Validity of police contacts as a performance indicator for the public mental health care system in Amsterdam: an open cohort study

  • S. LauriksEmail author
  • M. C. A. Buster
  • M. A. S. de Wit
  • O. A. Arah
  • A. W. Hoogendoorn
  • J. Peen
  • N. S. Klazinga
Original Paper



The Public Mental Health Care (PMHC) system is a network of public services and care- and support institutions financed from public funds. Performance indicators based on the registration of police contacts could be a reliable and useful source of information for the stakeholders of the PMHC system to monitor performance. This study aimed to provide evidence on the validity of using police contacts as a performance indicator to assess the continuity of care in the PMHC system.


Data on services received, police contacts and detention periods of 1928 people that entered the PMHC system in the city of Amsterdam were collected over a period of 51 months. Continuity of care was defined as receiving more than 90 days of uninterrupted service. The associations between police contacts and continuity were analyzed with multilevel Poisson and multivariate linear regression modeling.


Clients had on average 2.12 police contacts per person-year. Clients with police contacts were younger, more often single, male, and more often diagnosed with psychiatric or substance abuse disorders than clients without police contacts. Incidence rates of police contacts were significantly lower for clients receiving continuous care than for clients receiving discontinuous care. The number of police contacts of clients receiving PMHC coordination per month was found to be a significant predictor of the percentage of clients in continuous care.


The number of police contacts of clients can be used as a performance indicator for an urban PMHC system to evaluate the continuity of care in the PMHC system.


Public mental health care Performance indicators Police contacts Continuity of care Care coordination 



The authors would like to acknowledge the contributions of Rob de Neef of the Central Information Organization of the Police Department Amsterdam-Amstelland; Peter Hilberts and Tom Verhulst of the Municipal Welfare Service; Paul Lickens and Richard Hendriks of the Department of Judicial Institutions of the Ministry of Safety and Justice; Jack Dekker, Ph.D. and Doep van Dijk of Arkin Institute for Mental health; Jan Theunissen† Ph.D. of the Ingeest Mental Health Services; and Natalie Runtuwene and Ron van Wifferen of the Public Health Service Amsterdam. This study was funded within the Academic Collaborative Centres Public Health Programme by ZonMW, The Netherlands Institute for Health Research and Development.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 19 KB)
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Supplementary material 3 (DOCX 19 KB)


  1. 1.
    Sundararaman R (2009) The US mental health delivery infrastructure: a Primer. CRS Report for Congress 7-5700, R40536 Congressional Research Service, Washington DCGoogle Scholar
  2. 2.
    Health Canada (2002) A Report on Mental Illness in Canada. Health Canada, OttawaGoogle Scholar
  3. 3.
    Bransen E, Wolf J (2001) Public mental health care for socially vulnerable people: Report and study of the current practice in PMHC for the socially vulnerable [Dutch]. Trimbosinstituut, UtrechtGoogle Scholar
  4. 4.
    Lauriks S, De Wit MAS, Buster MCA, Ten Asbroek AHA, Arah OA, Klazinga NS (2008) Performance indicators for public mental health care: a conceptual framework [Dutch]. Tijdschrift voor Gezondheidswetenschappen 86(6):328–336CrossRefGoogle Scholar
  5. 5.
    Lauriks S, Buster MCA, De Wit MAS, Arah OA, Klazinga NS (2012) Performance indicators for public mental health care: an international inventory. BMC Public Health 12:214. CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Donabedian A (1980) The definition of quality and approaches to its assessment. Vol1. Explorations in quality assessment and monitoring. Health Administration Press, Ann ArborGoogle Scholar
  7. 7.
    Lauriks S, De Wit MAS, Buster MCA, Arah OA, Klazinga NS (2014) Composing a core set of performance indicators for public mental health care: a modified delphi procedure. Adm Policy Ment Health 41:625–35.
  8. 8.
    Salzer MS, Nixon CT, Schut JA, Karver MS, Bickman L (1997) Validating quality indicators: quality as relationship between structure, process and outcome. Eval Rev 21:292. CrossRefPubMedGoogle Scholar
  9. 9.
    Turner TH, Ness MN, Imison CT (1992) ‘Mentally disordered persons found in public places’ diagnostic and social aspects of police referrals (Sect. 136). Psychol Med 22:765–774. CrossRefGoogle Scholar
  10. 10.
    Watson MA, Segal SP, Newhill CE (1993) Police referral to psychiatric emergency services and its effect on disposition dicisions. Psych Serv 44(11):1085–1090CrossRefGoogle Scholar
  11. 11.
    Kneebone P, Rogers J, Hafner RJ (1995) Characteristics of police referrals to a psychiatric emergency unit in Australia. Psych Serv 46(6):620–622CrossRefGoogle Scholar
  12. 12.
    Fisher WH, Simon L, Roy-Bujnowski K et al (2011) Risk of arrest among public mental health services recipients and the general public. Psych Serv 61(1):67–72CrossRefGoogle Scholar
  13. 13.
    McGuire JF, Rosenheck RA (2004) Criminal history as a prognostic indicator in the treatment of homeless people with severe mental illness. Psych Serv 55(1):42–48CrossRefGoogle Scholar
  14. 14.
    Cuellar AE, Snowden LM, Ewing T (2007) Criminal records of persons served in the public mental health system. Psych Serv 58(1):114–1120CrossRefGoogle Scholar
  15. 15.
    Mechanic D (1991) Strategies for integrating public mental health services. Psych Serv 42(8):797–801CrossRefGoogle Scholar
  16. 16.
    Agranoff R (1991) Human services integration: Past and present challenges in public administration. Public Adm Rev 51(6):533–542CrossRefGoogle Scholar
  17. 17.
    Rosenheck R, Morrissey J, Lam J et al (1998) Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness. Am J Public Health 88(11):1610–1615CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Robertson AG, Swanson JW, Van Dorn RA, Swartz MS (2014) Treatment participation and medication adherence: effects on criminal justice costs of persons with mental illness. Psych Serv 65(10):1189–1191CrossRefGoogle Scholar
  19. 19.
    Schwartz MS, Swanson JW, Hiday VA, Wagner HR, Burns BJ, Borum R (2001) A randomized controlled trial of outpatient commitment in North Carolina. Psych Serv 52(3):325–329CrossRefGoogle Scholar
  20. 20.
    Hawthorne WB, Folsom DP, Sommerfeld DH et al (2012) Incarceration among adults who are in the public mental health system: rates, risk factors, and short-term outcomes. Psych Serv 63(1):26–32CrossRefGoogle Scholar
  21. 21.
    Baird AF, Campanaro CS, Eisele JL, Hall T, Wright JD (2014) “How can we stay sober?” homeless women’s experience in a substance abuse treatment center. Society 51:404–407CrossRefGoogle Scholar
  22. 22.
    Harris AHS, Kivlahan D, Barnett PG, Finney JW (2012) Longer length of stay is not associated with better outcomes in VHA’s substance abuse residential rehabilitation treatment programs. J Behav Health Serv Res 39(1):68–79CrossRefPubMedGoogle Scholar
  23. 23.
    Pfeiffer PN, Ganoczy D, Zivin K, McCarthy JF, Valenstein M, Blow FC (2012) Outpatient follow-up after psychiatric hospitalization for depression and later readmission and treatment adequacy. Psych Serv 63(12):1239–1242CrossRefGoogle Scholar
  24. 24.
    Taylor AC, Bond GR (2014) Employment specialist competencies as predictors of employment outcomes. Community Ment Health J 50(1):31–40CrossRefPubMedGoogle Scholar
  25. 25.
    Rasbash J, Browne WJ, Healy M, Cameron B, Charlton C (2009) MLwiN Version 2.27. Centre for Multilevel Modelling, University of Bristol, BristolGoogle Scholar
  26. 26.
    IBM Corp (2012) IBM SPSS Statistics for Windows, Version 21.0. IBM Corp, ArmonkGoogle Scholar
  27. 27.
    Wolff N, Diamond RJ, Helminiak TW (1997) A new look at an old issue: people with mental illness and the law enforcement system. J Mental Health Adm 24(2):152–165CrossRefGoogle Scholar
  28. 28.
    Clark RE, Ricketts SK, McHugo GJ (1999) Legal system involvement and costs for persons in treatment for severe mental illness and substance use disorders. Psych Serv 50(5):641–647CrossRefGoogle Scholar
  29. 29.
    Brekke JS, Prindle C, Bae SW, Long JD (2001) Risks for individuals with schizophrenia who are living in the community. Psych Serv 52(10):1358–1366CrossRefGoogle Scholar
  30. 30.
    Roy L, Crocker AG, Nicholls T et al (2016) Profiles of criminal justice system involvement of mentally ill homeless adults. Int J Law Psychiatry 45:75–88CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of EpidemiologyHealth Promotion and Health Care Innovation of the Public Health Service AmsterdamAmsterdamThe Netherlands
  2. 2.Department of EpidemiologyUCLA Fielding School of Public HealthLos AngelesUSA
  3. 3.Department of PsychiatryVU University Medical CenterAmsterdamThe Netherlands
  4. 4.The EMGO+ Institute for Health and Care ResearchAmsterdamThe Netherlands
  5. 5.Arkin Institute for Mental HealthAmsterdamThe Netherlands
  6. 6.Department of Public Health, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  7. 7.OECD Health DivisionParis Cedex 16France

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