Showcasing: Police Ambulance Early Access to Mental Health via Telehealth

Region
Hunter New England

Lead agency
Hunter New England Local Health District, NSW Police Force and NSW Ambulance 

Living Well domain

  • Providing the right type of care
  • Making it local 
newcastle

Program Overview

The Police Ambulance Early Access to Mental Health Assessment via Telehealth initiative (the initiative) includes mental health clinicians and emergency services staff working together to provide mental health assessments by telehealth. The mental health clinicians provide mental health assessment and triage via telephone in a person’s own home or community, rather than emergency services staff transporting those people to the Calvary Mater Hospital (the Mater) in Newcastle for assessment. Emergency service staff are present with the person being assessed.

NSW Police Force, NSW Ambulance and the Hunter New England Local Health District jointly planned and codesigned the project with people with lived experience in 2016. People with lived experience contributed to project design through interviews with 26 current and past people with mental health issues who had attended the Mater, 10 people who are in caring roles of people who had attended the Mater, and 20 other people who interacted with emergency services. 

The initiative commenced in 2017 and focused on the Port Stephens Local Government Area. In 2018, the project assessed 49 people in their own home or community, avoiding the need for transportation to hospital. 

Challenge

When services work in silos, people with lived experience of mental health issues facing acute illness and distress, may have poor experiences of care.

Long distances and significant travel time are involved when people need to be transported by ambulance or police for mental health assessment in Newcastle. In 2015/16, NSW Ambulance and NSW Police Force transported 5,658 people to the Mater for mental health reasons. At an estimated cost of $4,500 per presentation, this amounts to $25 million per year.

This practice impacts on the experience of people with lived experience of mental health issues who are transported, their families and on the availability of emergency services for other purposes. In 2014-15, 60 percent of people transported for mental health triage and assessment in HNELHD were not admitted. This can lead to further distress essentially in arranging return transport or accommodation. Additionally, for a person with lived experience of mental health issues or their family, having to repeat their story each time they are seen by emergency services and hospital staff adds additional distress.

Solution

The initiative aims to support people to stay in their home and empower them to make decisions regarding their health and wellbeing, knowing that people recover better in a supportive community environment.

The initiative’s goals and objectives were:

  • for frontline police and paramedics to gain access to specialised mental health assessments
  • to provide care to people at the right time in the right place
  • to reduce transportation by 50% within 6 months
  • to keep available emergency services within the community.

Outcomes

In 2018, 62 people accessed the initiative. Of these, 13 were transported to hospital at a cost of almost $53,000. The mental health service assessed 49 people at home, saving over $248,500 in transport and hospital admission costs. This initiative saved an average of $3,600 per person, 133 hours of NSW Police Force time and 104 hours of NSW Ambulance time.

Feedback from one person assisted by the initiative

‘… didn’t have to take you away and feel uncomfortable. I get stressed when I have to be taken away. In my own home was great.’

Mutual understanding of police, ambulance and mental health service roles has been promoted through this initiative. 

The initiative won many awards in 2018 – Agency for Clinical Innovation Rural Innovation Award, Australian Council on Healthcare Standards Clinical Excellence and Patient Safety Award, NSW Government Excellence Award High Value Health Care: Excellence in the provision of Mental Health Service and 2018 Hunter New England Mental Health Award High Quality Health Care Project or Innovation of the Year.
 

Next Steps

The initiative continues to operate within Port Stephens.

newcastle