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- 1. Police and Mental Health Norman Pascal Chief Inspector Local Policing Area Commander Bath & North East Somerset
- 2. Police and Mental Health The majority of people who end up in prison have a mental health condition, a substance misuse problem or a learning disability and one in four has a severe mental health illness, such as chronic depression or psychosis. With this in mind, how much time do you think police officers spend dealing with people with mental health issues? The answer is between 15% to 25% of their time. This is a major part of modern day policing and I would welcome your thoughts on how you feel we meet this challenge. Through this presentation I want to give you a better sense of police training, powers and provisions and answer any questions you may have.
- 3. Training for Police Officers Initial training programme for new recruits Mental health is a thread running through many elements of policing Our training provides an overview for officers: • Increased mental health awareness • Overview of diagnoses • Real life scenarios from people with mental health issues • Treatment & support options • Police powers in relation to mental illness • Tools to support continual good practice We are not experts and we rely heavily on our partners to guide us and provide the expert services they do.
- 4. Police Powers Section 135 – Mental Health Act Section 136 – Mental Health Act
- 5. Research & Findings Independent Police Complaints Commission (IPCC) Approximately half of all deaths in or following police custody involve detainees with some form of mental health problem Long accepted that police custody is not a suitable place of safety. Police custody should only be used as a last resort but it is used far too frequently. Her Majesty’s Inspectorate of Constabulary (HMIC) The use of police cells as a place of safety was far from exceptional Those detained under section 136 may be detained for up to 72 hours, without any requirement for review during this period Those arrested may generally only be detained for 24 hours, with their detention regularly reviewed to ensure that it is still appropriate.
- 6. New Arrangements A new agreement between police and the NHS seeks to improve mental health crisis care. • The use of police cells as a place of safety to be halved • The agreement called "crisis care concordat" was signed by 22 national organisations, including the Department of Health, the Home Office and the charity Mind. • Aims to dramatically improve provision for those having a mental health crisis • It challenges local services to make sure beds are always available for people who need them urgently and that police custody should never be used just because mental health services are not available.
- 7. Local Changes In February a new four bed mental health place of safety facility opened its doors at Southmead Hospital This facility is for those detained in Bristol, North Somerset, BANES and South Gloucestershire and replaces the one bed provision previously at Callington Road • This represents real progress in ensuring those who are most vulnerable receive the support they need • A result of significant partnership working between all agencies • There is still more work to do to further increase provision of places of safety across the force area and we will continue to do so.
- 8. Appropriate Adults At the last meeting, the subject of appropriate adults was raised by Jude from Bath Mind. An appropriate adult must be called whenever we detain or interview a child (aged 10 to 17) or a vulnerable adult Current provision has been running for about 4 yrs, and has 9 volunteer members This will increase to 60 volunteers that can provide cover 24/7 by July 2014 In the future the training package designed by the national appropriate adult network will be used to provide further independence and a nationally consistently level of training for volunteers.
Editor's Notes
- The majority of people who end up in prison have a mental health condition, a substance misuse problem or a learning disability and one in four has a severe mental health illness, such as chronic depression or psychosis. With this in mind, how much time do you think police officers spend dealing with people with mental health issues? The answer is between 15% to 25% of their time. This is a major part of modern day policing and I would welcome your thoughts on how you feel we meet this challenge. Through this presentation I want to give you a better sense of police training, powers and provisions and answer any questions you may have
- During the initial training programme for new recruits there is an ongoing input around mental health. Mental health is a thread through many elements of police work such as antisocial behaviour, missing persons and alcohol and drug abuse. The charity Rethink provide a full days training on mental ill health, aimed at raising awareness and providing an overview of the main topics: Increased mental health awareness Overview of diagnoses Real life scenarios from people with mental health issues Treatment & support options Police powers in relation to mental illness Tools to support continual good practice We provide our officers with a level of understanding that allows them to fulfil their role and gives them tools to identify mental ill health and interact with those suffering from it in a compassionate way. However, we can never be experts and we rely heavily on our partners to guide us and provide the expert services they do. The reality is that our officers don’t patrol with mental health professionals and at 03:00 in the morning the police officer is often the only person available to provide support. We therefore need to improve the way we support those suffering with mental ill health.
- The Mental Health Act is the law which can be used to admit people to hospital for assessment and/or treatment for a mental illness. Section 135 requires a warrant to be issued and it provides a power to remove a person from a private place to a place of safety. The application for the warrant has to be applied for by an approved mental health professional that has reasonable cause to suspect mental illness. The police must be accompanied by a mental health professional and registered medical practitioner in order to execute the warrant Individuals can be detained under this section for up to 72 hours. During this time, mental health professionals can arrange a Mental Health Act assessment, to establish if there is a need for the person to be in hospital because of their mental health. After being assessed, individuals are either sectioned using the Mental Health Act, or released. There are of course rights under this section, such as getting legal advice, the police or hospital telling someone where the person is and getting treatment from a healthcare professional The police can use section 136 of the Mental Health Act to take a person to a place of safety when they are in a public place. The police can move people between places of safety if necessary and again individuals can be detained for up to 72 hours, pending a Mental Health Act assessment. Again there are right under this section, such as getting legal advice, the police or hospital telling someone where the person is and getting treatment from a healthcare professional The biggest issue for the police and indeed the individuals detained is the fact that police custody is deemed a place of safety, despite it clearly not providing the most suitable location for someone in crisis.
- Independent Police Complaints Commission (IPCC) The IPCC found that approximately half of all deaths in or following police custody involve detainees with some form of mental health problem and was keen to get a better insight into the issues concerning mental health and custody. They recognise that it has long been accepted that police custody is not a suitable place of safety. They also recognise that it has the effect of criminalising people who are in need of medical attention, that it can exacerbate their mental state, and in the most tragic cases it can lead to deaths in custody. For the past twenty years it has been government policy that police custody should only be used as a last resort but our experience tells us that it is used far too frequently. Her Majesty’s Inspectorate of Constabulary (HMIC) A report by four official watchdogs last summer including the HMIC, the Care Quality Commission, Her Majesty's Inspectorate of Prisons and the Health Inspectorate of Wales –showed the use of police cells as a place of safety was far from exceptional, and detailed how 9,000 people with mental health problems were detained in police custody in 2011-12. Some were as young as 14. The fact is that those detained under section 136 have not committed any crime and they are not under arrest; they are suspected of suffering from a mental disorder. They may be detained for up to 72 hours, without any requirement for review during this period. In contrast a person arrested for a criminal offence may generally only be detained for 24 hours, with their detention regularly reviewed to ensure that it is still appropriate.
- Recently a new agreement between police and the NHS seeks to improve mental health crisis care. Emergency support for people in mental health crisis is set to see dramatic improvements across the country as part of a far-reaching new agreement between police, mental health trusts and paramedics. The number of times police cells are used as a place of safety for people having a mental health crisis is intended to be halved under these new arrangements. The agreement called "crisis care concordat" was signed by 22 national organisations, including the Department of Health, the Home Office and the charity Mind. It is aimed at securing dramatic improvements in the treatment of people having a mental health crisis. It challenges local services to make sure beds are always available for people who need them urgently and also that police custody should never be used just because mental health services are not available.
- In February a new four bed mental health place of safety facility opened its doors at Southmead Hospital. This facility is open to those detained under section 136 of the Mental Health Act within Bristol, North Somerset, BANES and South Gloucestershire and replaces the one bed provision previously at Callington Road. This is real progress in ensuring those who are most vulnerable receive the support they need by the people best placed to provide it and is a major step forward to reducing even further the numbers of those detained within our custody facilities for section 136 Mental Health Act. The new suite has been set up as a result of significant partnership working between all agencies involved in meeting mental health needs of our communities. We know there is still more work to do to further increase provision of places of safety across the force area and we will continue to do so.
- Appropriate Adults An appropriate adult must be called whenever we detain or interview a child (aged 10 to 17) or a vulnerable adult. They must be present for a range of police processes, including intimate searches, and identification procedures. However, there is no statutory provision for vulnerable adults and formal schemes are not available in all parts of England and Wales. Our Current provision To bridge the Gap to cover out of hours for predominantly vulnerable adults, we set up a team of volunteers who currently cover Banes. This is led by Custody staff and currently our Custody Inspector if the sponsor. It has been running for about 4 yrs and at the moment has 9 volunteer members. These volunteers are called out by custody staff when a need for them is identified. Our Future provision Looking ahead to our new custody suite opening at Keynsham, it was clear that the provision for appropriate adults needed to increase. A recruitment drive took place which involved going out into the community and seeking volunteers. By the time Keynsham custody unit opens in July, we anticipate having up to 60 volunteer appropriate adults available to call upon to cover 24/7. All the volunteers are trained using a package we have devised. It is a one day training session. Once trained they are vetted and given ID cards Group Independence It is a concern of some bodies such as the national appropriate adult network and the youth offending services, that the group is not seen as independent from the Police. However, with the absence of a statutory provision and with no else setting up or funding such a scheme, our leading was the only option. To achieve dependency from Police, we do have 4 volunteer coordinators that have a higher vetting level. These volunteers attend Bath Police station on a weekly basis to update records, complete admin and communicate with the other volunteers. In addition, we hold monthly meetings to work towards Police having minimal involvement. We also have a defence solicitor who voluntarily attends our training and our monthly meetings when they are available. The Future The national appropriate adult network has agreed to provide us with their training package which will further assist with independence and a nationally consistently level of training for volunteers. Alternatives and collaboration are being explored at a senior level and we would not be averse to considering passing control of the group to a statutory body or volunteer organisation in the future. Indeed, our aim is for our group to be independent of the Police and operate in its own right.