# Factors associated with repeat contact with an out-of-hours mental health crisis service: an observational study

## TL;DR

This study examines why people use a mental health crisis service multiple times, finding that depression, suicidal thoughts, and psychosis are linked to repeat visits.

## Contribution

The study provides novel insights into factors associated with repeat engagement with a non-clinical mental health crisis service.

## Key findings

- Half of the clients contacted the service more than once.
- Depressive disorder and suicidal ideation or self-harm were strongly associated with repeat contacts.
- Clients with a psychosis diagnosis had more total contacts with the service.

## Abstract

Repeat attendances to healthcare services are common. Safe Spaces are innovative non-clinical mental health support services, which aim to address service gaps in crisis management. They are often offered in collaboration with the voluntary and community sector and are delivered in the community as a welcoming and comfortable space for anyone with mental health needs to seek support. To date, there is limited evidence exploring repeat engagement with these services. Our objective was to describe the frequency of repeat contacts with a Safe Space service and to investigate associated factors.

Data were collected by Bath Mind Breathing Space, in Bath and North East Somerset between April 2020 and June 2022. The primary outcome was repeat contact. Exposure variables included age, gender, ethnicity, existing mental health diagnosis, presenting symptoms and lifestyle and physical health factors. Univariable and multivariable logistic regression analyses were used to assess exposure variables’ association with repeat contact.

Repeat contact with the service occurred in 50% of cases (252). Clients reporting symptoms of depressive disorder (OR 3.29, 95% CI 1.63 to 6.63), or suicidal ideation or self-harm (OR 2.61, 95% CI 1.16 to 5.87) were more likely to have a repeat contact. Having a diagnosis of psychosis (Coeff 3.53, 95% CI 1.67 to 7.39) was associated with an increase in total contacts.

Breathing Space has a high proportion of repeat contacts. Further evaluation is needed to determine how to best support clients with symptoms of depression and suicidal ideation or self-harm or a diagnosis of psychosis to ensure care optimisation.