title: Costs of the police service and mental healthcare pathways experienced by individuals with enduring mental health needs.
abstract: Substantial policy, communication and operational gaps exist between mental health services and the police for individuals with enduring mental health needs.
  
  
  
  To map and cost pathways through mental health and police services, and to model the cost impact of implementing key policy recommendations.
  
  
  
  Within a case-linkage study, we estimated 1-year individual-level healthcare and policing costs. Using decision modelling, we then estimated the potential impact on costs of three recommended service enhancements: street triage, Mental Health Act assessments for all Section 136 detainees and outreach custody link workers.
  
  
  
  Under current care, average 1-year mental health and police costs were £10 812 and £4552 per individual respectively (n = 55). The cost per police incident was £522. Models suggested that each service enhancement would alter per incident costs by between -8% and +6%.
  
  
  
  Recommended enhancements to care pathways only marginally increase individual-level costs.
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK margaret.heslin@kcl.ac.uk.
authors.forename: Margaret
authors.initials: M
authors.lastname: Heslin
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Lynne
authors.initials: L
authors.lastname: Callaghan
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Barrett
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Lea
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Eick
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Morgan
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Bolt
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Thornicroft
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Rose
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Healey
authors.affiliation: Margaret Heslin, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Lynne Callaghan, PhD, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth; Barbara Barrett, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London; Susan Lea, PhD, Department of Psychology, Social Work & Counselling, University of Greenwich, London; Susan Eick, BSc, Faculty of Health and Human Sciences, Plymouth University, Plymouth; John Morgan, DipClinPsychol, Centre for Mental Health and Justice, Cornwall Partnership NHS Foundation Trust, Bodmin; Mark Bolt, PGCE, Devon & Cornwall Constabulary, Camborne, Cornwall; Graham Thornicroft, PhD, Diana Rose, PhD, Andrew Healey, PhD, Anita Patel, PhD, King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Anita
authors.initials: A
authors.lastname: Patel
mesh_terms: D004637:Emergency Services, Psychiatric / Q000191:economics*; D004739:England; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000191:economics* / Q000628:therapy; D008605:Mental Health Services / Q000191:economics*; D016495:Police / Q000191:economics*; D014218:Triage / Q000191:economics*