Mental health and policing: Picking up the pieces in a broken system.

A key theme of this article is the need to view the intersection of public safety and public health through a new lens to break down the traditional information silos of the many agencies that serve vulnerable populations and the impact of inadequate community-based mental health services that contribute to the increasing number of calls to police in responding to people in or approaching a mental health crisis. The manifestation of this crisis in the community is that the police are too often the first port in the storm. This article suggests the system is broken and needs fixing. Implementing a population health approach to identifying the high utilizers in the community and building a case for sustained funding, partnerships, resources, and accountability together with data sharing agreements, community partners and police collaboratively design and evaluate outcome approaches aimed at prevention and recovery to minimize contact with the police.

Family physician access to specialist advice by telephone: Reduction in unnecessary specialist consultations and emergency department visits.

PROBLEM ADDRESSED: Timely access to specialist care is an important issue for patients with mild to moderate symptoms, and wait times for referrals are currently quite long. OBJECTIVE OF PROGRAM: To provide FPs with quick telephone access to other specialists for treatment advice for patients with nonserious conditions that they would otherwise refer to specialist care. PROGRAM DESCRIPTION: The RACE (Rapid Access to Consultative Expertise) program is a telephone hot-line providing FPs and nurse practitioners in the Vancouver, BC, area with timely access to specialist consultations. An evaluation of data from RACE found 60% of RACE calls prevented patients from visiting a specialist and 32% of calls prevented FP referrals to hospital emergency departments. CONCLUSION: Supported by RACE, FPs can more effectively remain the locus of patient care, calling on other specialist expertise when appropriate and providing better coordination of care for their patients. Evaluations to date suggest RACE helps reduce system costs by reducing unnecessary emergency department visits and face-to-face specialist consultations.