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Etailed information is contained in the address field for some cases, allowing us to discern a variety of location types, including residences, hospitals, police precincts, transportation hubs, businesses, and parks. 2.2. Analysis We deployed spatial analytic techniques available in ArcGIS software to create a kernel density map of the city for the year 2011. Based on case distribution we created a legend with scales ranging from low to high density. We used the data from the entire eight-year period to identify 11-Deoxojervine price addresses that have been the site of repeat transportation pick-ups to discern repeat patterns within and across years.NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript2For our analysis we have drawn the boundaries provided to us by Center City District (CCD). There are subtle differences between this Business Improvement District area and the Center City Police District boundaries which are not relevant to our analysis here. Int J Law Psychiatry. Author manuscript; available in PMC 2015 September 01.Wood and BeierschmittPageTo begin the repeat analysis, the clean addresses derived from the matching process were aggregated so there is a count of how many calls were made to each address. The resulting table was then used to determine the number of addresses that had repeat calls. The results were categorized according to addresses that had one call, two to three calls, four or five calls, and six or more. The number of calls per category was then converted into percentages. To compare trends in Center City District (CCD) against city-wide patterns, we conducted the same analysis, using an “intersection function” to delimit cases to the CCD boundaries.NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript3. Results3.1. Hotspots of vulnerability Figure 1 illustrates the distribution of mental health transportation cases Ro4402257MedChemExpress Ro4402257 citywide for the year 2011. As the map confirms, there are specific areas of the city with moderate to high case density. As suggested by our partners, Center City has an especially high concentration. For the entire eight-year time span, 25,527 unique addresses accounted for the total of 50,212 cases. Some of these addresses were sites of cases that spanned over more than one year. We explored whether repeat location patterns varied across the years or remained generally constant. These results can be seen in Table 1 below. Over the eight-year span there were 613 addresses in Center City that received at least one transport (2.4 of the total city addresses). Notably, for every year the percentage of repeat calls in each category in CCD is higher than the citywide totals. In the year 2011, for example, 32 of CCD addresses had two or more transports, compared to 18 of city-wide addresses with two or more. In seeking to understand what helps make Center City a hotspot for behavioral health vulnerability, and to identify opportunities for enhanced engagement and intervention, we turn to our qualitative data. 3.2. Qualitative findings: Engagement challenges and opportunities This section ties together themes that emerged through both the police and outreach focus groups. We connect these data to individual interview data where space allows. Our analysis reveals five core themes: (1) police knowledge about “micro-places” of vulnerability is nuanced, and untapped; (2) the cycle of crisis response is perpetual; (3) there are few “sticks” and fewer “carrots” to influence behav.Etailed information is contained in the address field for some cases, allowing us to discern a variety of location types, including residences, hospitals, police precincts, transportation hubs, businesses, and parks. 2.2. Analysis We deployed spatial analytic techniques available in ArcGIS software to create a kernel density map of the city for the year 2011. Based on case distribution we created a legend with scales ranging from low to high density. We used the data from the entire eight-year period to identify addresses that have been the site of repeat transportation pick-ups to discern repeat patterns within and across years.NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript2For our analysis we have drawn the boundaries provided to us by Center City District (CCD). There are subtle differences between this Business Improvement District area and the Center City Police District boundaries which are not relevant to our analysis here. Int J Law Psychiatry. Author manuscript; available in PMC 2015 September 01.Wood and BeierschmittPageTo begin the repeat analysis, the clean addresses derived from the matching process were aggregated so there is a count of how many calls were made to each address. The resulting table was then used to determine the number of addresses that had repeat calls. The results were categorized according to addresses that had one call, two to three calls, four or five calls, and six or more. The number of calls per category was then converted into percentages. To compare trends in Center City District (CCD) against city-wide patterns, we conducted the same analysis, using an “intersection function” to delimit cases to the CCD boundaries.NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript3. Results3.1. Hotspots of vulnerability Figure 1 illustrates the distribution of mental health transportation cases citywide for the year 2011. As the map confirms, there are specific areas of the city with moderate to high case density. As suggested by our partners, Center City has an especially high concentration. For the entire eight-year time span, 25,527 unique addresses accounted for the total of 50,212 cases. Some of these addresses were sites of cases that spanned over more than one year. We explored whether repeat location patterns varied across the years or remained generally constant. These results can be seen in Table 1 below. Over the eight-year span there were 613 addresses in Center City that received at least one transport (2.4 of the total city addresses). Notably, for every year the percentage of repeat calls in each category in CCD is higher than the citywide totals. In the year 2011, for example, 32 of CCD addresses had two or more transports, compared to 18 of city-wide addresses with two or more. In seeking to understand what helps make Center City a hotspot for behavioral health vulnerability, and to identify opportunities for enhanced engagement and intervention, we turn to our qualitative data. 3.2. Qualitative findings: Engagement challenges and opportunities This section ties together themes that emerged through both the police and outreach focus groups. We connect these data to individual interview data where space allows. Our analysis reveals five core themes: (1) police knowledge about “micro-places” of vulnerability is nuanced, and untapped; (2) the cycle of crisis response is perpetual; (3) there are few “sticks” and fewer “carrots” to influence behav.

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