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A new approach to mental health 

The CRT is an opportunity for Wellington Free Ambulance’s ambulance staff to be heard among the changing world of emergency services and mental health. It’s a crucial role, and one that’s vastly underrated. "Since the inception of the Co-Response Team (CRT) in 2020, I’ve been lucky enough to be part of the team," she says. 

Chris explains that the CRT is a collaborative effort involving Wellington Free Ambulance, the Police, and Te Whatu Ora/Health NZ, with a special Memorandum of Understanding (MOU) between the agencies. This level of cooperation allows them to respond in more appropriate ways that weren’t possible before. "The CRT works by sharing information between all three agencies, Wellington Free Ambulance, Police, and Mental Health (MHAIDs)," Chris shares. "This does take time. But is crucial to understanding the needs of our patients. As we're the only emergency mental health service that responds to 111 calls." 

Before CRT, Chris says there was little cooperation between these services. "Prior to CRT there was minimal discussion between all agencies. Described as working in silos. No-one knew what the other party was doing to help these vulnerable patients."  

"Our aim is to be a more holistic response to people in mental health crisis," Chris explains. “All team members within each agency contribute, police for safety, of both patients and the team, paramedic for medical concerns, and mental health clinicians for their mental health support." 

CRT helps by reducing the demand on emergency services, and to keep patients out of hospital and out of the police cells. It also alerts the community teams if their clients are coming to attention as it can mean they need extra support.  

The collaborative sharing of information allows the team to understand what the patient needs. "Because of the shared information, this helps us assist wherever needed. This often means we can stand down the ambulance attendance or police."  

There’s an increasing demand for mental health support in New Zealand and pressure on all services, with police taking the brunt of this over the years. This has meant that working together is paramount to support patients and all agencies. Although police are reducing their involvement in mental health cases, they’re not withdrawing entirely and will still respond when there’s a risk to patients, whānau or paramedics. Their continued role makes the Co-Response Team even more important, and they remain committed to it. 

As a result, Chris says that hospital transport is only necessary when the risk is high.  

Why mental health matters 

Chris’s passion for mental health stems from her years of responding to these calls, often feeling that people in need weren’t getting the right care. “I often felt helpless. I wanted to support our patients, though knew I didn’t know how to achieve this," she says.  

For Chris, the formation of the CRT was a way to address that gap and improve care for those in need of mental health support.  

A day in the life of CRT 

Chris works Monday to Thursday, from 7:30am to 6pm, in close collaboration with a police officer and a mental health clinician, with the second team of police and the mental health clinician starting Tuesday to Friday 12pm to 10pm. Their first task is to review all mental health-related 111 calls and decide which require immediate attention. This continues throughout the day.  

"We check all the incoming calls to see if any have been missed or need urgent attention," she explains. Police get the bulk of the calls. "Sometimes, a call might not require an emergency response, and that’s where we step in to ensure the right services are involved." We also help other services with advice throughout the day. 

This process helps avoid unnecessary emergency responses, allowing the team to provide the right support. 

"We check to see if the person has been seen by mental health services before," she says. "If they have, we can avoid unnecessary transport and instead work with their existing team to ensure they get the best care." 

The impact of collaboration 

Chris believes the success of the CRT is in its people, and the collaboration. She explains that when the team started, over 70% of the patients they saw were already known to mental health services. 

"In the first year of CRT, we found that over 70% of the people we responded to were already known to mental health services," she reveals. "This was a revelation. It showed us that many of these calls didn’t need an emergency response at all." 

This insight has helped save both time and resources, ensuring that patients receive the right care. 

The emotional toll of the job 

"Some calls are really difficult, particularly when we’re dealing with people who have been through a lot of abuse or violence," she admits. "But it’s part of the job, and we work together as a team to manage it." 

Chris also highlights the challenge of working with patients who have a history of trauma, and the emotional complexity that comes with understanding their behaviour. "Dealing with patients who have experienced historical trauma, can be very tough," she says. "Sometimes delving into their history to understand their behaviour can be difficult." 

Even in the face of tough situations, Chris finds rewarding moments in her work. "When we manage to connect someone to their mental health team, support them in the community when a trip to hospital ED is not in their best interest which allows an ambulance resource to be respond elsewhere - that's a real win as this in turn reduces their stress," she says. 

Maintaining mental well-being 

Chris understands the importance of looking after her own mental health in such a challenging role. "I have regular supervision," she says. "Which began when I started with the CRT. This has become invaluable, and has helped me process this job, my peer support role, and previous difficult jobs from my years on front line work."