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There is a proportion of psychiatric service users whose needs are not met by existing models of care. This can lead to a reliance on acute and crisis services. These service users may be considered high intensity users (HIUs). The purpose of this research is to evaluate the Crisis Plus model, an intervention designed to better support HIUs in the community and reduce dependency on acute and crisis services.

Forty-seven HIUs were involved in Crisis Plus. The core intervention of Crisis Plus was an Anticipatory Management Plan (AMP), produced in collaboration with service users, their families and their care coordinators. AMPs were shared with relevant services and attached to electronic patient notes to ensure a uniform, psychologically informed approach to care.

HIU service use was compared pre and post-AMP. On average, number of inpatient admissions, number of days spent on the ward, accepted psychiatric liaison referrals and accepted home treatment team (HTT) referrals decreased significantly.

Crisis Plus has taken a collaborative, proactive approach to engage HIUs, their families and the services that care for them. Crisis interventions that emphasise collaborative working and service user agency are key.

The provision of dedicated psychological support to HIUs and their professional and personal network is crucial to reduce reliance on acute and crisis care. Crisis Plus is unique in that it instigates co-production and active consultation with HIUs and services to improve clinical outcomes, in addition to reducing NHS expenditure.

The purpose of this paper is to evaluate the impact on recovery and personal goal attainment of a transition intervention service for return to the community following exit from an alternative to psychiatric inpatient admission – a residential recovery house. The services seek to facilitate community reintegration, promote recovery and prevent future mental health crisis. The service was funded by the Stone Family Foundation.

This evaluation employed a within groups design: a single case evaluation follow-up. Analysis of Recovery Star and personal goal achievement data collected at service entry and exit points during routine practice (n=181), at four sites in England. The adults had mental illness diagnoses including depression, schizophrenia, bipolar disorder, personality disorder, and anxiety disorder.

There was a significant increase in overall Recovery Star scores with a large effect size, and significant increases in eight of the ten Recovery Star life domains. There were significant increases in the goal scores linked to “Managing mental health”, “Self-care” and “Living skills”.

A transitional intervention service provided by the third sector for return to community following mental health crisis may contribute to recovery and personal goal achievement. A randomised control trial of this transition intervention service is recommended.

This is first outcome evaluation of an alternative to psychiatric inpatient admission transition intervention service and findings indicate the potential positive effect of having this service incorporated into the design of alternative to admission provision.

To evaluate the impact of crisis house admission in terms of mental health recovery and achievement of personal goals for people using the service.

Mental Health Recovery Star (Recovery Star) and Personal Goal Scoring data were collected at entry and exit points in routine practice as part of a bespoke support planning process from 722 adults using one of three Rethink Mental Illness Crisis Houses. The adults had mental illness diagnoses including depression, schizophrenia, bipolar disorder, personality disorder, and anxiety disorder.

There were significant increases in all ten Recovery Star domains, for example: managing mental health (up 2.11 points (1-10 scale)), identity and self-esteem (up 1.56 points), trust and hope (up 1.48 points), and self-care (up 1.35 points). The analysis of Personal Goal Scoring data (scored on 1-10 scale) showed significant increases on how close people were to achieving their goals. For all goals listed there was an average increase of 2.5 point from 3 to 5.5, showing that people made progress during their stay in the service.

Services provided by the third sector may offer an important contribution to support people's recovery and prevent admission to psychiatric hospital.

The findings of the evaluation study support a growing body of evidence regarding the effectiveness of services offering alternatives to admission, and they highlight the value of using recovery-oriented support planning and outcome capture tools in routine practice.

Women with learning disabilities have many social, personal and psychological problems that stem from being neglected, as well as from being doubly disadvantaged by their gender and their learning disability. Most of these psychosocial problems are not addressed as they arise, and lead to psychiatric diagnosis and medicalisation of non‐medical issues. It is important to recognise parenting in women with learning disabilities, as well as concerns such as sexual and emotional abuse and violence, and to address them by appropriate agencies. Research suggests that trained mental health staff with a good understanding of gender as well as of disabilities would be able to address the needs before they turn into crises. International and national surveys give a good understanding of where the needs lie and how services could be structured most effectively. Recognition of the problems, a robust gender‐sensitive approach and management skills at community level seem to be most important in dealing with women with learning disabilities. Most women with learning disabilities need local, generic, gender‐sensitive non‐stigmatising services. Only a very small minority of women with behavioural problems will need the highly specialised psychiatric learning disabilities team.

The purpose of this paper is to evaluate a police department's Post-Crisis Assistance Program (PCAP) for consumers who experienced a police-abated mental health crisis. The authors analyzed three questions: First, does PCAP reduce a consumer's future mental health calls for service (CFS)? Second, does PCAP reduce a consumer's odds of being arrested? Third, does PCAP reduce the odds of a consumer being taken into emergency protective custody (EPC)?

The authors use propensity score matching to analyze data from a sample of individuals (n=739) who experienced a police-abated mental health crisis.

The authors find that PCAP consumers generated fewer mental health CFS, were less likely to be arrested, and were less likely to be taken into EPC than non-PCAP consumers six months following a police-abated mental health crisis.

The research only examined outcomes six months after a mental health crisis. The authors encourage future research to examine whether the benefits of PCAP persist over longer periods of time.

The study demonstrates that partnerships between police departments and local mental health groups can help police officers better serve citizens with mental health conditions.

To the knowledge, this is the first study to evaluate the impact of a PCAP for citizens experiencing police-abated mental health crises.

Support for individualism can leave marginalised people feeling even more isolated and hopeless. Families often attempt to help but can soon become emotionally depleted. The ‘secondary family’, created when community agencies partner with one another, can offer hope for stabilisation, if not recovery, for individuals living with mental illness. This article describes a Canadian programme where crisis services are working with police to de‐escalate psychiatric crisis. Shared goals bring crisis staff and police together to provide compassion, support and follow‐up.

The purpose of this paper is to propose a focus for mental health training efforts to better equip officers to provide interventions and supports to help facilitate improved outcomes for people experiencing mental health crises.

A reflection on key evidence relating to mental health training programmes delivered to police, focussing on Australia, the USA and Canada.

While there are a number of similarities in the core content of mental health training programmes offered internationally, the availability and uptake of training across jurisdictions remains piecemeal and idiosyncratic. Police officers report a strong preference for hands-on experiential learning; this has immediate and direct relevance to their operational duties, and is consistent with core principles of andragogy. While all police employees require mental health training, specialised mental health training programmes should clearly be reserved for a select group of officers who volunteer after acquiring sufficient operational experience.

Priorities should centre on measuring the effectiveness of mental health training packages and discerning the active elements associated with changes in police skills and confidence, as well as identifying elements that support improved outcomes for people who experience mental illness and who have contact with the police.

Police need to continue to need to seek legitimacy with respect to their guardianship role as mental health interventionists. Training should tap into practice-based wisdom. Training should be practical, applied and reinforced through wider knowledge-based learning and workplace reinforcement. Training is needed for everyone, but specialised training is not for all. Police need to focus on the partnerships and expend time, energy and resources to maintain and grow them. Specialist (and other forms of) training needs to be evaluated so we understand what works?

There may be opportunities to streamline the delivery of knowledge-based aspects of mental health training and focus much more on experiential learning, both in specialised training courses as well as shorter mental health awareness sessions.

Autistic youth face higher risks for experiencing mental health crises. To develop and test a county-level social network measure of care coordination between police departments and other systems that support autistic youth experiencing suicidal crisis.

To measure the structure of care coordination for autistic youth experiencing suicidal crisis, the authors created a roster of all police departments and youth servicing organizations in two East Coast counties in the United States. They met or exceeded the whole network recruitment threshold of 70% completion in both counties. From the data, the authors created a directed matrix for each county of all reported connections, which they used to create sociograms and calculate standard network measures, including indegree, outdegree and total degree for each organization in the network. Data management and processing were done using R-programming and ORA.

Social network findings indicated that about half of all police departments surveyed coordinate care for autistic youth in suicidal crisis. Coordination varied by county, with nonpolice organizations acting as connectors between police and other nonpolice organizations. Two structural configurations were found, including a nonpolice organizational hub structure and a lead police structure. More research is needed to determine how different police integration structures shape care coordination for autistic youth.

Limitations include the small number of counties included in the study. A larger sample of counties is required for generalizable results.

This article introduces new tools and approaches to assist police in building their capacity to measure and improve their coordination of care with other community systems during crisis situations for youth on the autism spectrum. Network science (e.g. matrix and graph theoretic algebra methods) can be used to measure the configuration of relationships police departments have with complex multi-level healthcare systems.

Implications for findings include the consideration of police integration across systems in ways that produce new collaboration possibilities to support autistic youth experiencing suicidal crisis.

While police departments play a critical role in coordinating care for youth in suicidal crisis, little is known if or how police departments collaborate with other systems to provide assistance for autistic youth during a suicidal crisis. Improving care continuity within and between systems could potentially address clinical and structural challenges and reduce risk for autistic youth experiencing a suicidal crisis.