS, et al. Multiple contacts with diversion at the point of arrest. Medicine, 12 science, and the law 2003;43(2):105-10. 13 88. Rowlands R, Inch H, Rodger W, et al. Diverted to where? What happens to the diverted mentally 14 disordered offender. The Journal of Forensic Psychiatry 1996;7(2):284-96. doi: 15 10.1080/09585189608415013 16 89. Scott D, McGillowayFor S, peer Donnelly M. A review prospective comparative only evaluation of a Criminal Justice 17 Liaison and Diversion Service in Belfast. The Journal of Forensic Psychiatry & Psychology 18 19 2016;27(2):198. 20 90. Police TV. Thames Valley police (2015). Oxfordshire Mental Health Street Triage Pilot. . 2015 21 91. Vaughan PJ, Kelly M, Pullen N. The working practices of the police in relation to mentally 22 disordered offenders and diversion services. Medicine, science, and the law 2001;41(1):13-20. 23 92. Wain N. May the force be with you. Community Care 2000;31:22-23. 24 93. Barrett JG, Janopaul-Naylor E. Description of a collaborative community approach to impacting 25 juvenile arrests. Psychological Services 2016;13(2):133. 26 94. Bonkiewicz L, Green AM, Moyer K, et al. Left alone when the cops go home: evaluating a post- 27 mental health crisis assistance program. Policing-an International Journal of Police Strategies & 28 Management 2014;37(4):762-78. doi: 10.1108/pijpsm-04-2014-0035 29 95. Borum R, Deane MW, Steadman HJ, et al. Police perspectives on responding to mentally ill people 30 in crisis: perceptions of program effectiveness. Behav Sci Law 1998;16(4):393-405. 31 96. Bracey JR, Foley Geib C, Plant R, et al. Connecticut's Comprehensive Approach to Reducing In- 32
School Arrests: Changes in Statewide Policy, Systems Coordination and School Practices. Family http://bmjopen.bmj.com/ 33 Court Review 2013;51(3):427-34. 34 97. Clayfield JC, Grudzinskas JAJ, Fisher WH, et al. E pluribus unum: creating a multi-organizational 35 structure for serving arrestees with serious mental illness. Research in Social Problems & Public 36 Policy 2005;12:27-49. 37 98. Coggins MH, Pynchon MR. Mental health consultant to law enforcement: Secret Service 38 39 development of a Mental Health Liaison Program. Behav Sci Law 1998;16(4):407-22. 40 99. Compton MT, Broussard B, Hankerson-Dyson D, et al. System- and Policy-Level Challenges to Full on September 26, 2021 by guest. Protected copyright. 41 Implementation of the Crisis Intervention Team (CIT) Model. Journal of Police Crisis 42 Negotiations 2010;10(1/2):72-85. 43 100. Crutcher KD. The Early Notification Program. FBI Law Enforcement Bulletin 2011;80(7):12-15. 44 101. Deane MW, Steadman HJ, Borum R, et al. Emerging partnerships between mental health and law 45 enforcement. Psychiatr Serv 1999;50(1):99-101. 46 102. DeCuir W, Lamb R. Police response to the dangerous mentally ill. The Police Chief 1996:99-106. 47 103. Dupont R, Cochran S, Pillsbury S. Crisis Intervention Team core elements. The University of 48 Memphis School of Urban Affairs and Public Policy, Dept. of Criminology and Criminal Justice, 49 CIT Center2007 [Available from: 50 http://www.cit.memphis.edu/information_files/CoreElements.pdf accessed 2016 2016. 51 104. el-Mallakh RS, Wulfman G, Smock W, et al. Implementation of a crisis intervention program for 52 police response to mental health emergencies in Louisville. J Ky Med Assoc 2003;101(6):241-3. 53 [published Online First: 2003/07/04] 54 105. Frank J, Eck J, Ratansi S. Mobile crisis team/police collaboration evaluation2004. 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 26 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 27 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 106. Geller J, L., , Fisher W, H, , McDermet MA. A national survey of mobile crisis services and their 4 evaluation. Psychiatr Serv 1995;46(9):893-97. doi: 10.1176/ps.46.9.893 5 107. Gordon C, Chabot L. Jail diversion program shows power of teamwork. Behav Healthc Tomorrow 6 2004;13(4):31-35. 7 108. Grudzinskas AJ, Jr., Clayfield JC, Roy-Bujnowski K, et al. Integrating the criminal justice system into 8 mental health service delivery: the worcester diversion experience. Behav Sci Law 9 2005;23(2):277-93. 10 109. Hails J, Borum R. Police training and specialized approaches to respond to people with mental 11 illnesses. Crime & Delinquency 2003;49(1):52-61. doi: 10.1177/0011128702239235 12 110. Hamilton ZK, Sullivan CJ, Veysey BM, et al. Diverting Multi-Problem Youth from Juvenile Justice: 13 Investigating the Importance of Community Influence on Placement and Recidivism. Behav Sci 14 Law 2007;25(1):137-58. doi: http://dx.doi.org/10.1002/bsl.720 15 111. Hartford K, Carey R, Mendonca J. Pre-arrest Diversion of People with Mental Illness: Literature 16 Review For and International peer Survey.review Behav Sci only Law 2006;24(6):845-56. doi: 17 http://dx.doi.org/10.1002/bsl.738 18 19 112. Hatcher C, Mohandie K, Turner J, et al. The role of the psychologist in crisis/hostage negotiations. 20 Behav Sci Law 1998;16(4):455-72. 21 113. Helfgott JB, Hickman MJ, Labossiere AP. A descriptive evaluation of the Seattle Police 22 Department's crisis response team officer/mental health professional partnership pilot 23 program. Int J Law Psychiatry 2016;44:109-22. doi: 24 http://dx.doi.org/10.1016/j.ijlp.2015.08.038 25 114. Hill R, Quill G, Ellis K. The Montgomery County CIT model: Interacting with people with mental 26 illness. FBI Law Enforcement Bulletin 2004;73(7):18-25. 27 115. Hoff RA, Baranosky MV, Buchanan J, et al. The effects of a jail diversion program on incarceration: 28 A retrospective cohort study. Journal of the American Academy of Psychiatry and the Law 29 Online 1999;27(3):377-86. 30 116. James RK, Logan J, Davis SA. Including School Resource Officers in school-based crisis intervention: 31 Strengthening student support. School Psychology International 2011;32(2):210-24. 32
117. Janofsky Js, Tamburello AC. Diversion to the Mental Health System: Emergency Psychiatric http://bmjopen.bmj.com/ 33 Evaluations. J Am Acad Psychiatry Law 2006;34(3):283-91. 34 118. Klein M. Law Enforcement's Response to People with Mental Illness. FBI Law Enforcement Bulletin 35 2002;71(2):11. 36 119. Lacey CH. Collaborative Partnerships and School Change: Evaluating Project SOBEIT: Online 37 Submission, 2006. 38 39 120. Lamb HR, Shaner R, Elliott DM, et al. Outcome for psychiatric emergency patients seen by an 40 outreach police–mental health team. New Dir Ment Health Serv 1995;2001(90):67-76. doi: on September 26, 2021 by guest. Protected copyright. 41 10.1002/yd.23320019007 42 121. Lattimore PK, Broner N, Sherman R, et al. A Comparison of Prebooking and Postbooking Diversion 43 Programs for Mentally Ill Substance-Using Individuals With Justice Involvement. Journal of 44 Contemporary Criminal Justice 2003;19(1):30. 45 122. Lord VB, Bjerregaard B. Helping Persons with Mental Illness: Partnerships between Police and 46 Mobile Crisis Units. Victims & Offenders 2014;9(4):455-74. 47 123. Marans S, Berkowitz SJ, Cohen DJ. Police and mental health professionals: Collaborative responses 48 to the impact of violence on children and families. Child Adolesc Psychiatr Clin N Am 49 1998;7(3):635-51. 50 124. McGuire AB, Bond GR. Critical elements of the crisis intervention team model of jail diversion: an 51 expert survey. Behav Sci Law 2011;29(1):81-94. doi: http://dx.doi.org/10.1002/bsl.941 52 125. Murphy RA, Rosenheck RA, Berkowitz SJ. Acute service delivery in a police-mental health program 53 for children exposed to violence and trauma. Psychiatr Q 2005;76(2):107-21. 54 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 27 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 28 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 126. Oliva JR, Compton MT. A statewide Crisis Intervention Team (CIT) initiative: evolution of the 4 Georgia CIT program. J Am Acad Psychiatry Law 2008;36(1):38-46. [published Online First: 5 2008/03/21] 6 127. Perez A, Leifman S, Estrada A. Reversing the criminalization of mental illness. Crime & Delinquency 7 2003;49(1):62-78. doi: 10.1177/0011128702239236 8 128. Project Link DoP, University of Rochester, Rochester New York. Gold Award: Prevention of Jail and 9 Hospital Recidivism Among Persons With Severe Mental Illness. Psychiatr Serv 10 1999;50(11):1477-80. 11 129. Rosenbaum N. Street-Level Psychiatry—A Psychiatrist's Role with the Albuquerque Police 12 Department's Crisis Outreach and Support Team. Journal of Police Crisis Negotiations 13 2010;10(1/2):175-81. 14 130. Saunders JEG. Missing and Wandering Children with Autism and Down Syndrome: The Project 15 Lifesaver Partnership Meets the Challenge. Sheriff 2006;58(5):26-28. 16 131. Scott RL. EvaluationFor peer of a Mobile Crisisreview Program: Effectiveness, only Efficiency, and Consumer 17 Satisfaction. Psychiatr Serv 2000;51(9):1153-56. doi: 10.1176/appi.ps.51.9.1153 18 19 132. Shafer MS, Arthur B, Franczak MJ. An analysis of post-booking jail diversion programming for 20 persons with co-occurring disorders. Behav Sci Law 2004;22(6):771-85. 21 133. Skubby D, Bonfine N, Novisky M, et al. Crisis Intervention Team (CIT) programs in rural 22 communities: A focus group study. Community Ment Health J 2013;49(6):756-64. 23 134. Steadman HJ, Deane MW, Morrissey JP, et al. A SAMHSA Research Initiative Assessing the 24 Effectiveness of Jail Diversion Programs for Mentally Ill Persons. Psychiatr Serv 25 1999;50(12):1620-23. doi: 10.1176/ps.50.12.1620 26 135. Steadman HJ, Naples M. Assessing the effectiveness of jail diversion programs for persons with 27 serious mental illness and co-occurring substance use disorders. Behav Sci Law 28 2005;23(2):163-70. doi: 10.1002/bsl.640 [published Online First: 2005/04/09] 29 136. Swartz MS, Swanson JW, Kim M, et al. Use of outpatient commitment or related civil court 30 treatment orders in five U.S. communities. Psychiatr Serv 2006;57(3):343-49. doi: 31 http://dx.doi.org/10.1176/appi.ps.57.3.343 32
137. Teske SC. A study of zero tolerance policies in schools: a multi-integrated systems approach to http://bmjopen.bmj.com/ 33 improve outcomes for adolescents. Journal of child and adolescent psychiatric nursing : official 34 publication of the Association of Child and Adolescent Psychiatric Nurses, Inc 2011;24(2):88-97. 35 doi: http://dx.doi.org/10.1111/j.1744-6171.2011.00273.x 36 138. Teller JL, Munetz MR, Gil KM, et al. Crisis intervention team training for police officers responding 37 to mental disturbance calls. Psychiatr Serv 2006;57(2):232-7. 38 39 139. Trupin EW, Selby PM, McCauley E, et al. The Prime Time Project: Developing an Intensive 40 Community-Based Intervention for Youth in the Juvenile Justice System, 1996. on September 26, 2021 by guest. Protected copyright. 41 140. Van Hasselt VB, Killam G, Schlessinger KM, et al. The Adolescent Drug Abuse Prevention and 42 Treatment (ADAPT) Program: A Mental Health-Law Enforcement Collaboration. J Child Adolesc 43 Subst Abuse 2005;15(2):87-104. 44 141. Wolff N. Interactions between mental health and law enforcement systems: problems and 45 prospects for cooperation. Journal of Health Politics, Policy & Law 1998;23(1):133-74. 46 142. Wood JD, Beierschmitt L. Beyond police crisis intervention: Moving "upstream" to manage cases 47 and places of behavioral health vulnerability. Int J Law Psychiatry 2014;37(5):439-47. doi: 48 http://dx.doi.org/10.1016/j.ijlp.2014.02.016 49 143. Meehan AJ. From conversion to coercion: The police role in medication compliance: Psychiatric 50 Quarterly 1995. 51 144. Sharp CR. Theoretical and Practical Application of Loose Coupling: A Study of Criminal Justice 52 Agencies in the State of Florida. Southwest Journal of Criminal Justice 2009;6(1):45-58. 53 145. Steadman HJ, Deane MW, Borum R, et al. Comparing outcomes of major models of police 54 responses to mental health emergencies. Psychiatr Serv 2000;51(5):645-49. doi: 55 http://dx.doi.org/10.1176/appi.ps.51.5.645 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 28 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 29 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 146. Wellborn. Responding to individuals with mental illness. FBI Law Enforcement Bulletin 4 1999;68(11):6. 5 147. Rollison J, Hill G, Yu P, et al. Evaluation of a complex, multisite, multilevel grants initiative. Eval 6 Program Plann 2012;35(2):273-79. 7 148. Wolff N, Frueh BC, Huening J, et al. Practice informs the next generation of behavioral health and 8 criminal justice interventions. Int J Law Psychiatry 2013;36(1):1-10. 9 149. Wolff N, Diamond RJ, Helminiak TW. A new look at an old issue: People with mental illness and 10 the law enforcement system. J Ment Health Adm 1997;24(2):152-65. 11 150. Crisp AP. Understanding Best Practice: The Emergency Response to Mental Illness-An Exploratory 12 Report. 2015 13 151. Steadman HJ, Cocozza JJ, Veysey BM. Comparing outcomes for diverted and nondiverted jail 14 detainees with mental illnesses. Law Hum Behav 1999;23(6):615-27. [published Online First: 15 2000/01/14] 16 152. Ligon JAN, For Thyer BA. peer CLIENT AND FAMILYreview SATISFACTION only WITH BRIEF COMMUNITY MENTAL 17 HEALTH, SUBSTANCE ABUSE, AND MOBILE CRISIS SERVICES IN AN URBAN SETTING. Crisis 18 19 Intervention and Time-Limited Treatment 2000;6(2):93-99. doi: 10.1080/10645130008951135 20 153. Durcan G, et a. The Bradley report five years on: an independent review of progress to date and 21 priorities for further development. London: Centre for Mental Health 2014. 22 154. Department of Health. Mental Health Act 1983: Code of Practice. In: Health Do, ed. Norwich: The 23 Stationery Office, 2015. 24 155. College of Policing. Statistical data: College of Policing; 2017 [The annual data requirement (ADR) 25 is a list of all requests for data made to all police forces in England and Wales under the Home 26 Secretary’s statutory powers and is used to report crime and policing related statistics. 27 28 29 30 A list of current data requirement publications can be found below:]. accessed 14th July 2017 2017. 31 156. O'Mara‐Eves A, Brunton G, McDaid D, et al. Techniques for identifying cross‐disciplinary and ‘ 32 hard to detect evidence for systematic review. Research synthesis methods 2014;5(1):50-59. http://bmjopen.bmj.com/ 33 ‐ ‐ ’ 34 157. Macvean M, Humphreys C, Healey L, et al. The PATRICIA Project: PAThways and Research in 35 Collaborative Inter-Agency working: State of knowledge paper Sydney: ANROWS Landscapes 36 14/2015, 2015. 37 158. Munetz MR, Griffin PA. Use of the sequential intercept model as an approach to decriminalization 38 of people with serious mental illness. Psychiatr Serv 2006;57(4):544-49. doi: 39 10.1176/appi.ps.57.4.544 40 159. Charette Y, Crocker AG, Billette I. Police encounters involving citizens with mental illness: use of on September 26, 2021 by guest. Protected copyright. 41 resources and outcomes. Psychiatr Serv 2014;65(4):511-16. 42 160. McManus S, Meltzer H, Brugha T, et al. Adult psychiatric morbidity in England, 2007: results of a 43 household survey: The NHS Information Centre for health and social care 2009. 44 161. Craig P, Dieppe P, Macintyre S, et al. Developing and evaluating complex interventions: the new 45 Medical Research Council guidance. BMJ 2008;337:a1655. 46 162. Department of Health and Concordat signatories. Mental Health Crisis Care Concordat: Improving 47 outcomes for people experiencing mental health crisis. In: Health Do, ed.: HM Government, 48 2014. 49 163. UK Crown. Policing and Crime Act 2017. In: Office TS, ed., 2017. 50 164. Kane E, Evans E, Shokraneh F. Effectiveness of current policing-related mental health 51 52 interventions in England and Wales and Crisis Intervention Teams as a future potential model: 53 a systematic review. Systematic Reviews 2017;6(1):85. doi: 10.1186/s13643-017-0478-7 54 165. Innes M. A ‘Mirror’ and a ‘Motor’: Researching and Reforming Policing in an Age of Austerity1. 55 Policing: A Journal of Policy and Practice 2010;4(2):127-34. doi: 10.1093/police/pap058 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 29 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 30 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 166. Valentijn PP, Schepman SM, Opheij W, et al. Understanding integrated care: a comprehensive 4 conceptual framework based on the integrative functions of primary care. International 5 Journal of Integrated Care 2013;13:e010. 6 167. Moore GF, Audrey S, Barker M, et al. Process evaluation of complex interventions: Medical 7 Research Council guidance. BMJ : British Medical Journal 2015;350 doi: 10.1136/bmj.h1258 8 9 10 11 Figure legend 12 13 Figure 1: Flowchart of study selection process, adapted from PRISMA [27] 14 15 16 For peer review only 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 Inter-agency scoping review manuscript v9 13/02/2018 Page 30 of 30 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 31 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
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1 2 3 4 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 5 6 APPENDIX 1 7 The following eligibility criteria were applied: 8 9 10 Population 11 The police and collaborating organisations who deal with members of the public appearing to be 12 13 suffering from mental disorder, mental vulnerability or learning disability. We use the following 14 definitions to define our population of interest: 15 16 17 ‘Police’ refer to law enforcement agencies broadly, including regional and national police 18 For peer review only 19 forces as well as bodies with limited executive powers and their staff. Examples from the UK 20 include the British Transport Police and the UK Border Force. 21 22 ‘In line with the UK 1983 MHA [166], ‘mental disorder’ refers to ‘people who appear to be 23 24 suffering from mental disorder’ rather than people with a known diagnosis of mental illness. 25 The following additional definitions, based on the UK National Policing Improvement Agency 26 27 (NPIA) ‘Guidance on responding to people with mental ill health or learning disabilities’, are 28 29 used [167]: ‘Mental ill health’ is used broadly to encompass all other mental health terms, 30 including mental health disorders, mental illness, and mental health needs. ‘Mental disorder’ 31 32 refers to ‘any disorder or disability of the mind’ and includes conditions such as schizophrenia, 33 34 depression, bipolar disorder, anxiety disorder, obsessive-compulsive disorder, personality 35 disorders, eating disorders and dementia. Not all mental disorders meet the criteria for the 36 37 exercise of powers under the Mental Health Act. ‘Mentally vulnerable’ refers to people who http://bmjopen.bmj.com/ 38 39 ‘because of their mental state or capacity may not understand the significance of what is said 40 to them (for example in the form of questions) or of their replies’ [168]. 41 42 People with learning disabilities were also included: their needs and disability may not be 43 44 obvious but they may be extremely vulnerable and learning disabilities frequently co-occur 45 on September 26, 2021 by guest. Protected copyright. 46 with mental ill health. 47 We included children, adolescents and adults. Adolescence is defined as the period including 48 49 and between 10–19 years as defined by the World Health Organization [169]. 50 51 Intervention 52 53 We focused on models of inter-agency collaboration between the police and other organisations. 54 55 A number of different terms have been used to describe inter-agency and inter-professional 56 57 models These including: ‘multi-agency partnerships’, ‘inter-professional collaboration’, 58 59 ‘integrated care’, ‘inter-agency working’ and ‘joint working’ [12,170,171]. Although these 60
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terms are often used interchangeably, they can refer to distinctive forms of activity. The prefix BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 ‘multi-’ (e.g. multi-agency) is sometimes used to refer to specific collaborative activities around 6 7 an individual person [172]; while ‘inter-’ (e.g. inter-agency) tends to have a more inclusive 8 meaning, referring to collaborative activities across the wider network of professional 9 10 relationships and structures. ‘Inter-professional’ may vary from ‘inter-agency’ in that the 11 12 former refers to collaborative working across individuals (potentially at the same site), while 13 the latter refers to collaborative working across services. ‘Integration’ is sometimes used to 14 15 refer to the highest level of synthesis [173]. 16 17 ‘Inter-agency collaboration’ refers to a broad range of collaborative activities and models 18 across professionalFor relationshipspeer review and structures, whichonly include the core principles of 19 20 information sharing, joint decision making and coordinated intervention. 21 22 Organisations collaborating with the police refer to any agency or organisation, professional 23 agencies statutory or otherwise, involved in the care of people perceived to be suffering from 24 25 mental health problems. This can include other emergency services such as the ambulance 26 27 service, accident and emergency, crisis resolution and home treatment teams, etc.; other 28 29 health care providers such as mental health early intervention services; or third sector 30 organisations [174]. Third sector organisations are patient and carer organisations which 31 32 represent and support patients and the family, friends and significant others of people with 33 34 mental health problems. 35 We included models that focus, either exclusively or predominantly, on close collaboration 36 37 between the police and at least one other organisation that offers help to people with mental http://bmjopen.bmj.com/ 38 39 health problems. This included models that focus on multi-agency working at a single site; 40 models that focus on collaboration across child and adult mental health services; and models 41 42 where inter-agency collaboration was one of several other components, provided there is a 43 44 clear reporting of the inter-agency collaboration component. 45 on September 26, 2021 by guest. Protected copyright. 46 Comparator(s) 47 Any comparators were included, as were studies with no comparator. 48 49 50 Outcomes 51 All outcomes were eligible as the purpose of this review was to map the available evidence. Outcomes 52 53 measured could include perceived benefits such as enhanced effectiveness of services; impact on 54 service users, such as improved access to services, through speedier and more appropriate referral; 55 56 mental health outcomes; and early intervention. 57 58 59 Context 60
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Inter-agency collaboration models could be in the context of: the national level; county or state wide; BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 cities or rural setting; private or public services or settings; or in homes, police stations, on the street, 6 7 safe havens, schools, accident and emergency, etc. We included police working at the interface with 8 the criminal justice system, for instance at the court level or as part of a rehabilitation service; 9 10 however we did not include prisons since separate arrangements exist for prisons. 11 12 UK-based evidence and international literature from Organisation for Economic Co-operation and 13 14 Development (OECD) countries were included. We hypothesised that OECD countries would have 15 16 sufficiently similar health and criminal justice systems to allow lessons learned to be potentially 17 transferable. 18 For peer review only 19 20 Study Design 21 Eligible studies included empirical evaluations or descriptions of models of inter-agency collaboration. 22 23 Other relevant legislation and good practice guidance were included, where these were subject to 24 25 empirical evaluation. 26 27 Evidence from empirically-based research and evaluation, both qualitative and quantitative, 28 29 provided there was systematic data collection and analysis. We included systematic reviews; 30 31 Randomised Controlled Trials (RCTs); non-randomised controlled trials; observational studies 32 such as cohort, interrupted time series and case studies describing or evaluating an 33 34 intervention to determine the range of approaches that have been tried and described, and 35 36 ideally, potentially promising or unacceptable approaches http://bmjopen.bmj.com/ 37 We included qualitative studies exploring issues around inter-agency collaboration, such as 38 39 barriers or facilitators around implementing inter-agency models 40 41 42 Exclusion criteria 43 The following were excluded: 44 45 on September 26, 2021 by guest. Protected copyright. 46 Studies where the interagency collaboration was focused solely on substance abuse, without 47 48 including individuals with co-occurring mental health problems 49 Diagrammatical and mathematical modelling of inter-agency collaboration models for 50 51 organisations 52 53 Patient-doctor or patient-clinician shared decision-making 54 Inter-agency collaboration without the involvement of the police 55 56 Studies published in languages other than English 57 58 Opinion pieces and editorial articles 59 60 Due to changing context of data protection legislation, studies published before 1995
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BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 For peer review only 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 http://bmjopen.bmj.com/ 38 39 40 41 42 43 44 45 on September 26, 2021 by guest. Protected copyright. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
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1 2 3 4 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 5 6 APPENDIX 2: SEARCH STRATEGY USED IN ASSIA 7 ASSIA 8 9 10 Via Proquest 11 12 Search date=25th July 2016 13 14 15 Records retrieved=138 records 16 17 18 Set# Searched for For peer review only Databases Results 19 20 21 S1 SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 10841 22 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing) Sciences Index &° 23 24 Abstracts 25 26 (ASSIA) 27 28 29 S2 police OR policing Applied Social 10762 30 Sciences Index &° 31 32 Abstracts 33 34 (ASSIA) 35 36 37 S3 (SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 10841 http://bmjopen.bmj.com/ 38 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) Sciences Index &° 39 40 OR (police OR policing) Abstracts 41 42 (ASSIA) 43 44 45 S4 SU.EXACT("Service integration") Applied Social 78° on September 26, 2021 by guest. Protected copyright. 46 Sciences Index & 47 48 Abstracts 49 50 (ASSIA) 51 52 53 S5 SU.EXACT("Interagency collaboration") Applied Social 757° 54 Sciences Index & 55 56 Abstracts 57 58 (ASSIA) 59 60
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S6 (multi-agency NEAR/2 (approach* or collaborat* or cooperat* or coordinat* Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 264° 5 or department* or model* or team* or partner* or program* or working)) ORSciences Index & 6 7 (multiagency NEAR/2 (approach* or collaborat* or cooperat* or coordinat* Abstracts 8 9 or department* or model* or team* or partner* or program* or working)) (ASSIA) 10 11 (multi-professional NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 12 S7 182° 13 coordinat* OR department* OR model* OR team* OR partner* OR program*S ciences Index & 14 15 OR working)) OR (multiprofessional NEAR/2 (approach* OR collaborat* OR Abstracts 16 17 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 18 OR program* ORFor working)) peer review only 19 20 21 S8 (multi-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 2159° 22 23 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 24 25 OR working)) OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 26 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 27 28 OR program* OR working)) 29 30 31 S9 (inter-agency NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 1025° 32 33 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 34 OR working)) OR (interagency NEAR/2 (approach* OR collaborat* OR Abstracts 35 36 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 37 http://bmjopen.bmj.com/ 38 OR program* OR working)) 39 40 41 S10 (inter-professional NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social 131° 42 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 43 44 OR working)) OR (interprofesional NEAR/2 (approach* OR collaborat* OR Abstracts 45 on September 26, 2021 by guest. Protected copyright. 46 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 47 OR program* OR working)) 48 49 50 S11 (inter-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social ° 51 4128 52 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 53 54 OR working)) OR (interdisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 55 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 56 57 OR program* OR working)) 58 59 60
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S12 (trans-disciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 119° 5 coordinat* OR department* OR model* OR team* OR partner* OR program*Sciences Index & 6 7 OR working)) OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR Abstracts 8 9 cooperat* OR coordinat* OR department* OR model* OR team* OR partner*(ASSIA) 10 OR program* OR working)) 11 12 13 S13 "joint agency" or "joint approach" or "joint collaborat*" or "joint cooperat*" Applied Social 450° 14 15 or "joint coordinat*" or "joint department*" or "joint team*" or "joint Sciences Index & 16 17 partner*" or "joint program*" or "joint working" Abstracts 18 For peer review only (ASSIA) 19 20 21 S14 integrat* NEAR/2 (agency or approach* or department* or model* or team* Applied Social 4279° 22 23 or partner* or program* or working) Sciences Index & 24 25 Abstracts 26 (ASSIA) 27 28 29 S15 "cross agency" or "cross department*" or "cross team*" or "cross partner*" Applied Social 54° 30 31 or "cross program*" Sciences Index & 32 33 Abstracts 34 (ASSIA) 35 36 37 http://bmjopen.bmj.com/ S16 "across agency" or "across department*" or "across team*" or "across Applied Social 116° 38 39 partner*" or "across program*" Sciences Index & 40 41 Abstracts 42 (ASSIA) 43 44 45 on September 26, 2021 by guest. Protected copyright. S19 information NEAR/1 (integrat* or governance or share* or sharing or Applied Social ° 46 1765 47 transfer*) Sciences Index & 48 49 Abstracts 50 (ASSIA) 51 52 53 S20 knowledge NEAR/1 (integrat* or governance or share* or sharing or Applied Social ° 54 913 55 transfer*) Sciences Index & 56 57 Abstracts 58 (ASSIA) 59 60
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S21 data NEAR/1 (integrat* OR governance OR share* OR sharing OR transfer*) Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 391° 5 Sciences Index & 6 7 Abstracts 8 9 (ASSIA) 10 11 technology NEAR/1 (integrat* OR governance OR share* OR sharing OR Applied Social 12 S22 398° 13 transfer*) Sciences Index & 14 15 Abstracts 16 17 (ASSIA) 18 For peer review only 19 20 S23 "communities of practice" Applied Social 208° 21 Sciences Index & 22 23 Abstracts 24 25 (ASSIA) 26 27 28 S24 SU.EXACT("Clinical risk management" OR "Risk management") Applied Social 866° 29 Sciences Index & 30 31 Abstracts 32 33 (ASSIA) 34 35 36 S25 "single assessment process" Applied Social 18° http://bmjopen.bmj.com/ 37 Sciences Index & 38 39 Abstracts 40 41 (ASSIA) 42 43 44 S26 SU.EXACT("Service integration") OR SU.EXACT("Interagency collaboration") Applied Social 15367 45 on September 26, 2021 by guest. Protected copyright. OR ((multi-agency NEAR/2 (approach* or collaborat* or cooperat* or Sciences Index &° 46 47 coordinat* or department* or model* or team* or partner* or program* or Abstracts 48 49 working)) OR (multiagency NEAR/2 (approach* or collaborat* or cooperat* or(ASSIA) 50 coordinat* or department* or model* or team* or partner* or program* or 51 52 working))) OR ((multi-professional NEAR/2 (approach* OR collaborat* OR 53 54 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 55 OR program* OR working)) OR (multiprofessional NEAR/2 (approach* OR 56 57 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 58 59 team* OR partner* OR program* OR working))) OR ((multi-disciplinary 60
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NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 department* OR model* OR team* OR partner* OR program* OR working)) 6 7 OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 8 9 coordinat* OR department* OR model* OR team* OR partner* OR program* 10 OR working))) OR ((inter-agency NEAR/2 (approach* OR collaborat* OR 11 12 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 13 14 OR program* OR working)) OR (interagency NEAR/2 (approach* OR 15 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 16 17 team* OR partner* OR program* OR working))) OR ((inter-professional 18 For peer review only 19 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 20 department* OR model* OR team* OR partner* OR program* OR working)) 21 22 OR (interprofesional NEAR/2 (approach* OR collaborat* OR cooperat* OR 23 24 coordinat* OR department* OR model* OR team* OR partner* OR program* 25 OR working))) OR ((inter-disciplinary NEAR/2 (approach* OR collaborat* OR 26 27 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 28 29 OR program* OR working)) OR (interdisciplinary NEAR/2 (approach* OR 30 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 31 32 team* OR partner* OR program* OR working))) OR ((trans-disciplinary 33 34 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 35 department* OR model* OR team* OR partner* OR program* OR working)) 36 37 OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR http://bmjopen.bmj.com/ 38 39 coordinat* OR department* OR model* OR team* OR partner* OR program* 40 OR working))) OR ("joint agency" or "joint approach" or "joint collaborat*" or 41 42 "joint cooperat*" or "joint coordinat*" or "joint department*" or "joint 43 44 team*" or "joint partner*" or "joint program*" or "joint working") OR 45 on September 26, 2021 by guest. Protected copyright. (integrat* NEAR/2 (agency or approach* or department* or model* or team* 46 47 or partner* or program* or working)) OR ("cross agency" or "cross 48 49 department*" or "cross team*" or "cross partner*" or "cross program*") OR 50 ("across agency" or "across department*" or "across team*" or "across 51 52 partner*" or "across program*") OR (information NEAR/1 (integrat* or 53 54 governance or share* or sharing or transfer*)) OR (knowledge NEAR/1 55 56 (integrat* or governance or share* or sharing or transfer*)) OR (data NEAR/1 57 (integrat* OR governance OR share* OR sharing OR transfer*)) OR 58 59 (technology NEAR/1 (integrat* OR governance OR share* OR sharing OR 60
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transfer*)) OR "communities of practice" OR SU.EXACT("Clinical risk BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 management" OR "Risk management") OR "single assessment process" 6 7 8 S27 "criminal justice" or "youth justice" or" juvenile justice" Applied Social 7998° 9 10 Sciences Index & 11 Abstracts 12 13 (ASSIA) 14 15 16 S28 (probation or parole or court* or justice) NEAR/2 (personnel or staff or Applied Social 993° 17 18 worker* or caseworker*For peer or office* or reviewofficial* or employee*) only Sciences Index & 19 20 Abstracts 21 (ASSIA) 22 23 24 S29 SU.EXACT("Probation service") Applied Social 727° 25 26 Sciences Index & 27 28 Abstracts 29 (ASSIA) 30 31 32 S30 paramedic* or para-medic* Applied Social 267° 33 34 Sciences Index & 35 36 Abstracts http://bmjopen.bmj.com/ 37 (ASSIA) 38 39 40 S31 (emergency or ambulance or casualty) NEAR/2 (personnel or staff or worker*Applied Social 363° 41 42 or office* or official* or employee*) Sciences Index & 43 44 Abstracts on September 26, 2021 by guest. Protected copyright. 45 (ASSIA) 46 47 48 S32 SU.EXACT("Presentence reports" OR "Social services departments") OR Applied Social 8979° 49 50 SU.EXACT("Befriending" OR "Care assistants" OR "Child care centres" OR Sciences Index & 51 52 "Child contact centres" OR "Community care" OR "Consumer operated drop Abstracts 53 in centres" OR "Day care" OR "Day care centres" OR "Day centres" OR (ASSIA) 54 55 "Deinstitutionalization" OR "Drop in centres" OR "Family centres" OR 56 57 "Halfway houses" OR "Home care" OR "Home health aides" OR "Home helps" 58 OR "Home ventilation" OR "Hospital at home schemes" OR "Local health and 59 60
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social service centres" OR "Long term community care" OR "Long term home BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 care" OR "Meals on wheels" OR "Out of school care" OR "Probation day 6 7 centres" OR "Psychiatric day centres" OR "Social services" OR "Welfare 8 9 services") OR SU.EXACT("Jewish Association for Services for the Aged" OR 10 "Social services agencies") 11 12 13 S33 SU.EXACT("Analytical social work" OR "Behavioural social work" OR "Care Applied Social 15597 14 15 orders" OR "Child care" OR "Child protection" OR "Childminding" OR "Clinical Sciences Index &° 16 17 social work" OR "Community nurseries" OR "Community work" OR "Creches" Abstracts 18 OR "Critical socialFor work" peerOR "Day foster review care" OR "Day nurseries" only OR (ASSIA) 19 20 "Detached youth work" OR "Educational social work" OR "Family child care" 21 22 OR "Family preservation services" OR "Family social work" OR "Feminist 23 community work" OR "Feminist people" OR "Feminist social work" OR "Foster 24 25 care" OR "Geriatric social work" OR "Guardians ad litem" OR "Guardianship" 26 27 OR "Hospital social work" OR "In care" OR "Kinship foster care" OR "Leaving 28 care" OR "Long term foster care" OR "Medical social work" OR 29 30 "Neighbourhood work" OR "Nurseries" OR "Occupational social work" OR 31 32 "Parent aide services" OR "Political social work" OR "Postadoption services" 33 OR "Private foster care" OR "Psychiatric social work" OR "Quality child care" 34 35 OR "Radical community work" OR "Radical social work" OR "Residential social 36 37 work" OR "Social casework" OR "Social work" OR "Temporary foster care" OR http://bmjopen.bmj.com/ 38 "Therapeutic child care" OR "Voluntary social work" OR "Wardship" OR 39 40 "Youth work") 41 42 43 S34 "social services" or "social work" Applied Social 32896 44 45 Sciences Index &° on September 26, 2021 by guest. Protected copyright. 46 Abstracts 47 48 (ASSIA) 49 50 51 S35 "voluntary group*" or "voluntary work" Applied Social 236° 52 53 Sciences Index & 54 Abstracts 55 56 (ASSIA) 57 58 59 60
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S36 SU.EXACT("Voluntary work") Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 139° 5 Sciences Index & 6 7 Abstracts 8 9 (ASSIA) 10 11 "community group*" or "self help group*" or "third sector" or "social Applied Social 12 S37 1005° 13 enterprise*" Sciences Index & 14 15 Abstracts 16 17 (ASSIA) 18 For peer review only 19 20 S38 SU.EXACT("Community groups") Applied Social 119° 21 Sciences Index & 22 23 Abstracts 24 25 (ASSIA) 26 27 28 S39 SU.EXACT("Selfhelp groups") Applied Social 439° 29 Sciences Index & 30 31 Abstracts 32 33 (ASSIA) 34 35 36 S40 SU.EXACT("Social enterprises") Applied Social 47° http://bmjopen.bmj.com/ 37 Sciences Index & 38 39 Abstracts 40 41 (ASSIA) 42 43 44 S41 ("criminal justice" or "youth justice" or" juvenile justice") OR ((probation or Applied Social 51930 45 on September 26, 2021 by guest. Protected copyright. parole or court* or justice) NEAR/2 (personnel or staff or worker* or Sciences Index &° 46 47 caseworker* or office* or official* or employee*)) OR SU.EXACT("Probation Abstracts 48 49 service") OR (paramedic* or para-medic*) OR ((emergency or ambulance or (ASSIA) 50 casualty) NEAR/2 (personnel or staff or worker* or office* or official* or 51 These databases 52 employee*)) OR (SU.EXACT("Presentence reports" OR "Social services 53 are searched for 54 departments") OR SU.EXACT("Befriending" OR "Care assistants" OR "Child part of your 55 care centres" OR "Child contact centres" OR "Community care" OR 56 query. 57 "Consumer operated drop in centres" OR "Day care" OR "Day care centres" 58 59 OR "Day centres" OR "Deinstitutionalization" OR "Drop in centres" OR "Family 60
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centres" OR "Halfway houses" OR "Home care" OR "Home health aides" OR BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 "Home helps" OR "Home ventilation" OR "Hospital at home schemes" OR 6 7 "Local health and social service centres" OR "Long term community care" OR 8 9 "Long term home care" OR "Meals on wheels" OR "Out of school care" OR 10 "Probation day centres" OR "Psychiatric day centres" OR "Social services" OR 11 12 "Welfare services") OR SU.EXACT("Jewish Association for Services for the 13 14 Aged" OR "Social services agencies")) OR SU.EXACT("Analytical social work" 15 OR "Behavioural social work" OR "Care orders" OR "Child care" OR "Child 16 17 protection" OR "Childminding" OR "Clinical social work" OR "Community 18 For peer review only 19 nurseries" OR "Community work" OR "Creches" OR "Critical social work" OR 20 "Day foster care" OR "Day nurseries" OR "Detached youth work" OR 21 22 "Educational social work" OR "Family child care" OR "Family preservation 23 24 services" OR "Family social work" OR "Feminist community work" OR 25 "Feminist people" OR "Feminist social work" OR "Foster care" OR "Geriatric 26 27 social work" OR "Guardians ad litem" OR "Guardianship" OR "Hospital social 28 29 work" OR "In care" OR "Kinship foster care" OR "Leaving care" OR "Long term 30 foster care" OR "Medical social work" OR "Neighbourhood work" OR 31 32 "Nurseries" OR "Occupational social work" OR "Parent aide services" OR 33 34 "Political social work" OR "Postadoption services" OR "Private foster care" OR 35 "Psychiatric social work" OR "Quality child care" OR "Radical community 36 37 work" OR "Radical social work" OR "Residential social work" OR "Social http://bmjopen.bmj.com/ 38 39 casework" OR "Social work" OR "Temporary foster care" OR "Therapeutic 40 child care" OR "Voluntary social work" OR "Wardship" OR "Youth work") OR 41 42 ("social services" or "social work") OR ("voluntary group*" or "voluntary 43 44 work") OR SU.EXACT("Voluntary work") OR ("community group*" or "self help 45 on September 26, 2021 by guest. Protected copyright. group*" or "third sector" or "social enterprise*") OR SU.EXACT("Community 46 47 groups") OR SU.EXACT("Selfhelp groups") OR SU.EXACT("Social enterprises") 48 49 50 S43 SU.EXACT("Suicide") Applied Social 3383° 51 52 Sciences Index & 53 Abstracts 54 55 (ASSIA) 56 57 58 59 60
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S44 SU.EXACT("Vulnerable people") Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 389° 5 Sciences Index & 6 7 Abstracts 8 9 (ASSIA) 10 11 Applied Social 12 S45 SU.EXACT("Stigmatization") 2448° 13 Sciences Index & 14 15 Abstracts 16 17 (ASSIA) 18 For peer review only 19 20 S46 SU.EXACT("Learning disabilities") Applied Social 2054° 21 Sciences Index & 22 23 Abstracts 24 25 (ASSIA) 26 27 28 S47 "learning disabilit*" or "learning difficult*" or "learning disorder*" or Applied Social 11637 29 "intellectual disabilit*" or "mental retard*" or "special need*" Sciences Index &° 30 31 Abstracts 32 33 (ASSIA) 34 35 36 S48 mental* NEAR/2 (ill* or vulnerab*) Applied Social 11374 37 http://bmjopen.bmj.com/ Sciences Index &° 38 39 Abstracts 40 41 (ASSIA) 42 43 44 S49 SU.EXACT("Mental health") Applied Social 8565° on September 26, 2021 by guest. Protected copyright. 45 Sciences Index & 46 47 Abstracts 48 49 (ASSIA) 50 51 52 S50 SU.EXACT("Psychiatric disorders") Applied Social 6061° 53 Sciences Index & 54 55 Abstracts 56 57 (ASSIA) 58 59 60
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S51 "mental disorder*" Applied Social BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 4204° 5 Sciences Index & 6 7 Abstracts 8 9 (ASSIA) 10 11 Applied Social 12 S52 SU.EXACT("Schizophrenia") 4882° 13 Sciences Index & 14 15 Abstracts 16 17 (ASSIA) 18 For peer review only 19 20 S53 SU.EXACT("Bipolar affective disorder") Applied Social 2330° 21 Sciences Index & 22 23 Abstracts 24 25 (ASSIA) 26 27 28 S54 SU.EXACT("Depression") Applied Social 18305 29 Sciences Index &° 30 31 Abstracts 32 33 (ASSIA) 34 35 36 S55 SU.EXACT("Suicide") OR SU.EXACT("Vulnerable people") OR Applied Social 62157 37 http://bmjopen.bmj.com/ SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") OR Sciences Index &° 38 39 ("learning disabilit*" or "learning difficult*" or "learning disorder*" or Abstracts 40 41 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* (ASSIA) 42 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 43 These databases 44 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 45 are searched for on September 26, 2021 by guest. Protected copyright. 46 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR part of your 47 SU.EXACT("Depression") 48 query. 49 50 51 S56 ((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR Applied Social 409° 52 53 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) Sciences Index & 54 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable Abstracts 55 56 people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities")(ASSIA) 57 58 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 59 These databases "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 60
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NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR are searched for BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR part of your 6 7 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR query. 8 9 SU.EXACT("Depression")) 10 11 (SU.EXACT("Service integration") OR SU.EXACT("Interagency collaboration") Applied Social 12 S57 21° 13 OR ((multi-agency NEAR/2 (approach* or collaborat* or cooperat* or Sciences Index & 14 15 coordinat* or department* or model* or team* or partner* or program* or Abstracts 16 17 working)) OR (multiagency NEAR/2 (approach* or collaborat* or cooperat* or(ASSIA) 18 coordinat* or department*For peer or model* review or team* or partner* only or program* or 19 These databases 20 working))) OR ((multi-professional NEAR/2 (approach* OR collaborat* OR 21 are searched for cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 22 part of your 23 OR program* OR working)) OR (multiprofessional NEAR/2 (approach* OR 24 query. 25 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 26 27 team* OR partner* OR program* OR working))) OR ((multi-disciplinary 28 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 29 30 department* OR model* OR team* OR partner* OR program* OR working)) 31 32 OR (multidisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 33 coordinat* OR department* OR model* OR team* OR partner* OR program* 34 35 OR working))) OR ((inter-agency NEAR/2 (approach* OR collaborat* OR 36 37 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* http://bmjopen.bmj.com/ 38 OR program* OR working)) OR (interagency NEAR/2 (approach* OR 39 40 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 41 42 team* OR partner* OR program* OR working))) OR ((inter-professional 43 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 44 45 department* OR model* OR team* OR partner* OR program* OR working)) on September 26, 2021 by guest. Protected copyright. 46 47 OR (interprofesional NEAR/2 (approach* OR collaborat* OR cooperat* OR 48 coordinat* OR department* OR model* OR team* OR partner* OR program* 49 50 OR working))) OR ((inter-disciplinary NEAR/2 (approach* OR collaborat* OR 51 52 cooperat* OR coordinat* OR department* OR model* OR team* OR partner* 53 OR program* OR working)) OR (interdisciplinary NEAR/2 (approach* OR 54 55 collaborat* OR cooperat* OR coordinat* OR department* OR model* OR 56 57 team* OR partner* OR program* OR working))) OR ((trans-disciplinary 58 NEAR/2 (approach* OR collaborat* OR cooperat* OR coordinat* OR 59 60
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department* OR model* OR team* OR partner* OR program* OR working)) BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 OR (transdisciplinary NEAR/2 (approach* OR collaborat* OR cooperat* OR 6 7 coordinat* OR department* OR model* OR team* OR partner* OR program* 8 9 OR working))) OR ("joint agency" or "joint approach" or "joint collaborat*" or 10 "joint cooperat*" or "joint coordinat*" or "joint department*" or "joint 11 12 team*" or "joint partner*" or "joint program*" or "joint working") OR 13 14 (integrat* NEAR/2 (agency or approach* or department* or model* or team* 15 or partner* or program* or working)) OR ("cross agency" or "cross 16 17 department*" or "cross team*" or "cross partner*" or "cross program*") OR 18 For peer review only 19 ("across agency" or "across department*" or "across team*" or "across 20 partner*" or "across program*") OR (information NEAR/1 (integrat* or 21 22 governance or share* or sharing or transfer*)) OR (knowledge NEAR/1 23 24 (integrat* or governance or share* or sharing or transfer*)) OR (data NEAR/1 25 (integrat* OR governance OR share* OR sharing OR transfer*)) OR 26 27 (technology NEAR/1 (integrat* OR governance OR share* OR sharing OR 28 29 transfer*)) OR "communities of practice" OR SU.EXACT("Clinical risk 30 management" OR "Risk management") OR "single assessment process") AND 31 32 (((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR 33 34 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) 35 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable 36 37 people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") http://bmjopen.bmj.com/ 38 39 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 40 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 41 42 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 43 44 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 45 on September 26, 2021 by guest. Protected copyright. SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR 46 47 SU.EXACT("Depression"))) 48 49 50 S58 (("criminal justice" or "youth justice" or" juvenile justice") OR ((probation or Applied Social 130° 51 52 parole or court* or justice) NEAR/2 (personnel or staff or worker* or Sciences Index & 53 caseworker* or office* or official* or employee*)) OR SU.EXACT("Probation Abstracts 54 55 service") OR (paramedic* or para-medic*) OR ((emergency or ambulance or (ASSIA) 56 57 casualty) NEAR/2 (personnel or staff or worker* or office* or official* or 58 These databases employee*)) OR (SU.EXACT("Presentence reports" OR "Social services 59 are searched for 60
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departments") OR SU.EXACT("Befriending" OR "Care assistants" OR "Child part of your BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 care centres" OR "Child contact centres" OR "Community care" OR query. 6 7 "Consumer operated drop in centres" OR "Day care" OR "Day care centres" 8 9 OR "Day centres" OR "Deinstitutionalization" OR "Drop in centres" OR "Family 10 centres" OR "Halfway houses" OR "Home care" OR "Home health aides" OR 11 12 "Home helps" OR "Home ventilation" OR "Hospital at home schemes" OR 13 14 "Local health and social service centres" OR "Long term community care" OR 15 "Long term home care" OR "Meals on wheels" OR "Out of school care" OR 16 17 "Probation day centres" OR "Psychiatric day centres" OR "Social services" OR 18 For peer review only 19 "Welfare services") OR SU.EXACT("Jewish Association for Services for the 20 Aged" OR "Social services agencies")) OR SU.EXACT("Analytical social work" 21 22 OR "Behavioural social work" OR "Care orders" OR "Child care" OR "Child 23 24 protection" OR "Childminding" OR "Clinical social work" OR "Community 25 nurseries" OR "Community work" OR "Creches" OR "Critical social work" OR 26 27 "Day foster care" OR "Day nurseries" OR "Detached youth work" OR 28 29 "Educational social work" OR "Family child care" OR "Family preservation 30 services" OR "Family social work" OR "Feminist community work" OR 31 32 "Feminist people" OR "Feminist social work" OR "Foster care" OR "Geriatric 33 34 social work" OR "Guardians ad litem" OR "Guardianship" OR "Hospital social 35 work" OR "In care" OR "Kinship foster care" OR "Leaving care" OR "Long term 36 37 foster care" OR "Medical social work" OR "Neighbourhood work" OR http://bmjopen.bmj.com/ 38 39 "Nurseries" OR "Occupational social work" OR "Parent aide services" OR 40 "Political social work" OR "Postadoption services" OR "Private foster care" OR 41 42 "Psychiatric social work" OR "Quality child care" OR "Radical community 43 44 work" OR "Radical social work" OR "Residential social work" OR "Social 45 on September 26, 2021 by guest. Protected copyright. casework" OR "Social work" OR "Temporary foster care" OR "Therapeutic 46 47 child care" OR "Voluntary social work" OR "Wardship" OR "Youth work") OR 48 49 ("social services" or "social work") OR ("voluntary group*" or "voluntary 50 work") OR SU.EXACT("Voluntary work") OR ("community group*" or "self help 51 52 group*" or "third sector" or "social enterprise*") OR SU.EXACT("Community 53 54 groups") OR SU.EXACT("Selfhelp groups") OR SU.EXACT("Social enterprises")) 55 56 AND (((SU.EXACT("Cautions" OR "Colonial police" OR "Diversion schemes" OR 57 "Police" OR "Prosecutor fine" OR "Transport police") OR (police OR policing)) 58 59 OR (police OR policing)) AND (SU.EXACT("Suicide") OR SU.EXACT("Vulnerable 60
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people") OR SU.EXACT("Stigmatization") OR SU.EXACT("Learning disabilities") BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 OR ("learning disabilit*" or "learning difficult*" or "learning disorder*" or 6 7 "intellectual disabilit*" or "mental retard*" or "special need*") OR (mental* 8 9 NEAR/2 (ill* or vulnerab*)) OR SU.EXACT("Mental health") OR 10 SU.EXACT("Psychiatric disorders") OR "mental disorder*" OR 11 12 SU.EXACT("Schizophrenia") OR SU.EXACT("Bipolar affective disorder") OR 13 14 SU.EXACT("Depression"))) 15 16 17 18 For peer review only 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 http://bmjopen.bmj.com/ 38 39 40 41 42 43 44 45 on September 26, 2021 by guest. Protected copyright. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
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BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 For peer review only 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 http://bmjopen.bmj.com/ 38 39 40 41 42 43 44 45 on September 26, 2021 by guest. Protected copyright. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
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1 2 3 4 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from 5 6 APPENDIX 3: DESCRIPTION OF STUDY DESIGNS 7 Study Design Description 8 Audit An assessment of current practice within a specific setting or context, in 9 10 line with best practice or to inform best practice, using for instance an 11 audit checklist [84] 12 Case study Description of policy or model within a specific context or setting, along 13 with presentation of routinely collected data pre- and post- 14 introduction, such as Teske et al. (2011) [137] 15 Qualitative Qualitative research concerns itself with aspects of research such as 16 experience and understanding. Techniques used include in-depth semi- 17 structured interviews and focus groups, and data can take any form 18 For peer review only 19 including audio recordings or words, such as Boscarto et al. (2014) [29] 20 Scoping review “A scoping review or scoping study is a form of 21 knowledge synthesis that addresses an exploratory research question 22 aimed at mapping key concepts, types of evidence, and gaps in research 23 related to a defined area or field by systematically searching, selecting, 24 and synthesising existing knowledge” [175] 25 Mixed methods Involves quantitative components such as a national survey involving 26 27 the police; and qualitative components such as focus groups and 28 interviews [57]. 29 Controlled before and A controlled before and after study compares one group receiving an 30 after study intervention with another (control) group that typically does not 31 receive the intervention. This can be a parallel group where the 32 comparison is made at the same time that the intervention group 33 receives the intervention, or a retrospective comparison can be made 34 where for example those referred to court diversion schemes are 35 36 compared with a retrospective group of defendants referred for 37 psychiatric reports by the same courts in the 1-2 year period http://bmjopen.bmj.com/ 38 immediately prior to the introduction of the diversion scheme [64]. 39 Service evaluation This describes and evaluates a service or model to examine practicality, 40 feasibility or pilot of a model within its’ initial stages. For example, to 41 examine the practicability of a recommendation to abolish or amend 42 Magistrates’ power to remand people perceived to have mental health 43 problems in custody for psychiatric reports and report the first 12 44 45 months of the service [33]. on September 26, 2021 by guest. Protected copyright. 46 Survey Typically using questionnaire to gather information within a specific 47 time point. For example, using a questionnaire distributed to health 48 and criminal justice staff to explore factors that impede or facilitate 49 information exchange between criminal justice and health agencies 50 [77]. 51 Description of model Description of the development and implementation of a model of 52 interagency collaboration, for example of a joint protocol for the 53 54 investigation of crimes against vulnerable adults [56] 55 Prospective An observational study, often longitudinal in nature, for which the 56 observational study consequential outcomes of interest occur after study commencement 57 (including creation of a study protocol and analysis plan, and study 58 initiation) [176]. 59 60
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1 2 3 4 !∞∞•Æ§©∏ 4: $•¥°©¨•§ §•≥£≤©∞¥©ØÆ Ø¶ ¥®• ≠ا•¨≥ 5 !rranged in the order of the most frequently occurring models. 6 7 bame 5efinition bo of Çype of model 8 9 studies 10 11 tolice-based specialised tolice-based specialised police response. Çhese 2 tre-arrest 12 police response [95,145] models involve sworn diversion 13 14 officers who have special mental health training, 15 serving as the first-line 16 For peer review only 17 police response to mental health crises in the 18 community and acting as liaisons 19 20 to the formal mental health system. 21 22 aental health training tolice officer receive training by mental health 3 tre-arrest 23 [101,118,143] professional to increase awareness and diversion 24 25 sensitivity to mental health issues and crisis and 26 facilitate access to services. Ürban and rural 27 population. íhen receive a call police officer 28 who has been trained is assigned wherever 29 30 possible. {ite also implemented pilot project 31 where psychiatric nurse who could admit people 32 directly to ward was paired with trained police http://bmjopen.bmj.com/ 33 officer to attend crisis calls and conduct follow- 34 up assessments on people in recent contact with 35 36 police. 37 38 39 40 !nother example is the aulti-agency training on September 26, 2021 by guest. Protected copyright. 41 initiative. Çhe half day course included reception 42 of patients at the hospital, legal requirements 43 (use of {ections 135 and 136 of the aI! 1983), 44 missing patients, restraint of patients, police use 45 46 of /{ spray and liaison with other professionals. 47 48 tost-crisis !ssistance tost-crisis !ssistance trogram (t/!t). tolice 1 tre-arrest 49 trogram (t/!t) [94] officers can refer individuals (via email) to diversion 50 aental Iealth !ssociation after incidents and 51 v ul Œ ( ŒŒo• (}Œ vÇ Z}v•µu Œ•[ ]v Œ]•]•X 52 5ata sharing between police and mental health 53 54 is primarily via email referrals. Collowing referral 55 šZ u všo Z ošZ ••}]š]}v • v• Z‰ Œ 56 •‰ ]o]•š[ }všš• šZ }v•µu Œ ]v ‰ Œ•}vX t Œ 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 54 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialists are consumers with long term mental 4 health plans. Çhey make consumers aware of 5 services relevant to their needs. 6 7 Çhe alternative place of Çhe alternative place of safety (!to{) legislation, 1 tre-arrest jail 8 safety (!to{) [68] which held adults under the aental Iealth !ct 5iversion 9 10 outside of a custody suite or traditional health- 11 based place of safety (I.to{), to give people a 12 better experience whilst they await a mental 13 health assessment 14 15 9mergency 9xamination 9mergency 9xamination hrders, which 1 tre-arrest jail 16 For peer review only 17 hrders [36] empowers police and ambulance officers (and 5iversion 18 psychiatrists) to transport patients to an 19 9mergency 5epartment or other authorised 20 mental health service for assessment 21 22 Çhe {econdary Camily {ZÇ }vŒÇZ Cu]oÇ[U }uuµv]šÇ Œ]•]• 1 tre-arrest jail 23 [45] response model which provides support for 5iversion 24 25 people with mental illness in times of crisis. Çhis 26 is as partnership of hospitals, tolice and a 27 /ommunity /risis wesponse programme who 28 provide a collective approach to support 29 provision. Çhe aim was to help individuals in 30 31 mental health crisis experience supportive 32 relationships in order to help them build http://bmjopen.bmj.com/ 33 resilience, to direct them in the right direction 34 35 Çhe {ubstance Çhe {ubstance !buse and aental Iealth 1 tre-arrest jail 36 {ervices !dministration ({!aI{!) jail 5iversion 37 !buse and aental Iealth 38 {ervices diversion initiative, which are pre-booking and 39 40 post-booking programmes !dministration ({!aI{!) on September 26, 2021 by guest. Protected copyright. 41 42 jail 43 44 diversion initiative [134] 45 46 aassachusetts aental aassachusetts aental Iealth 5iversion and 1 tre-arrest jail 47 Iealth 5iversion and Lvš PŒš]}v tŒ}PŒuu U Za u‰Z]•-like /LÇ- 5iversion 48 Lntegration trogramme ‰Œ}PŒuu [ šZš o•} ]voµ šZ o}o ‰}o] 49 [97] department and community care 50 representatives. Çhe aim was to develop 51 52 integrated treatment alternatives for people 53 with mental health, substance abuse, and/or 54 homelessness issues who become involved with 55 law enforcement 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 55 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Çhe aontgomery /LÇ Çhe aontgomery /LÇ. !imed to provide law 1 tre-arrest jail 4 [114] enforcement officers with the skills they need to 5iversion 5 safely deescalate situations with people with 6 mental illness in crisis 7 8 aobile /ommunity .ased on the Çraining in /ommunity [iving 1 tre-arrest jail 9 10 Çreatment program trogram. 5iversion 11 (a/Ç) [149] 12 13 14 thilosophy based on outreach efforts, with staff 15 }(š v P}]vP š} o] vš•[ Z}u v Á}Œl]vP š} 16 For connectpeer in any wayreview possible from providing only rids 17 to the grocery store to crisis intervention to help 18 19 with specific skill training. [inkages developed 20 with other community agencies including 21 hospital emergency rooms, police and county 22 jail. 23 24 ZLš ]• šÇ‰]o }( PŒ}Á]vP vµu Œ }( !/Ç 25 programs that are all based on similar operating 26 27 ‰Œ]v]‰o • ]v •]u]oŒ ‰}‰µoš]}vX[ !/Ç ‰Œ}À] • 28 mental health and other support on an on-going 29 basis, using community-based outreach 30 treatment teams. 31 32 /risis hutreach !nd /risis hutreach !nd {upport Çeam (/h!{Ç) 1 tre-arrest jail http://bmjopen.bmj.com/ 33 {upport Çeam (/h!{Ç) 5iversion 34 9xpanded /LÇ program involving civilians in crisis 35 [129] }µšŒ ZX ÇZ (]À ^Œ]•]• •‰ ]o]•š•_ ]v šZ 36 37 civilian unit are employees of and supervised by 38 the police. /h!{Ç workers are college graduates 39 with a background in case management, social 40 work, or psychology and includes a psychiatrist. on September 26, 2021 by guest. Protected copyright. 41 Çhey respond on-site in the field; conduct non- 42 43 urgent follow-ups; and make proactive visits to 44 homeless people to engage them with services 45 46 /risis Lntervention Çeam tre-booking, police-based programs that provide 17 tre-arrest jail 47 (/LÇ) mental health treatment in lieu of arrests. tre- 5iversion 48 [29,34,43,99,103,104,111 arrest diversion generally involves collaboration 49 50 ,114,116,118,124,126,12 between state and local law enforcement, 51 7,133,138,145,150] emergency services (e.g., dispatchers and 52 ambulatory services), and community 53 behavioural health treatment providers such as 54 clinical staff from local behavioural health 55 56 departments, hospital emergency departments, 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 56 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 specialised psychiatric centres. 4 5 6 7 Çhe most common pre-arrest diversion model is 8 the aemphis /risis Lntervention Çeam (/LÇ), 9 which is a police based first responder program 10 of pre-arrest jail diversion for those in a mental 11 12 illness crisis. Çhis provides law enforcement 13 based crisis intervention training for helping 14 those individuals with mental illness. Ln addition, 15 /LÇ works in partnership with mental health 16 For professionalspeer to review provide a system of servicesonly to 17 18 assist to the individuals with mental illness, 19 family members, and the police officers. 20 21 Çhe /ommunity /risis Çhe /ommunity /risis Lntervention Çeam (//LÇ); 1 tre-arrest jail 22 Lntervention Çeam (//LÇ) an innovative program utilizing crisis 5iversion 23 [43] intervention services and mobile crisis outreach 24 25 within an emergency room (9w) setting 26 27 /ivil commitment law /ivil commitment law, which allows for the 1 tre-arrest jail 28 [117] forced hospitalization 5iversion 29 30 of mentally ill individuals who are in need of 31 care, who are dangerous to themselves or 32 others, and http://bmjopen.bmj.com/ 33 34 who are either unwilling or unable to consent to 35 hospitalisation. Çhe aim was to allow people 36 37 who are mentally ill and exhibit problematic 38 behaviour in the community to be diverted, 39 before booking, from the criminal justice system 40 into the mental health system without the on September 26, 2021 by guest. Protected copyright. 41 necessity of arrest or criminal court involvement 42 43 44 {chool wesource {chool wesource 1 tre-arrest jail 45 5iversion 46 hfficers ({whs) [116] hfficers ({whs), school-based police officers with 47 /LÇ mental health training 48 49 who are trained to deal with a wide variety of 50 both instrumental and 51 52 expressive criminal acts 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 57 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 Çhe Cixated Çhreat Çhe Cixated Çhreat !ssessment /entre (CÇ!/), a 1 tre-arrest jail 4 !ssessment /entre joint police/ 5iversion 5 (CÇ!/) [75] 6 bational Iealth {ervice unit in the Ünited 7 Yingdom, which was set up 8 9 to assess and manage risks in people with 10 intense pathological fixation with public figures 11 12 vueensland Cixated vueensland Cixated Çhreat !ssessment /entre. 1 tre-arrest jail 13 14 Çhreat !ssessment Lnvolves intelligence gathering, risk assessment, 5iversion 15 /entre [38] alerting and awareness training for police and 16 For healthpeer professionals. review vCÇ!/ staff have only specialist 17 skills in the evaluation of the fixated, particularly 18 19 risks of violence, and from persistence, 20 disruption and escalation, which minimises 21 uncertainty and unmet security needs. 22 23 Çhe /ommunity {ervice Çhe /ommunity {ervice hfficer (/{h) model. ! 1 tre-arrest jail 24 hfficer (/{h) model [111] /ommunity {ervice hfficer (/{h), provides 5iversion 25 support in crime prevention, investigation, and 26 27 response where full police powers are 28 unnecessary and assists police officers in 29 upholding law and order 30 31 tre-arrest jail 5iversion ! separate but collaborative approach between 3 tre-arrest jail 32 [135] mental health and police teams. tolice bring 5iversion http://bmjopen.bmj.com/ 33 individuals in mental health crisis to emergency 34 35 department where mental health nurse is on 36 duty to assist. 37 38 aental Iealth aental Iealth Lntervention Çeam (aILÇ). Cront 2 tre-arrest jail 39 Lntervention Çeam line police officers receive enhanced mental 5iversion 40 (aILÇ) [30,31] health. Yey aims are: on September 26, 2021 by guest. Protected copyright. 41 42 1. weduce the risk of injury to police and mental 43 44 health consumers during mental health crisis 45 events; 46 47 2. Lmprove awareness by frontline police of risks 48 involved in dealing with mental health 49 consumers and strategies to reduce injuries to 50 police and consumers; 51 52 3. Lmprove collaboration with other government 53 54 and non-government agencies in the response 55 to and management of mental health crisis 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 58 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 events; and 4 5 4. weduce the time taken by police in the 6 handover of mental health consumers into the 7 health care system. 8 9 Çhe /ornwall ! pilot beighbourhood hutreach scheme to 1 tre-arrest jail 10 support police with vulnerable individuals with diversion 11 /riminal Wustice [iaison 12 suspected mental illness but not necessarily and 5iversion {ervice 13 criminal involvement. 14 (/W[5{) [61] 15 16 ëictoria model of For ëictoriapeer model ofreview wesponding to aental only Iealth 1 /o-response 17 wesponding to aental /rises in the /ommunity. !ims to provide 18 Iealth /rises in the assistance to people in mental health crises and 19 maintain their safety and that of others, and to 20 /ommunity [41] 21 receive assessment and treatment 22 23 Çhe tsychiatric Çhe tsychiatric 9mergency wesponse Çeam 2 /o-response 24 9mergency wesponse (t9wÇ) model. Çhe tsychiatric 9mergency 25 Çeam (t9wÇ) model wesponse Çeams (t9wÇ) consist of specially 26 trained officers and deputies who are paired 27 [33,111] with licensed mental health professionals. 28 29 Çogether, they respond on-scene to situations 30 involving people who are experiencing a mental 31 health related crisis and have come to the 32 attention of law enforcement. Çhe goal is to http://bmjopen.bmj.com/ 33 provide the most appropriate resolution to the 34 35 crisis by linking people to the least restrictive 36 level of care and to help prevent the 37 unnecessary incarceration or hospitalization of 38 those seen. 39 40 aental-health-based aental-health-based specialized mental health 1 /o-response on September 26, 2021 by guest. Protected copyright. 41 42 specialised mental health response. Ln this more traditional model, 43 response [95] partnerships or cooperative agreements are 44 developed 45 46 between police and mobile mental health crisis 47 teams (a/Çs) that exist as 48 49 part of the local community mental health 50 services system and operate independently of 51 52 the police department. 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 59 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 aobile /risis Çeams aobile /risis Çeams. Ln this instance, when 9 /o-response 4 [101,105,111] necessary, calls involving mentally disordered 5 [43,48,50,106,131] [152] individuals are handled by community health 6 [122] [146] based crisis teams in coordination with the 7 8 police department. !imed to improve the 9 handling of calls involving mentally impaired 10 individuals, and provide benefit to the 11 /incinnati tolice 5ivision and the local criminal 12 justice system generally. 13 14
15 16 For aobilepeer psychiatric review crisis assessment andonly 17 18 treatment teams, independently of but 19 responsive to requests from police. {hared 20 protocols providing guidelines for police and 21 mental health staff in handling situations 22 23 requiring a joint response have also been 24 implemented. 25 26 /o-responding tolice- aobile /risis Lntervention Çeams (a/LÇs), a 3 /o-response 27 aental Iealth programs police and mental health system co-response 28 (police and mental health partnership to assist police in responding to 29 professional) [29,43,49] people experiencing mental 30 31 health crises 32 http://bmjopen.bmj.com/ 33 {treet triage [69,71,90] {treet triage, this model involved a psychiatric 3 /o-response 34 35 nurse attending incidents with a police 36 constable. Çhe model of street triage 37 implemented contains the following 38 39 key elements: 40 on September 26, 2021 by guest. Protected copyright. 41 ¾ Çhe street triage team consists of one 42 dedicated police constable and one psychiatric 43 44 nurse; 45 ¾ 46 Çhe team physically attends the scene of 47 incidents reported, unless they are already 48 attending another 49 50 incident, in which case telephone support is 51 provided; 52 53 ¾ /all handlers filter calls to {ussex tolice and 54 55 allocate incidents to the street triage team if 56 there is an indication that the incident requires 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 60 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 support for mental health needs or crises; 4 5 ¾ Çhe street triage team are not the initial 6 response to emergency or life-threatening 7 events; 8 9 Çhe .irmingham Çhe .irmingham /ommunity {ervice hfficers- 1 /o-response 10 11 /ommunity {ervice police-based specialised mental health response: 12 hfficers [95] mental health professionals are employed by 13 police department to provide on-site telephone 14 consultations to officers in the field. 15 16 For peer review only 17 18 Çhe Ynoxville trogram Çhe Ynoxville trogram: aental-health-based 1 /o-response 19 [95] specialised mental health response: partnerships 20 21 or cooperative agreements are developed 22 between police and mobile mental health crisis 23 teams that exist as part of the local community 24 mental health service system and operate 25 independently to police department 26 27 aental 9valuation Ünit aental 9valuation Ünit (a9Ü), consisting of a 28 1 /o-response 29 (a9Ü) [150] {ystemíide aental !ssessment wesponse 30 Çeam, /ase !ssessment aanagement 31 trogramme, and aental Iealth Lntervention 32 Çraining. Çhe aim was to provide response to http://bmjopen.bmj.com/ 33 34 people in mental health crisis 35 36 Çhe {ystemwide aental Çhe {ystemwide aental !ssessment wesponse 3 /o-response 37 !ssessment wesponse Çeam, which allows mental health clinicians to 38 Çeam ({a!wÇ) [102] be present at incidents to employ and explore 39 non judicial alternatives such as diversion to a 40 private hospital, substance abuse centre or on September 26, 2021 by guest. Protected copyright. 41 42 outpatient mental health programme. Ço 43 provide a more effective and reliable way for 44 police to handle acutely mentally ill in the field 45 46 tolice !mbulance /risis t!/9w (tolice !mbulance /risis 9mergency 1 /o-response 47 9mergency wesponse) model. t!/9w was a dual secondary 48 49 wesponse(t!/9w) model service to aIC! for new police recruits, with 50 [28] mental health personnel travelling with police 51 and working together to manage individuals in 52 crisis in the community. 53 54 borthern tolice and borthern tolice and /linician 9mergency 1 /o-response 55 /linician 9mergency wesponse (bt!/9w) team. {econd response 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 61 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 wesponse (bt!/9w) [35] model consisting of police officer and mental 4 health professional attending mental health 5 crisis in the community, after initial police 6 response requires the person to be assessed by 7 8 mental health practitioner. 9 10 aental Iealth aental Iealth 9mergency {ervice, where police 1 /o-response 11 9mergency {ervice [150] officer and mental health nurse respond to 12 mental health calls. Çhe aim was to provide 13 response to people in mental health crisis 14 15 !ssertive hutreach Çeam !ssertive hutreach Çeam, a multi-professional 1 /o-response 16 For peer review only 17 [150] approach placing police officers as part of a 18 mental health team that addresses problematic 19 clients. Çhe aim was to provide response to 20 people in mental health crisis 21 22 .ehavioural Iealth .ehavioural Iealth {pecialised /o-wesponse 1 /o-response 23 {pecialised /o-wesponse Çeam builds on /LÇ model to have a full time 24 25 Çeam [150] aental Iealth /oordinator, a clinician. Çhe aim 26 was to provide response to people in mental 27 health crisis 28 29 /o-response aodel [150] ! /o-response aodel, which partners a police 1 /o-response 30 officer and mental health practitioner as a police 31 32 response team. Çhe aim was to provide http://bmjopen.bmj.com/ 33 response to people in mental health crisis 34 35 Iostage/barricade crisis /risis negotiation co-response. tsychologist or 2 /o-response 36 negotiation co-response. mental health professional as an integrated
37 [112] team member 38 39 tolice, !mbulance and t!/9w was a joint crisis response from police 1 /o-response 40 /linical 9arly wesponse and mental health clinicians to people on September 26, 2021 by guest. Protected copyright. 41 42 (t!/9w) [33] experiencing a behavioural disturbance in the 43 community. aental health clinician and police 44 operating together in an 8 hour shift. t!/9w unit 45 is a secondary unit that can be requested by a 46 primary responder police unit attending an 47 48 incident in the community. t!/9w can also be 49 requested by ambulance via police 50 communications 51 52 Çhe Lntegrated aobile Çhe Lntegrated aobile /risis wesponse Çeam , 1 /o-response 53 /risis wesponse [44] which aims to combine varied front-line crisis 54 55 responder elements into 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 62 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 a more efficient, responsive, and 4 interdisciplinary crisis response team that can 5 attend to the full continuum of community 6 crises 7 8 /risis wesponse Çeam /risis wesponse Çeam (/wÇ) consisting of 1 /o-response 9 10 (/wÇ) [113] dedicated /risis Lntervention Çeam (/LÇ) officers 11 (hC/) paired with a aental Iealth trofessional 12 (aIt). !ims to improve the police response in 13 situations involving mentally ill and chemically 14 15 dependent 16 For peer review only 17 individuals through specialized mental health 18 provider response 19 20 in the field 21 22 ! multi-agency police ! multi-agency police liaison scheme comprising 1 tost booking 23 liaison scheme [59] a rapid screening and mental health assessment jail diversion 24 at the earliest point of contact with the criminal 25 justice system, plus a mechanism for 26 27 appropriate referral or diversion to health and 28 social services 29 30 Çhe !dolescent 5rug ! multi-component, cognitive-behavioural 1 tost booking 31 !buse trevention and outpatient intervention serving children and jail diversion 32 Çreatment (!5!tÇ) youths referred directly from local police http://bmjopen.bmj.com/ 33 trogram [140] agencies 34 35 36 aental Iealth/Wuvenile aental Iealth/Wuvenile Wustice 5iversion troject 1 tost booking 37 Wustice 5iversion troject (aI/WW) jail diversion 38 (aI/WW) [110] 39 Lnvolves diverting youth out of the juvenile 40 justice system and linking them to appropriate on September 26, 2021 by guest. Protected copyright. 41 treatments in their counties. !ims to (1) to 42 reduce out-of-community placement, (2) to 43 44 prevent recidivism, and (3) to increase the 45 general functioning of youth and their families 46 47 tolvuest [83] 5eveloped a manual and training package for 1 tost-booking 48 tolvuest, a new police custody questionnaire. jail diversion 49 50 51 52 tolvuest-police and mental health screening 53 questionnaire which aimed to bridge the gap 54 between mental health services and police by 55 56 helping with the identification and referral of 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 63 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 individuals with mental health problems. 4 5 Çhe aassachusetts Çhe aassachusetts aental Iealth 5iversion and 1 tost-booking 6 aental Iealth 5iversion Lntegration jail diversion 7 and Lntegration 8 trogram (aaI5Lt), identify service strengths 9 trogram (aaI5Lt) [108] and gaps in delivering effective, integrated 10 services to persons suffering with mental illness, 11 12 substance abuse, and/or homelessness issues. 13 Çhis aimed to address the current needs for our 14 target population and facilitate better 15 interagency communication, cooperation, and 16 For peer review only 17 resource sharing. 18 19 òouth offending team òouth offending team-multi-disciplinary teams 1 tost-booking 20 [66] that work with young people who have jail diversion 21 committed crimes or who are believed to be at 22 risk of committing crimes. 23 24 !ssertive community Çhe !ssertive community treatment is a post- 3 tost-booking 25 treatment (!/Ç). !n booking, jail-based diversion program diverting jail diversion 26 27 Lntensive case individuals into psychiatric treatment in lieu of 28 management incarceration or reduced incarceration (with 29 [141,143,149] possible reductions in charges) 30 31 Çhe tolice [iaison Çhe tolice [iaison /ommunity tsychiatric burse 1 tost-booking 32 /ommunity tsychiatric troject. Çhree aims: 1) Ldentify and assess jail diversion http://bmjopen.bmj.com/ 33 34 burse troject [63] mentally disordered offenders; 2) direct these 35 cases into the healthcare system; 3) provide a 36 quantitative indication of the size of the 37 problem, in order to make recommendations for 38 future services. Çhe aim was to identify and 39 40 assess mentally disordered offenders and direct on September 26, 2021 by guest. Protected copyright. 41 these cases into the healthcare system 42 43 ÇZ Z[]vl í}Œl Œ ÇZ Z[]vl í}Œl Œ {Z u [U ]u š •šo]•Z]vP 1 tost-booking 44 {Z u [ [65] relationships with people with mental health jail diversion 45 and multiple problems in contact with the police 46 in order to improve the ways in which the full 47 48 range of their needs can be understood and met 49 50 /ourt diversion scheme /ourt diversion scheme. 5efendants are 2 tost-booking 51 [72,74] screened prior to their appearance in court, by jail diversion 52 forensic community psychiatric nurses. Çhey 53 look at charge sheets and previous convictions, 54 55 for any unusual aspects such as multiple drug or 56 alcohol related offences or and possible serious 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 64 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 mental illness. /ustody or probation officers may 4 refer a prisoner they have concerns about. 5 6 .elfast screening, Çhe police station provides a setting for the 1 tost-booking 7 assessment and referral treatment, questioning and identification of jail diversion 8 service for mentally mentally disordered suspects. {ervice based on 9 10 disordered offenders [89] the 5iversion at the point of arrest model, 11 providing mental health assessment at the 12 earliest point of contact with the criminal justice 13 system and guidance and referrals to local 14 15 health and social services. trovided by 16 For /ommunitypeer mental review health nurses and only supported 17 by forensic psychiatry. burses screen custody 18 record forms of all detainees. Lndividuals may 19 also be referred by an Corensic aedical officer, 20 21 custody sergeant or magistrate. Collowing 22 assessment make recommendations for 23 treatment and support. 24 25 5iversion at the point of 5iversion at the point of arrest (5!t!) 2 tost-booking 26 arrest (5!t!) [86,87] jail diversion 27 28 aulti-agency police aulti-agency police liaison scheme. Çhe service 1 tost-booking 29 liaison scheme [59] comprises a rapid screening of custody records jail diversion 30 31 for all detainees and mental health assessment 32 where needed at the earliest point of contact http://bmjopen.bmj.com/ 33 with the /W{, plus a mechanism for appropriate 34 referral or diversion to health and social 35 36 services. Çhe nurses also co-ordinate follow-up 37 care and provide ongoing advice and support to 38 offenders, the police and health care 39 professionals. !imed to identify offenders with 40 psychiatric illness and/or learning disabilities on September 26, 2021 by guest. Protected copyright. 41 42 within the integrated health and social care 43 system 44 45 Wail diversion programme Wail diversion programme, a process where 13 tost-booking 46 [59,70,74,81,84,107,115, alternatives to criminal sanctions are made jail diversion 47 121,127,132,133,134, available to persons with mental illness (taL) 48 135] who have come into contact with the law. Ço 49 50 identify detainees who have {aL and/or
51 substance misuse problems and establish mental 52 health treatment programs that meet their 53 needs in the least restrictive environment. 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 65 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 hutreach team and hutreach team and police department. Çhe 1 Lnformation 4 police department [53] team contact police for help in finding missing sharing 5 persons and the police contact the team when agreements 6 they observed strange behaviour in a homeless 7 8 person that suggests the need for mental health 9 information. .y establishing ongoing 10 communication with the police, outreach team 11 hoped it could foster better relations with the 12 police and between the police and the target 13 14 population, leading to fewer arrests and 15 incarcerations of people with mental health 16 For problemspeer and arereview homeless. !lso helped only the 17 police would help them find hard-to-find at risk 18 19 people with mental health problems that are 20 living on the streets. 21 22 /risis /are concordat [67] Çhe /risis /are /oncordat, a national agreement 1 Lnformation 23 between the different agencies and services sharing 24 involved in the care of people experiencing, or at agreements 25 risk of experiencing, a mental health crisis in the 26 27 ÜY. Çwenty-seven national bodies have signed 28 up to the /oncordat, representing health, the 29 police, social care, housing, national and local 30 government (including the Iome hffice, 31 5epartment of Iealth and the ainistry of 32 http://bmjopen.bmj.com/ 33 5efence) and voluntary and community sector 34 organisations. !ims to improve the quality and 35 availability of help and support, with a focus on 36 acute mental health crises, although it also 37 38 recognises the importance of prevention and 39 recovery. Çhe four main aims of the /oncordat 40 are to improve: access to support before crisis on September 26, 2021 by guest. Protected copyright. 41 point; urgent and emergency access to crisis 42 care; vuality of treatment and care when in 43 44 crisis; wecovery and staying well 45 46 Çhe tsychiatry/ aental Cormally organised at two levels: managerial and 1 Lnformation 47 Iealth {ervices operational level. aanagerial level has one sharing 48 cooperation model [52] representative from each sector and the agreements 49 operational level has one representative at mid- 50 level from each of the three sectors and a 51 52 coordinator who is also a member at managerial 53 o À oX ZÇZ u}•š ]u‰}Œšvš š•l[ ]• š} }}Œ]nate 54 the information about vulnerable citizens and 55 their situation to designate the most appropriate 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 66 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 sector to deal with their issues. 4 5 6 7 9arly botification 9arly botification trogram (9bt) 1 Lnformation 8 trogram (9bt) sharing ! system where people with mental illnesses 9 agreements 10 [100] and special needs can voluntarily provide the 11 police with their medical information to aid 12 interaction. Çhe aim was to provide officers with 13 14 medical information to enable them to resolve 15 situations while protecting themselves and 16 For maintainingpeer the review safety of the individual only and the 17 community. 18 19 Lnformation sharing aulti-!gency tublic trotection !rrangements 1 Lnformation 20 agreements,(e.g. with (a!tt!) is a legal requirement in the ÜY under sharing 21 22 /W{; part of risk the /riminal Wustice !ct 2003. Çhe aim of a!tt! agreements 23 management (aulti- is to protect the public, including previous 24 !gency tublic trotection victims of crime, from serious harm by sexual 25 !rrangements - a!tt!); and violent offenders. a!tt! requires the local 26 safeguarding) [85] criminal justice agencies and other bodies 27 28 dealing with offenders to work together in 29 partnership in dealing with these offenders, by 30 identifying individuals who should be under 31 a!tt!; management of such individuals; multi- 32 http://bmjopen.bmj.com/ 33 agency storing and sharing information about 34 offenders; disclosure of information to the 35 public about individual offenders in particular 36 circumstances; risk assessment and 37 management; multiagency meetings and case 38 39 reviews: 40 on September 26, 2021 by guest. Protected copyright. 41 Z[}}• }µ‰o]vP[ [144] Z[}}• }µ‰o]vP[ ]• }v ‰š šZš •µPP •š• 1 Lnformation 42 43 resilient system of independent agencies that sharing 44 work harmoniously in an exchange relationship agreements 45 while the different parts retain physical and 46 professional autonomy. 47 48 49 50 Çhe flexibility of loose coupling allows for 51 systems such as criminal justice and mental 52 53 health that seem ideologically incompatible to 54 join when a need arises and create composite 55 services. 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 67 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 [earning 5isabled [earning 5isabled hffenders' Corum. Lnitially a 1 Lnformation 4 hffenders' Corum [70] support group for sharing issues; membership sharing 5 expanded to enable not only interagency agreements 6 communication but to be instrumental in 7 8 improving services and their delivery. !imed to 9 improve communication between professionals 10 and agencies 11 12 Lnformation sharing [egislation and good practice guidance 3 Lnformation 13 agreements [56] [54] documents. sharing 14 agreements 15 16 For peer review only 17 Cor example: Lnformation sharing between bI{ 18 19 and criminal justice system. Çhe study explored 20 factors that enable or impede information 21 sharing and determined what information is 22 received and needed for bI{ and criminal 23 justice system agencies as well as attitudes and 24 25 practises about information sharing rather than 26 one model. 27 28 29 30 9xample: wecommendations made: 31 32 aove to community-based mental health http://bmjopen.bmj.com/ 33 services. Lmplement the trimary /are {trategy. 34 trovide social work services 24hrs, 7 days a 35 week. 36 37 aental health training for !n Darda {íochána. 38 39 9xamine the feasibility of /LÇs. 5evelop joint 40 protocol and formal liaison systems. Ço examine on September 26, 2021 by guest. Protected copyright. 41 the introduction of 5istrict court diversion 42 programme 43 44 Z/}vš u‰}ŒŒÇ t}o]]vP Z/}vš u‰}ŒŒÇ t}o]]vP Dµ] o]v • (}Œ í}Œl]vP 1 Lnformation 45 Duidelines for íorking with the aental Iealth {ysš u[X Z]• }µšo]v • sharing 46 Ç 47 with the aental Iealth proactive police approach to interactions with agreements 48 {Ç•š u[ [46] people with mental illness and with the mental 49 health system and identifies principles that can 50 be used by police organisations. Çhe aim was to 51 52 maximize the likelihood that crisis interactions 53 between police and people with mental illnesses 54 are prevented when possible and resolved safely 55 and respectfully when they do occur 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 68 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 .est practice model of Çhe program of work is culminating in the 1 Lnformation 4 policing people with development of a best practice model of policing sharing 5 mental illness [37] people with mental illness. agreements 6 7 trotocol for the Woint Çhis aims to strengthen communication and 1 Lnformation 8 collaboration between agencies in order to sharing 9 Lnvestigation of /rimes 10 protect vulnerable adults; to provide a agreements 11 /ommitted against framework for early cross-referral of /ases; to 12 ensure police involvement in the referral process 13 ëulnerable !dults [56] to ascertain whether a crime has been 14 15 committed; to minimise the number of 16 For interviewspeer conducted review with the victim; only to ensure 17 through good planning that criminal enquiries 18 run parallel to other lines of enquiry; to allow 19 accurate data to be collected on the incidence of 20 21 crimes against vulnerable adults. 22 23 tsychiatric assessment tsychiatric assessment scheme. weferred from 1 /ourt 24 scheme [64] court or other agencies for assessment. diversion 25 26 /ognitive !nalytic /ognitive !nalytic Çherapy (/!Ç) is a 1 /ourt 27 Çherapy (/!Ç) [76] collaborative time-limited psychotherapy. Çhe diversion 28 approach aims to formulate how early 29 experiences influence the development 30 31 }( µvZ o‰(µo ‰šš Œv• šZš u]vš]v ‰ Œ•}v[• 32 http://bmjopen.bmj.com/ 33 current difficult experiences. Çhis is represented 34 diagrammatically in a map. 35 36 /ourt diversion 5iversion includes all community-based 5 /ourt 37 [54,72,74,88,110] alternatives to standard prosecution that occur diversion 38 before an offender has 39 40 entered a plea or goes to trial; thus, the offender on September 26, 2021 by guest. Protected copyright. 41 42 ]• Z]À Œš [ (Œ}u •švŒ 43 44 prosecution and into specialised community- 45 based services that are better able to meet their 46 needs. /ourt diversion programmes occur 47 following arrest whilst the individual is 48 49 in initial detention, during initial hearings, or 50 while being assisted by 51 52 pre-trial services offer community based 53 54 alternatives to standard prosecution 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 69 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 hutpatient commitment hutpatient commitment- a civil court procedure 1 /ourt 4 [136] mandating adherence to outpatient mental diversion 5 health treatment. {tatutorily defined outpatient 6 commitment requires compliance with 7 8 recommended outpatient treatment but does 9 not permit forced medication of legally 10 competent individuals. Lf fail to comply with 11 treatment, outpatient statutes permit the 12 clinician to request law enforcement officers 13 14 transport the individual to an outpatient facility, 15 where clinicians will attempt to persuade them 16 For topeer accept treatment review or undertake an onlyevaluation 17 for inpatient commitment. 18 19 20 21 !dditionally, a number of related civil judicial 22 23 mechanisms may be used to compel outpatient 24 treatment. 25 26 [iaison and diversion [iaison and diversion services aim to identify and 2 /ourt 27 services [61,153] support people with mental health problems, diversion 28 learning difficulties and other vulnerabilities in 29 police stations and courts. Çhe aim is to identify 30 31 and support people with mental health 32 problems, learning difficulties and other http://bmjopen.bmj.com/ 33 vulnerabilities in police stations and courts 34 35 {ocial bavigator troject. {ocial bavigator troject. ({bt) 1 /ourt 36 ({bt) [47] diversion 37 Çhe social navigator is a full time paramedic who 38 works closely with !/ÇLhb (anti-violence) 39 officers to help repeat offenders Çhe bavigator 40 on September 26, 2021 by guest. Protected copyright. 41 works with social agencies to provide care that 42 serves the need. Çhe aim is to reduce contacts 43 with repeat offenders and get them the 44 appropriate care 45 46 tolice-based specialised tolice-based specialised mental health response. 1 /o-location 47 48 mental health response Ln this model, mental 49 [101] 50 health professionals (not sworn officers) are 51 employed by the police department to provide 52 on-site and telephone consultations to officers 53 in the field. hf the departments, 12% had this 54 type of program. 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 70 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 !labama, police-based /ommunity services officers provide crisis 1 /o-location 4 specialised mental health intervention and some follow-up assistance. 5 response [145] /ommunity service officers receive 6 weeks 6 training. !lso attend social service calls 7 8 (domestic violence) where required. 9 10 9mbedded model [78] tolice [iaison Corum. 1 /o-location 11 12 /ommunity police officer dedicated to charity 13 funded hospital facilities for mental health, 14 learning disability or acquired brain injury. 15 hfficer is managed as police officer but has 16 For peer review only 17 office at the hospital. !imed to improve 18 communications, consistency of decision- 19 making, police response, and reduce number of 20 violent incidents. and have a common approach 21 to referral to criminal justice system 22 23 9mbedded model [29,95] 9mbedded model where police employ mental 2 /o-location 24 25 health professionals who assess consumers 26 brought into police stations by frontline officers. 27 28 a [ v I}•‰]šo[• a [ v I}•‰]šo[• /}oo P a všo I oth 1 {ervice 29 /ollege aental Iealth trogram was established as an institutional integration 30 trogram [43] response to escalating, national college mental model 31 health concerns. ac[ean Iospital is the first 32 http://bmjopen.bmj.com/ 33 psychiatric hospital to develop a comprehensive 34 college student program that bridges the gap 35 between a psychiatric hospital and multiple 36 campus settings as an attempt to address the 37 38 specific needs of college student-patients across 39 levels of psychiatric care and diagnostic 40 areas/programs. Üsing a bioecological systems on September 26, 2021 by guest. Protected copyright. 41 framework, this review examines (1) the 42 strategic clinical, education/outreach, and 43 44 research efforts that collectively represent a 45 paradigm shift to extend responsibility for 46 addressing serious college mental health 47 challenges beyond college and university 48 campuses, (2) the challenges and benefits of 49 50 creating stronger multi-campus/hospital 51 collaborations in order to improve our 52 understanding of college students with serious 53 mental illness, and (3) the progress in addressing 54 these needs more effectively and in establishing 55 56 documented best practices and policies through 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 71 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 effective and innovative partnerships. 4 5 /ommunity-care betwork coordinator (often community 1 {ervice 6 networks[55] psychiatric nurse). tatient reported by one of integration 7 the network partners who gather relevant model 8 information and if necessary the coordinator 9 10 starts intensive outreach to contact the person. 11 ! plan of action is established and the 12 coordinator monitors implementation. !s soon 13 as possible community care involvement is 14 15 reduced and responsibility is transferred to the 16 For mostpeer appropriate review agency e.g. mental only health. 17 18 Çhe {afety bet Çhis is a multiagency integrated model of 1 {ervice 19 /ollaborative [93] preventive services for at-risk youth involving integration 20 mental health providers, police officers, schools, model 21 and the department of youth and families. Çhe 22 23 aim of the service was to decrease youth arrest, 24 decrease youth violence, improve school 25 attendance and completion, and reduce 26 symptoms of mental illness and psychological 27 distress. botably in this program, youth police 28 29 officers are actively involved in the follow-up 30 and outreach to at-risk youth. 31 32 Wuvenile justice policy /omprehensive three-pronged approach to 1 /omprehensiv http://bmjopen.bmj.com/ 33 reform, advocacy and reducing in-school arrests through reforms to e systems 34 systems coordination juvenile justice policy, advocacy and systems organisation 35 36 efforts, and changes to coordination efforts, and changes to school 37 school practice and practice and policy 38 policy from an 39 interdisciplinary 40 collaborative approach on September 26, 2021 by guest. Protected copyright. 41 42 [96] 43 44 troject {h.9LÇ [119] troject {h.9LÇ, which included six elements: (1) 1 /omprehensiv 45 safe school environment, e systems 46 organisation 47 (2) alcohol and other drug and violence 48 prevention and early intervention programs, (3) 49 school and community mental health preventive 50 and treatment intervention services, (4) early 51 52 childhood psychosocial and emotional 53 development programs, (5) educational reform, 54 and (6) safe school policies. !imed to provide 55 students and their families with enhanced 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 72 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 comprehensive educational, mental health, 4 social service, law enforcements and juvenile 5 justice services that promote healthy childhood 6 development and prevent violence and alcohol 7 8 and other drug abuse. Ln this model, school 9 police officers worked with other agencies to 10 encourage pro-social behaviour and reduce drug 11 use 12 13 {chool weferral {chool weferral weduction trotocol 1 /omprehensiv 14 weduction trotocol [137] e systems 15 Lntegrates community systems to reduce 16 For peer review only organisation 17 reliance on punitive measures while at the same 18 time providing additional resources for school 19 systems to assess and treat disruptive students. 20 21 tolice agencies use tolice agencies use mental health professional 1 /onsultation 22 mental health consultants working with police negotiation model 23 professional consultants teams in hostage and barricade situations. Çhe 24 25 to the negotiation team aim of the model is to preserve life, apprehend 26 the perpetrator and protect property 27 [98] 28 29 30 31 Çhe multidisciplinary Çhe multidisciplinary 1 /onsultation 32 model http://bmjopen.bmj.com/ 33 mental health care team mental health care team, provides a backup of 34 [42] skilled mental health workers to the general 35 hospital and community support services such as 36 the police, and contributes to the skill 37 development of staff, and maximizes the 38 39 resources provided by a specialist team 40 on September 26, 2021 by guest. Protected copyright. 41 hldham thone hldham thone Çriage/w!L5 tilot troject, 1 /onsultation 42 Çriage/w!L5 tilot troject consists of a 24-hour telephone number for model 43 [62] professional advice and assistance from w!L5 44 (wapid !ssessment Lnterface and 5ischarge), the 45 46 ÇŒµ•š[• ‰•ÇZ]šŒ] o]]•}v • ŒÀ] X ÇZ ]u Á• š} 47 provide a service available to local police officers 48 who attend incidents where an individual 49 appears to be experiencing mental health 50 problems. 51 52 ZW}]vš µoš tŒ}š š]}v ZW}]vš µoš tŒ}š š]}v LvÀ •š]Pš]}v•[ šŒ]v]vPU ]v 1 Woint 53 54 LvÀ •š]Pš]}v•[ šŒ]v]vPU o]v Á]šZ šZ ÜY P}À Œvu vš ‰}o]ÇU Zb} { Œ š•[X investigation 55 in line with the ÜY Çhe aim was to improve the conduct of joint or training 56 P}À Œvu vš ‰}o]ÇU Zb} multi-agency adult protection investigations by 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 73 of 77 BMJ Open BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 {X Œ š•[ [80] social care and health professionals and to 4 promote collaborative working in order to 5 achieve best practice in joint investigations and 6 in supporting the vulnerable adults involved. 7 8 Woint investigation tilot scheme of joint training for the police and 1 Woint 9 10 training [58] Iomefirst community trust-focussing on inter- investigation 11 agency reporting and investigation of crimes training 12 committed against vulnerable adults. Çraining 13 aimed to provide opportunities for police 14 15 officers and social workers to explore issues 16 For aroundpeer joint investigation review of crimes committedonly 17 against vulnerable adults. 18 19 trime Çime troject [139] Çhe project makes contact with youths and their 1 we-entry 20 families while the youths are detained and then 21 follows them into the community upon release. trogrammes 22 23 !ctivities include:(1) structured activities in a 24 local community center;(2) vocational training, 25 including hands-on job skills training; (3) training 26 such as social skills, affect management, 27 interpersonal problem-solving, and drug and 28 29 alcohol abuse; and (4) a youth and parent group 30 meeting 31 32 troject [ink [128] troject [ink 1 we-entry http://bmjopen.bmj.com/ 33 34 ! consortium of community service agencies trogrammes 35 based on assertive community treatment and 36 intensive case management. Çhere is a mobile 37 38 treatment team and case advocates in each of 39 five agencies who link consumers to psychiatric, 40 medical, residential and social services in the on September 26, 2021 by guest. Protected copyright. 41 community 42 43 Z{‰ l]vP µ‰ (}Œ iµ•š] [U {pecial measures throughout the criminal justice 1 {pecial 44 {pecial measures to system to protect vulnerable and intimidated protective 45 46 protect vulnerable witnesses. {pecial measures were brought under measures 47 witnesses [57] the 1999 /riminal Wustice !ct. Çhis aimed to 48 improve how vulnerable and intimidated 49 witnesses are treated. Çhis included the 50 identification and support of vulnerable 51 52 witnesses. 53 54 /hild 5evelopment- /hild 5evelopment-/ommunity tolicing troject. 1 {pecial 55 /ommunity tolicing /omprises: training; police exposure to social protective 56 and clinical services and clinician exposure to 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 74 of 77 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
1 2 3 troject [123] police practice; 24 hour access to clinician; case measures 4 conferences. 5 6 7 troject [ifesaver [130] teople enrolled in the project wear a 1 {pecial 8 personalised wristband tracking device. Çeams protective
9 are specially trained to use electronic tracking measures 10 equipment and how to approach a person who 11 12 has special needs and gain their trust. 13 14 Lntegrated model [93] 9arly tsychosis trogram, an integrated model of 1 Lntegrated 15 enhanced management within an adult mental model 16 For healthpeer service. Çhereview aim is to provide onlycontinuity, 17 familiarity and 18 19 support at an early stage throughout all settings 20 21 in the health service in order to facilitate trust, 22 reduce distress and trauma 23 24 25 26 27 28 29 30 31 32 http://bmjopen.bmj.com/ 33 34 35 36 37 38 39 40 on September 26, 2021 by guest. Protected copyright. 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
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1 PRISMA 2009 Checklist 2 3 Reported 4 Section/topic # Checklist item 5 on page # 6 7 TITLE 8 Title 1 Identify the report as a systematic review, meta-analysis, or both. 1 9 10 ABSTRACT 11 Structured summary 2 Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, 2 12 participants,For and interventions; peer study appraisal review and synthesis methods; only results; limitations; conclusions and 13 implications of key findings; systematic review registration number. 14 15 INTRODUCTION 16 Rationale 3 Describe the rationale for the review in the context of what is already known. 4 17 Objectives 4 Provide an explicit statement of questions being addressed with reference to participants, interventions,http://bmjopen.bmj.com/ 18 5 comparisons, outcomes, and study design (PICOS). 19 20 METHODS 21 Protocol and registration 5 Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide 22 5 registration information including registration number. 23 24 Eligibility criteria 6 Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, 5 25 language, publication status) used as criteria for eligibility, giving rationale. on September 26, 2021 by guest. Protected copyright. 26 Information sources 7 Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify 6 27 additional studies) in the search and date last searched. 28 29 Search 8 Present full electronic search strategy for at least one database, including any limits used, such that it could be Appendix 30 repeated. 2 31 32 Study selection 9 State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, 6 included in the meta analysis). 33 - 34 Data collection process 10 Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes 6 35 for obtaining and confirming data from investigators. 36 Data items 11 List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and 37 6 simplifications made. 38 39 Risk of bias in individual 12 Describe methods used for assessing risk of bias of individual studies (including specification of whether this was Not 40 studies done at the study or outcome level), and how this information is to be used in any data synthesis. applicable 41 as 42 43 scoping 44 review 45 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
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1 PRISMA 2009 Checklist 2 3 Summary measures 13 State the principal summary measures (e.g., risk ratio, difference in means). 4 N/A 5 Synthesis of results 14 Describe the methods of handling data and combining results of studies, if done, including measures of consistency 6 2 6 (e.g., I ) for each meta-analysis. 7 8 Page 1 of 2 9 Reported Section/topic # Checklist item 10 on page # 11 12 Risk of bias across studies 15 Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective N/A reportingFor within studies). peer review only 13 14 Additional analyses 16 Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating 6 15 which were pre-specified. 16 17 RESULTS http://bmjopen.bmj.com/ 18 Study selection 17 Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at 7 19 each stage, ideally with a flow diagram. 20 21 Study characteristics 18 For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and 8-11 provide the citations. 22 23 Risk of bias within studies 19 Present data on risk of bias of each study and, if available, any outcome level assessment (see item 12). N/A 24 25 Results of individual studies 20 For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each N/A intervention group (b) effect estimates and confidence intervals, ideally with a forest plot. on September 26, 2021 by guest. Protected copyright. 26 27 Synthesis of results 21 Present results of each meta-analysis done, including confidence intervals and measures of consistency. N/A 28 29 Risk of bias across studies 22 Present results of any assessment of risk of bias across studies (see Item 15). N/A 30 Additional analysis 23 Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item 16]). 11-16 31 32 DISCUSSION 33 Summary of evidence 24 Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to 16 34 key groups (e.g., healthcare providers, users, and policy makers). 35 36 Limitations 25 Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of 17 37 identified research, reporting bias). 38 Conclusions 26 Provide a general interpretation of the results in the context of other evidence, and implications for future research. 19 39 40 FUNDING 41 42 Funding 27 Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the 20 systematic review. 43 44 45 From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMAFor peer Group review (2009). only Preferred - http://bmjopen.bmj.com/site/about/guidelines.xhtml Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 BMJ Open: first published as 10.1136/bmjopen-2017-019312 on 27 March 2018. Downloaded from
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1 PRISMA 2009 Checklist 2 3 doi:10.1371/journal.pmed1000097 4 For more information, visit: www.prisma-statement.org. 5 Page 2 of 2 6 7 8 9 10 11 12 For peer review only 13 14 15 16 17 http://bmjopen.bmj.com/ 18 19 20 21 22 23 24 25 on September 26, 2021 by guest. Protected copyright. 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60