title: Decision analytic model exploring the cost and cost-offset implications of street triage.
abstract: OBJECTIVE
  To determine if street triage is effective at reducing the total number of people with mental health needs detained under section 136, and is associated with cost savings compared to usual police response.
  
  
  METHODS
  Routine data from a 6-month period in the year before and after the implementation of a street triage scheme were used to explore detentions under section 136, and to populate a decision analytic model to explore the impact of street triage on the cost to the NHS and the criminal justice sector of supporting people with a mental health need.
  
  
  METHODS
  A predefined area of Sussex, South East England, UK.
  
  
  METHODS
  All people who were detained under section 136 within the predefined area or had contact with the street triage team.
  
  
  METHODS
  The street triage model used here was based on a psychiatric nurse attending incidents with a police constable.
  
  
  METHODS
  The primary outcome was change in the total number of detentions under section 136 between the before and after periods assessed. Secondary analysis focused on whether the additional costs of street triage were offset by cost savings as a result of changes in detentions under section 136.
  
  
  RESULTS
  Detentions under section 136 in the street triage period were significantly lower than in the usual response period (118 vs 194 incidents, respectively; χ(2) (1df) 18.542, p<0.001). Total NHS and criminal justice costs were estimated to be £1043 in the street triage period compared to £1077 in the usual response period.
  
  
  CONCLUSIONS
  Investment in street triage was offset by savings as a result of reduced detentions under section 136, particularly detentions in custody. Data available did not include assessment of patient outcomes, so a full economic evaluation was not possible.
authors: King's Health Economics, King's College London, London, UK.
authors: Margaret
authors: M
authors: Heslin
authors: Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK.
authors: Lynne
authors: L
authors: Callaghan
authors: East Sussex Clinical Commissioning Groups, Sussex, UK.
authors: Martin
authors: M
authors: Packwood
authors: Sussex Partnership NHS Foundation Trust, Sussex, UK.
authors: Vincent
authors: V
authors: Badu
authors: King's Health Economics, King's College London, London, UK.
authors: Sarah
authors: S
authors: Byford
mesh_terms: D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D006801:Humans; D010348:Patient Care Team; D016495:Police; D011568:Psychiatric Nursing; D014218:Triage / Q000191:economics* / Q000379:methods*; D006113:United Kingdom
keywords: HEALTH ECONOMICS; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; MENTAL HEALTH