UL report reveals how CAST project is ‘transforming’ mental health crisis response

A new report from University of Limerick has revealed how a pioneering partnership between An Garda Síochána and HSE Mid West is transforming responses to people experiencing mental health crises by reducing detentions, arrests and presentations to emergency departments.

The report by UL researchers evaluates the Community Access Support Team (CAST) pilot project, a groundbreaking initiative between An Garda Síochána and HSE Mid West Mental Health Services that is reshaping how individuals experiencing mental health crisis are managed at the interface of health and policing.

The report reveals that the model reduces demand on An Garda Síochána, emergency departments and acute services by delivering safe, compassionate and effective responses for individuals with complex, high-risk needs during peak crisis periods.

Individuals who engaged with the service reported reductions in suicide attempts, detentions, or emergency department attendance as a result of CAST intervention.

Families of those in acute distress described the service as restoring hope in situations where they had previously felt exhausted and powerless. 

Crucially, CAST was not described as removing Garda involvement, but as rebalancing responsibility and normalising a non‑criminalising response to mental health crisis.

The report provides a clear roadmap for CAST’s future development and recommends that it should transition from pilot status to a formally established national interagency crisis response service.

Established within the Limerick Garda Division, CAST brings together members of An Garda Síochána and HSE staff to provide coordinated, trauma-informed responses to individuals experiencing acute crises, with an emphasis on diversion from criminal justice pathways to early intervention and continuity of care.

Between January 2025 and January 2026, CAST responded to more than 1,000 incidents from 477 individuals experiencing complex mental health issues, substance abuse and homelessness.

The report reveals that CAST intervention prevented an estimated 133 Section 12 detentions, 61 emergency department presentations and five arrests, while identifying 19 cases suitable for diversion from prosecution. 

Proactive post‑incident outreach was also highlighted in the report with over 450 callbacks completed. This continuity of care led to individuals who had historically resisted engagement beginning to respond once they experienced consistent, non‑judgemental follow‑up.

Drawing together survey findings and interview data from Garda personnel, HSE staff, service users and family members, the report reveals that CAST’s diversionary work was shown to have significantly improved how individuals in crisis are supported during contact with Gardaí. 

The service was consistently described by service users and their families as providing protection, reassurance and dignity during periods of acute distress. Those with histories of trauma, repeated detentions under Section 12, homelessness, or negative encounters with statutory services noted how CAST staff engaged with them as individuals rather than as ‘cases’, ‘frequent callers’, or ‘problems’.

The research team at UL was led by Professor Owen Doody and included Dr Ann-Marie Bright, Dr Steven Byrne and Dr Louise Murphy from UL's School of Nursing and Midwifery and Dr John Lombard from UL's School of Law. 

Professor Doody from UL’s School of Nursing and Midwifery said: “Our report provides compelling evidence that CAST is transforming mental health crisis response through partnership, compassion and clinical expertise.

“The research team has produced an evaluation that demonstrates both the human and system-wide benefits of the model, while offering a strong foundation for future expansion.”

Superintendent Andrew Lacey, An Garda Síochána’s CAST Project Implementation Lead at Limerick’s Henry Street Garda Station, said: “This evaluation report is a great example of meaningful research which provides front-line practitioners with real learnings and perspectives. 

“By combining policing and health expertise, CAST provides trauma informed, community-based support and diverts individuals away from arrest or emergency departments. The report shows the importance of strong interagency collaboration and coordinated follow up. CAST is reaching highly vulnerable people, providing support and delivering continuity of care when it matters most.

“It is important to reflect on what we can do better as public services. The partnerships developed through CAST, along with this meaningful research, aims to provide policymakers and practitioners with data that can be used to inform policy development, improve service provision and recognise that community safety is a shared responsibility in Ireland,” added Superintendent Lacey.

Nuala Kelly, Head of Service, HSE Mid West Mental Health Services, said: “This evaluation marks an important milestone for CAST and for the continued development of innovative, person-centred mental health services in the Mid West. 

“It is evident from the evaluation that CAST delivers safe, compassionate and clinically aligned crisis responses through collaborative decision-making based on best evidence. 

“I would like to express my sincere appreciation to Professor Owen Doody and his colleagues for their rigorous evaluation and valuable insights. I also wish to acknowledge the exceptional commitment of the CAST team, whose professionalism, compassion and collaborative approach are making a real difference in the lives of vulnerable people and their families. Finally, I want to thank An Garda Síochána for their partnership, leadership and shared vision in delivering a more integrated, trauma-informed and effective, rights-based response to people experiencing mental health crisis and vulnerability.”