Street Triage Update August 2014 26/09/2014 Street Triage Working Group update 1
Total Referrals and Calls to Advice Lines Monthly referrals to Street Triage team Triage referrals by LPA 90 350 80 70 300 36 45 60 41 56 50 38 250 38 30 10 186 40 24 13 30 14 200 8 9 12 20 7 13 36 26 10 19 20 19 17 17 13 150 0 29 Jan Feb Mar Apr May Jun Jul Aug 100 59 Face to Face Triage Phone Triage - Client Advice to Police 63 115 • Street clinician was unaccompanied by police officer 50 32 25 during Feb and March 31 21 0 Oxford Cherwell and West South and Vale Referrals by Triage Type Face to Face Triage Phone Triage - Client Advice to Police advice Line 10% Face to Face Triage • The uptake of Triage services is highest in Oxford LPA 30% • Whilst Oxford City should be the focus of Face to Face Phone Triage Triage, 31% seen were from incidents that occurred in - Police Phone other LPAs 45% Triage - Client 15% 26/09/2014 Street Triage Working Group update 2
In the 8 Months the Triage Pilot has been running the team has been involved in 562 cases Location of Incidents Age of referrals 100% 100% 75+, 11 65 - 74, 25 80% 215 78 55 - 64, 90% 51 60% 80% 40% 271 45 - 54, 77 122 20% 70% 76 12 0% 60% All referrals Face to face 35 - 44, Other Private Public 110 50% Other relates to Missing persons and Custody 40% Gender of referrals 25 - 34, 300 117 30% 250 20% 18 - 24, 200 78 10% 150 283 278 0 - 17, 48 100 0% 50 The youngest person see by triage was 10 years old 1 and the oldest 91 0 Female Male Transgender 26/09/2014 Street Triage Working Group update 3
S136 Detentions in Oxfordshire are following seasonal patterns and have started to fall below last year Volume of S136 Detentions in Oxfordshire 350 50 45 300 40 250 35 30 200 25 20 304 150 294 15 218 100 10 176 5 50 0 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 0 Last 12 Months Last 8 Months Total Linear (Total) Last Year This 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%. 26/09/2014 Street Triage Working Group update 4
The level of S136 detentions in Oxon have fallen below last year since the start of the Street Triage Pilot Number of S136 Detentions Year on Variance Jan - Aug Year 2103 vs Jan - Aug 2014 50 20.0% 45 15.0% 40 10.0% Berks, 17.5% 35 5.0% 30 0.0% TVP, Milton Keynes, 25 -3.3% Bucks, -3.2% -5.0% -8.3% 20 Oxon, -10.0% -19.7% 15 -15.0% 10 -20.0% 5 -25.0% 0 Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Last Year This Year • Oxfordshire has seen a greater reduction in S136 Detentions since Jan 14 (-19.7%) than all other LPAs 26/09/2014 Street Triage Working Group update 5
S136 Detentions in Oxfordshire have been falling due to Street Triage averting their use S136 vs. last year with averted S136 and averted S136 50 50 45 45 40 40 35 35 13 13 30 30 11 13 12 25 25 12 4 45 39 37 37 20 20 3 15 15 28 22 19 25 22 27 24 21 15 10 10 5 5 0 0 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Last Year Without Triage S136 Detentions S136 Detentions S136 Averted During the 8 months of the Pilot there have been 176 Number S136 Detention and Averted Detentions Detentions made 300 Had Oxfordshire not had the benefit of Street Triage this 250 would have been 257 as 81 were averted Averted, 81 200 With Triage there has been a 19.7% decrease in S136 150 detentions 218 100 Actual, 176 Without Triage this would have been an 18% increase 50 Far fewer S136 detentions were averted in Feb/Mar when the 0 MHP was not accompanied Last Year This Year 26/09/2014 Street Triage Working Group update 6
S136 Detentions have decreased most where Face to Face Triage Operates and on Days when Triage is available Last 8 Months to Aug 14 Variance last 8 Months to Aug 14 120 70% 60% 100 50% 40% 80 South and 30% Vale, 60.9% 60 20% 108 10% 40 79 77 0% 59 20 Cherwell and 37 -10% Oxford, West, -23.4% 23 -26.9% -20% 0 -30% Oxford Cherwell and West South and Vale -40% Last Year This Year • 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 26/09/2014 Street Triage Working Group update 7
Street Triage positively averts unnecessary S136 detentions S136 Detentions by Triage type S136 Averted by Triage Type 160 60 140 50 120 40 100 80 30 140 51 60 20 40 MHP to Police, 14 10 MHP to Poice, 20 16 Advice Line, 9 Advice Line, 11 7 5 4 0 0 None Advice to police Telephone Face to face Advice to police Telephone Triage Face to face Triage Triage Triage There have been 36 S136 Detentions following a Triage referral, Officers have reported that in 81 cases where triage is however only 9 of these followed direct contact with the Triage involved, a S136 Detention was averted because of the MHP. actions or advice given by the MHP. Detentions following Triage represent only 20% of the 176 detained, This would have taken total detentions to 257, 46% higher. 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. 26/09/2014 Street Triage Working Group update 8
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 S136 Outcomes 100% 90% 5 6 5 5 7 80% 10 14 13 70% 4 3 60% 10 7 13 50% 2 7 10 40% 30% 12 9 11 20% 9 8 7 9 7 10% 0% Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Formal Admission Community Referral No Referral 7/1/2014 9
Indirect benefits from the Triage Pilot include: Custody detentions are falling and lack of capaity has reduced • Police Officers are becoming more aware of 20 Mental Health issues 18 • Access to Rio and MH Expertise gives the 16 ability to convey critical information to ongoing incidents: 14 • MISPERS • Relevant Medical information 12 10 • Fewer clients being turned away from HBPOS due to 8 • Alcohol/Behavioural reasons • Lack of Capacity 6 4 • Reduced burden on A&E for Mental Health 2 0 Alcohol/ Behaviour No Capacity Other offence Not stated 26/09/2014 Street Triage Working Group update 10
Service User Feedback has been positive 107 Service users from Jan – June 14 were surveyed by post, to date 17 responses have been received 18 1 1 1 16 Strongly Disagree 1 1 1 14 2 3 Disagree 5 12 2 3 10 Neither 8 Agree 6 11 10 9 Strongly Agree 4 2 0 I felt that they listened and took my I was given advice that was right for I felt I was treated with courtesy and issues seriously my situation respect
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
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