Dyfed-Powys Police - mental health: a multi-agency approach

Over the last few months I seem to have read endless articles online (the latest just last week from the BBC here) about the increasing numbers of young people and adults being detained in police cells whilst experiencing mental distress. This is often because there are no suitable places of safety where people can be taken to be assessed, even though it is frequently accepted that a police custody suite is not usually an appropriate place in such circumstances.

In Powys, a multi-agency approach is now working to improve the police response to those with mental health needs. I first found out about this in November 2013 at a Dyfed Powys Police event called Mental Health: the Way Forward. Here we heard, amongst other things, some of the Force’s plans for change in the area of detention under Section 136 of the Mental Health Act.

Inspector Brian Jones

This week we found out more, from Inspector Brian Jones of Neighbourhood Development for Dyfed-Powys Police, about how plans had been progressing since the event. Brian started by addressing the issue of children and adults being placed in police cells due to the lack of mental health beds.

“In Powys, we have not found ourselves in this position during 2014”. The police are often called to assist with situations where someone has expressed concern for a family member, a friend or someone they have seen behaving in a manner which raises concern for their welfare. The police currently have minimal training on how best to deal with incidents where people have mental health needs, but will strive to treat everyone with dignity and respect. “Our first priority is to ensure that persons are safe and then to ensure that persons are cared for by specially trained experts at an agreed place of safety.”

Legislation

The legislation under the Mental Health Act, which is known as a Section 136, stipulates that “if a constable finds a person who appears to him/her to be suffering from mental disorder and to be in immediate need of care or control, in a place to which the public have access, the constable may, if he/she thinks it necessary, in the interest of that person or for the protection of other persons, remove that person to a place of safety.” No one will disagree that a police cell is not a suitable place or environment for someone with mental health needs. However, there are occasions when there is no other suitable alternative and this is when there are signs of violence, substance misuse or criminal offences for investigation with evidence to be preserved.

In order to make every effort to secure the correct and professional support for individuals, as well as avoiding police cells or any inappropriate use of police powers, a procedural pilot was introduced in Powys in March 2014. This pilot requires the Police’s Inspector’s authority before police mental health powers can be used. The Inspector will take an independent overview of the circumstances which have led to consideration being given to utilising the powers under the Mental Health Act.

Exceeding expectation

The pilot is exceeding expectation and the police cells have only been used on three occasions, which was justifiable in the circumstances and not due to having no suitable beds available. At no time have the police powers been inappropriately used and at no time during this period have any youths under the age of 18 been detained. There is a strong partnership approach between the police and health and social care partners, who are working together to raise awareness amongst colleagues, as it has been agreed that training is required for people who come into contact with people suffering from psychological problems.

Thank you to Inspector Brian Jones for his update. Let us know in the comments box below what you think about the new ways of working that the police are trialling in Powys - or elsewhere in the UK.

You can read a recently published report (6 February) from the House of Commons Home Affairs Committee on Policing & Mental Health here.

Dyfed-Powys Police - Mental Health: The Way Forward

Last Friday Laura and I attended a Dyfed-Powys Police conference at Police Headquarters in Carmarthen. We were there with our PAVO colleague Claire Powell, the Info Engine Officer, to promote the third sector in Powys. Laura also facilitated a session with two people from Powys who had experience of being arrested and detained by the police whilst mentally distressed.

Mental Health: The Way Forward, was promoted as an event which “will explore ways in which the police can work in partnership with statutory and third sector services in responding to people in mental distress.” Dyfed-Powys is obviously a vast chunk of Wales (Carmarthenshire, Ceredigion, Pembrokeshire & Powys), and we were able to network with colleagues from the statutory sector, including Bronllys Hospital and the Welsh Ambulance Service, as well as other voluntary groups and charities such as West Wales Action for Mental Health and Mind Llanelli. But our main role was to inform those police officers present of the mental health third sector groups in Powys, and the support these groups can provide to people experiencing any form of mental distress.

The event was kicked off by Temporary Deputy Chief Constable Carl Langley. He spoke about the recent joint review – “A criminal use of police cells? The use of police custody as a place of safety for people with mental health needs,” in which a police cell had been identified as the worst possible place for someone with mental health issues. Yet, as Carl admitted, cells are still used routinely as places of safety.

The average time taken to assess someone is 8 hours and 48 minutes. As a high percentage of people enter police cells having drunk alcohol, this time could be much longer. Carl then asked – “If that was my mother/daughter/sister who had experienced an episode which presents as mental health initially, how comfortable am I with that?” He went on to explain that as a police service “we don’t want these people in custody – we want to do the best for them… 9 hours is a long time.” Often the period of custody will exacerbate the level of anxiety experienced by someone already in distress. Recent TV programmes such as BBC’s Panorama and press articles have focussed on these issues.

Dyfed-Powys Police want to try things differently going forward. Carl asked if other statutory agencies present would be willing to share information, say from Care Treatment Plans, to help inform officers early on. Less than 10% of people who are detained in this way are sectioned, but what happens to the other 90%? Where do they receive support? Whilst Carl recognised that some people would benefit from support from the third sector, he said that the force currently underutilises these resources. And now is time to change that.

Temporary Chief Superintendent Andy John, the force Mental Health Lead, spoke with Helen Morgan-Howard, Equality & Diversity Manager, about Mental Health Street Triage (presentation available here). They began by describing “Section 136 of the Mental Health Act 1983 (which) allows a police officer to remove a person they think is mentally disordered and ‘in immediate need of care or control’ from a public place to a place of safety, in the interest of that person or for the protection of others.” Without access to a person’s records a Section 136 was described as “the only option”, despite it making people feel “I was locked up because I was ill.”

Dyfed-Powys Police are now asking:

• How do we provide better information to officers at the scene of an incident?
• Is there anywhere else we can take people to?
• Can we reduce the amount of time people wait to be assessed by mental health practitioners?
• Can we refer to support elsewhere, eg: third sector?
• Are there other crisis interventions out there that the police don’t know about? 

Andy described a real appetite to make a difference within the force, and pointed out key areas where change could be made, including staff training, and working more collaboratively with partners, including the third sector.

There was also talk of trialling mental health street triage. In nine force areas in England joint units comprising mental health practitioners and police officers, who have shared access to information, take to the streets together, resulting in better-informed decisions and better outcomes for people experiencing mental distress. There are already plans for a pilot scheme in Carmarthenshire in the lead-up to Christmas, and talks are imminent with Powys teaching Local Health Board about options for 2014. This approach, combined with the creation of new places of safety, away from a police cell, and local to an individual, look like a promising start.

Laura networking at the Dyfed-Powys Police mental health conference

Before leaving the conference for the day I asked someone who had been arrested on many occasions whilst mentally distressed, "where would your preferred place of safety be?" The answer, simply, was “anywhere but a police cell.”

Let’s hope it’s not that hard to arrange.

What do you think of mental health street triage? Let us know your thoughts on this, and any other aspects of policing in relation to mental distress, by commenting below.

Other speakers at the conference included:
Tim Burton, Deputy Police & Crime Commissioner, Dyfed-Powys Police
Tony Thomas, Criminal Justice Link Officer, Hafal
Gareth Coles, Public Services Delivery Officer, Wales Council for Voluntary Action

January 2014 BBC news update - Mental health units to be set up by Dyfed-Powys Police