Presentation by Mark Smith, Head of Suicide Prevention and Mental Health, British Transport Police at the Police Foundation's conference 'Policing and protecting vulnerable people' 5 November 2015.

1. Policing Mental Health and
Suicide Risk in BTP
Mark Smith
Head of suicide prevention and mental health

2. British Transport Police 2014/15
• 2,972 police officers
• 247 special officers
• 323 PCSOs
• 1,533 police staff
• 46,688 notifiable
offences
• 406 rail fatalities

3. The Rail Network
• A draw for the vulnerable
• Transient population
• Equality Issues
(access to services)
– Immigration status
– Homelessness
– Learning difficulties
– Alcohol & substance misuse
– Race and culture

4. Suicide & Mental Health 2014/15
• 7, 387 SPMH incidents
• 1,773 detentions under S136
Mental Health Act (includes S297
in Scotland)
• 1,334 people tried to take their
own lives on the railway
• 327 were killed
• 72 survived with serious injury
• 935 physically prevented from
taking their own lives
• 1,156 people subject of joint
police/health Suicide Prevention
Plans
• 289 calls to the Suicide
Prevention Hot Line

5. Comparative data 2014/15
• 7,387 SPMH incidents
• 2,029 serious assaults
• 1,399 sexual offences
• 358 robberies
• 1,455 motor vehicle offences
• 12,039 thefts of passenger
property

6. S136 – some tensions
• Police duty to protect life and manage risk
• S136 inextricably linked to mental health
impairment
• Further detention linked to clinical judgement,
treatability and resources
• Least restrictive principle
• Vulnerability of Police to DSI after contact
• Street Triage arrangements
• The dangers of voluntary attendance

7. Impact of fatalities
• 350 – 400 lives lost
each year
• £60m cost to the rail
industry each year
•12,646 police
deployment hours
2012/2013 2013/2014 2014/2015
Total Fatal Suicide Total Fatal Suicide Total Fatal Suicide
Fatal & Injury
Events
443 354 296 475 384 325 478 406 327
NR Lost Minutes 387,521 472,655 425,830

8. SPMH Teams
• Divisional Units in London Birmingham &
Glasgow
• London & Birmingham units have NHS staff
working in them (Industry/NHS funded )
• They use joint risk management processes to
concentrate activity against high risk cases
• RA tool devised by Oxford University and
considers Aggravating and Protective factors
• FHQ Unit has policy and analysis role and
strong links with Rail, NPCC, COP, Health, PHE,
Government and 3rd
Sector

9. Key prevention themes
• Effective primary care for depression and anxiety
• Understand vulnerabilities- people and places
• Target harden the railway
• Public messaging - lethality of the railway
• Effective intervention, risk assessment & case
management
• Multi agency safeguarding

10. Samaritans training Engineering solutions
Hot Spot identification

11. Operation Avert tactics
• 32 National hotspot locations identified
• Key days and times
• Briefing slides of high risk individuals
• Local community engagement and “Wellbeing”
surgeries
• High profile patrols involving police, rail staff,
Samaritans, special constables and community
volunteers
• Proactive approach to people who appear in
distress or where behaviour causes concern

12. Life saving interventions 2014/15
• 935 potential life saving interventions
• 725 to hospital, 103 to Custody (BTP 6)
• 526 by police (BTP 224)
• 236 by rail staff
• 129 by public, family or friends

13. SPMH - how does it work?
• Real time advice, intel’ & liaison with
local health
• Review previous 24 hrs incidents
• Joint risk based decisions
• Suicide Prevention Plans for relevant
cases
• GP letters, Referrals & sign-posting
• Post incident follow ups
• Support and enforcement - Acceptable
Behaviour Contract (ABCs)
• Situational prevention visits and PSGs
• Awareness meetings, focus groups, joint
training
• Referrals to MASH/MARAC/SAB
CRISIS TO CARE

14. SPMH results 2014/15
• 1156 SPPS opened
• 1442 info/locate markers on PNC
• 10 subjects went on to take their
own life (7 on the railway)
• Represents 0.86% fatality rate
(0.6% on rail)

15. Crisis Care Concordat
• February 2014 – BTP one of 22 national
Signatories
• December 2014 - BTP link in to local declarations
• March 2015 - BTP input to local action plans:
1. Local Railway related data
2. BTP potential to refer at risk individuals
3. How we link into S136 protocols
4. BTP request for info from health around
those at risk of suicide
5. Linking in with local joint training

16. Early warning system
Distributed to:
•Network Rail
•Train Operators
•Mental Health Trusts
•NHS Confederation
•Voluntary Sector
•Change in Deployment
Strategy
1 call a day to the
Hotline since February 2014

17. Zero suicide ambition
• Depression and Suicide
• How do we treat depression in the UK?
• Why don’t many suicidal people get detained
in Hospital?
• Announced by previous Government
• “Pursuing Perfect Depression care” model
• Restricting Access to Means
• Pilot Schemes in our high demand areas –
East Anglia, Merseyside, South West
• A chance to intervene with those who have
yet to attempt rather than those who have
Our ambition Zero Suicides amongst our
SPP subjects
C. Ed Coffey MD
CEO Behavioural Health
Services
Henry Ford Institute
Detroit
“If Zero is not the
right goal, then
what is?”