Mental Health Frequent Presenters to
Police: who are they ?
Research Project
Presentation to the International Congress
on Law and Mental Health
19th July 2011
Gina Andrews
Senior Policy Officer, Mental Health, NSW Police Force
[email protected]
Mental Health Frequent Presenters to Police
Presentation outline:
Setting the scene: a case study
Goals of the research project
Project history
Research stages
Research method
Research findings
Research next steps and program options
Scene Set: Mental Health Frequent Presenters Case Study
• ‘Naomi’: female aged 18
• 35 apprehensions Mental
Health Act in past year
• Total of 45 Police events
• Victim of sexual
• History of aggressive
behaviour & self harm
• Escalating behaviour
• Therapeutic response in
place but inadequate
Research Goals: Mental Health Frequent Presenters
1. To describe the characteristics of persons who
have frequent emergency mental health
contacts with Police, Ambulance and Health.
2. Developing appropriate care co-ordination
model for this group.
3. Trial a care co-ordination model.
Project History: Mental Health Frequent Presenters
• 2007: One of 8 Mental
Health projects
• Mid 2008 – 2009:
Develop business case
• 2010: research
contract awarded
• Jan 2011: Stage 1,
Phase 1 Report
Research Method: Mental Health Frequent Presenters
• Individual agency datasets: persons presenting 3 or
more times under the Mental Health Act in a year.
• 2005 as index year.
• NSW Statewide data identification used (except
emergency departments).
• Frequent (i.e. individual presenting three or more times
in given year under Mental Health Act) vs very high (i.e.
top 10% of MHFPs at each agency).
Research Stages: Mental Health Frequent Presenters
Stage 1: Examination of
data on Mental Health
Frequent Presenters
- Within agencies
Phase 1 (completed):
Within agencies
Stage 2: Identify
Develop and implement
service model/s
Research Findings: Mental Health Frequent Presenters
>3 presentations
1010 individuals
Female %
Aboriginal %
Avg Age (yrs)
Very High Frequency (top 10% of MHFP)
90th percentile
contact cutoff
Avg contacts top
10% FP
Min nu events = 7
Research Findings NSWP: Mental Health Frequent Presenters
• Over 13, 500 with at least one mental health event.
Total of 18, 672 mental health events in 2005.
7% (1010 persons) of overall population under the
MH Act had at least three or more contacts per year
therefore qualifying as Frequent Presenters.
• 7% of persons apprehended by Police under the
Mental Health Act were responsible for 23% of all MH
Act events.
• 33 people (3.3%) had 10 or more events per annum.
Research Findings NSWP: Mental Health Frequent Presenters
• 90% of MHFPs had contact other than MH Act that year:
– 82% as a “person of interest” (POI).
– 63% as victims of crime.
– The Mental Health Act contacts accounted for only
around 25-30% of total contacts for frequent
• Frequent presentation was not stable over time – >50%
did not continue pattern of MHFP in subsequent years
Research Next Steps: Mental Health Frequent Presenters
• Stage 1 : “Phase 2” (linked data):
– Awaiting ethics approval
– Time and resources required for data analysis & report 2
– Jostling for governance and hosting project.
• Stage 2 : Service model development:
– Clarification of scope (very high frequent presenters or
frequent presenters)
– Case management approach (medical & psycho social)
– Modeling of costs, business case development.
Research Next Steps: Mental Health Frequent Presenters
Possible program response ?
Very High FP
(top 10% of FP)
Approx 50 persons
New / targeted /
3 contacts with Police
= 1010 persons
across many
Conclusion: Mental Health Frequent Presenters
• MHFP to Police are a small group who use a
disproportionate amount of Police resources
• MHFP pattern of interaction with Police is diverse and
includes: Mental Health Act, Person of Interest, and victim.
• MHFPs are likely to interact heavily with the wider criminal
justice system and emergency services.
• Evidence base in favour of intensive case management of
MHFP demonstrates that such an intervention results in a
reduction of MHFPs interaction with emergency services.

Mental Health Frequent Presenters Project