Evaluating New Ambulance Mental Health Pathways (ENAMHP)

  • Research type

    Research Study

  • Full title

    Evaluation of ambulance innovations and mental health pathways in the East Midlands UK: a mixed-methods study

  • IRAS ID

    337212

  • Contact name

    Aloysius Niroshan Siriwardena

  • Contact email

    nsiriwardena@lincoln.ac.uk

  • Sponsor organisation

    University of Lincoln

  • Duration of Study in the UK

    2 years, 3 months, 17 days

  • Research summary

    This study is important as it aims to produce evidence by investigating the effectiveness of innovative mental health services within the Emergency Medical Services (EMS) context, specifically in the areas of workforce, training, service delivery, referral to other services, and experiences of patients and staff.

    Numbers of patients calling 999 emergency medical services with mental health problems has increased, placing higher demands on ambulance services to respond. In the East Midlands, 16.7% of the population reported experiencing mental health conditions in 2014. During 2020, the East Midlands Ambulance Service NHS Trust (EMAS) received 40,443 calls related to mental health conditions. The EMAS crews attended to 52,350 patients on-scene, where the cause for 999 calls was related to mental health concerns.
    EMAS has implemented innovative mental health services, since September 2022, which include four components: mental health training for frontline staff; Registered Mental Health Nurses (RMNs) within Emergency Operation Centres (EOCs); dedicated Mental Health Response Vehicles (MHRVs) staffed by RMNs and paramedics; and new pathways to mental health services. These interventions seek to provide frontline EMAS staff with the necessary knowledge, skills, resources and pathways to manage mental health emergencies with competence and sensitivity. Despite these significant changes, the mental health outcomes, associated costs, and functioning of these pathways within the context of EMAS remain largely unknown. This research is needed to investigate the costs and outcomes of these mental health services, and mechanisms by which these are achieved.

    We will analyse routine data from EMAS using an interrupted time-series design, encompassing periods before, during, and after introducing these services, to evaluate the effect of the intervention. We will also conduct an economic evaluation using EMAS data and NHS reference costs to understand costs of the intervention. We will use in-depth interviews with ambulance staff, mental health nurses and psychiatrists as well as patients who have received the services to explore their experiences of these services, and the mechanisms underlying any intervention effects.

  • REC name

    South Central - Oxford B Research Ethics Committee

  • REC reference

    24/SC/0082

  • Date of REC Opinion

    9 May 2024

  • REC opinion

    Further Information Favourable Opinion