Street Triage Update August 2014 26/09/2014 Street Triage Working - - PowerPoint PPT Presentation

Street Triage Update

August 2014

26/09/2014 Street Triage Working Group update 1

Total Referrals and Calls to Advice Lines

• Street clinician was unaccompanied by police officer

during Feb and March

• The uptake of Triage services is highest in Oxford LPA
• Whilst Oxford City should be the focus of Face to Face

Triage, 31% seen were from incidents that occurred in

• ther LPAs

2 26/09/2014 Street Triage Working Group update

36 19 20 19 26 17 13 17 10 9 8 14 13 12 13 7 36 24 30 41 45 38 38 56 10 20 30 40 50 60 70 80 90 Jan Feb Mar Apr May Jun Jul Aug

Monthly referrals to Street Triage team

Face to Face Triage Phone Triage - Client Advice to Police 115 21 31 29 25 32 186 63 59 50 100 150 200 250 300 350 Oxford Cherwell and West South and Vale

Triage referrals by LPA

Face to Face Triage Phone Triage - Client Advice to Police

Face to Face Triage 30% Phone Triage - Client 15% Phone Triage

• Police

45% advice Line 10%

Referrals by Triage Type

In the 8 Months the Triage Pilot has been running the team has been involved in 562 cases

26/09/2014 Street Triage Working Group update 3

278 283 1 50 100 150 200 250 300 Female Male Transgender

Gender of referrals

76 12 271 77 215 78 0% 20% 40% 60% 80% 100% All referrals Face to face

Location of Incidents

Other Private Public 0 - 17, 48 18 - 24, 78 25 - 34, 117 35 - 44, 110 45 - 54, 122 55 - 64, 51 65 - 74, 25 75+, 11 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Age of referrals

Other relates to Missing persons and Custody The youngest person see by triage was 10 years old and the oldest 91

S136 Detentions in Oxfordshire are following seasonal patterns and have started to fall below last year

The level of Section 136 detentions in Oxfordshire has started to decreased year on year. -3.3% in the last 12 M vs. the previous 12 M, since the Triage Pilot began there has been a decline of -19.3%. 4 26/09/2014 Street Triage Working Group update

5 10 15 20 25 30 35 40 45 50 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14

Volume of S136 Detentions in Oxfordshire

Total Linear (Total) 304 218 294 176 50 100 150 200 250 300 350 Last 12 Months Last 8 Months Last Year This Year

The level of S136 detentions in Oxon have fallen below last year since the start of the Street Triage Pilot

• Oxfordshire has seen a greater reduction in S136 Detentions since Jan 14 (-19.7%) than all other

LPAs

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5 10 15 20 25 30 35 40 45 50

Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug

Number of S136 Detentions Year on Year

Last Year This Year

Berks, 17.5% Bucks,

• 8.3%

Milton Keynes,

• 3.2%

Oxon,

• 19.7%

TVP,

• 3.3%
• 25.0%
• 20.0%
• 15.0%
• 10.0%
• 5.0%

0.0% 5.0% 10.0% 15.0% 20.0%

Variance Jan - Aug 2103 vs Jan - Aug 2014

S136 Detentions in Oxfordshire have been falling due to Street Triage averting their use

26/09/2014 Street Triage Working Group update 6

45 39 37 37 27 24 21 15 28 22 19 25 22 11 4 3 13 13 12 13 12 5 10 15 20 25 30 35 40 45 50 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug

S136 and averted S136

S136 Detentions S136 Averted 5 10 15 20 25 30 35 40 45 50 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug

S136 vs. last year with averted

Last Year Without Triage S136 Detentions

During the 8 months of the Pilot there have been 176 Detentions made Had Oxfordshire not had the benefit of Street Triage this would have been 257 as 81 were averted With Triage there has been a 19.7% decrease in S136 detentions Without Triage this would have been an 18% increase Far fewer S136 detentions were averted in Feb/Mar when the MHP was not accompanied

218 Actual, 176 Averted, 81 50 100 150 200 250 300 Last Year This Year

Number S136 Detention and Averted Detentions

S136 Detentions have decreased most where Face to Face Triage Operates and on Days when Triage is available

• Section 136 Detentions have reduced most in Oxford where Face to Face Triage is available
• The numbers of detention in South and Vale as so much lower than the other LPAs so the

variance apperars greater

7 26/09/2014 Street Triage Working Group update

108 77 23 79 59 37 20 40 60 80 100 120 Oxford Cherwell and West South and Vale

Last 8 Months to Aug 14

Last Year This Year Oxford,

• 26.9%

Cherwell and West, -23.4% South and Vale, 60.9%

• 40%
• 30%
• 20%
• 10%

0% 10% 20% 30% 40% 50% 60% 70%

Variance last 8 Months to Aug 14

Street Triage positively averts unnecessary S136 detentions

There have been 36 S136 Detentions following a Triage referral, however only 9 of these followed direct contact with the Triage MHP. Detentions following Triage represent only 20% of the 176 detained, and direct contact only 4.3% In many case the call was made to Triage following the Detention for advice and support in securing a bed. Officers have reported that in 81 cases where triage is involved, a S136 Detention was averted because of the actions or advice given by the MHP. This would have taken total detentions to 257, 46% higher.

8 26/09/2014 Street Triage Working Group update

140

Advice Line, 11

5 4

MHP to Poice, 16

20 40 60 80 100 120 140 160 None Advice to police Telephone Triage Face to face Triage

S136 Detentions by Triage type

Advice Line, 7 9 51

MHP to Police, 14

10 20 30 40 50 60 Advice to police Telephone Triage Face to face Triage

S136 Averted by Triage Type

User Outcomes – S136

• A higher proportion of those detained have a genuine need for a further MH

service

• Fewer people were discharged from S136 with no further MH referral

necessary

– Dropped from 42% in Dec13 to 23% in July14

7/1/2014 9

9 8 9 9 11 12 7 7 10 7 7 3 2 4 10 13 14 10 7 5 13 5 5 6 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14

S136 Outcomes

Formal Admission Community Referral No Referral

Indirect benefits from the Triage Pilot include:

10 26/09/2014 Street Triage Working Group update

• Police Officers are becoming more aware of

Mental Health issues

• Access to Rio and MH Expertise gives the

ability to convey critical information to ongoing incidents:

• MISPERS
• Relevant Medical information
• Fewer clients being turned away from

HBPOS due to

• Alcohol/Behavioural reasons
• Lack of Capacity
• Reduced burden on A&E for Mental Health

2 4 6 8 10 12 14 16 18 20

Custody detentions are falling and lack of capaity has reduced

Alcohol/ Behaviour No Capacity Other offence Not stated

Service User Feedback has been positive

107 Service users from Jan – June 14 were surveyed by post, to date 17 responses have been received

11 9 10 2 3 5 2 3 1 1 1 1 1 1 2 4 6 8 10 12 14 16 18 I felt that they listened and took my issues seriously I was given advice that was right for my situation I felt I was treated with courtesy and respect Strongly Disagree Disagree Neither Agree Strongly Agree

The additional comments suggest a more general frustration with the wider system

• No help in A&E
• The Police and nurse were excellent and I think it is a very good idea
• The police and prison officers always treated me kindly. The council officials are brutal and cruel
• Was distraught already when they arrived, nurse helped calm me down but felt they were telling

me what everyone told me before, that they can't help me straight away

• Although police were extremely helpful and did a great job calming the situation down, I found the

MH carers not helpful at all

• Felt slightly exposed being on the street but both the Police Officers and Nurse involved were

brilliant! Thank you to all involved!

• The fact that this form has been sent out 3 – 4 months after the incident says all you need to know

about Oxford MHS – rubbish

• I felt the response was excellent. Both Police and Mental Health team have supported me

throughout my crisis, and continue to check on my recovery, police officer Jacobs was amazing

• Great service from Oxford NHS
• I feel the police do a great and excellent service. The pressure they are under is sometimes large.

Thank you very much for your support