Mental health and the Police
The Police are often called to public incidents where someone is experiencing a mental health crisis, such as a severe panic attack, a psychotic breakdown, or perhaps where there is potential suicidal behaviour. It is not uncommon for very vulnerable people to be placed in a police cell, as that may be the only available place of safety. Police officers and custody staff may have little mental training or awareness. This could add to the distress of the individual and places undue pressure on police and custody resources. Sometimes, the police have little option than to enforce a involuntary admission to a mental health facility (under Section 136 of the Mental Health Act). In many cases, detainment in a police or involuntary sectioning are wholly inappropriate and may worsen the service users long term well being. Sometimes they are necessary.
Recently, a number of regions across England have been piloting mental health street triages, which seek to provide alternative options to (unnecessary) detainment in police cells or (inappropriate) sectioning to psychiatric inpatient facilities. Dorset is one such region, and I am honoured to be working with the local mental health triage, in collaboration with Dorset Police, Dorset HealthCare University NHS Foundation Trust (DHC), and the Dorset Police and Crime Commissioner (PCC). This work is part of the Dorset Criminal Justice Liaison and Diversion (CJLD) programme. We are not saying that anyone who has committed a crime, whilst experiencing a mental health problem, should be absolved of responsibility. However, there must be a better way to process those incidents.
The Dorset Police mental health street triage operates through DHC, with funding from Dorset PCC (Martyn Underhill), local authorities, and the Dorset Clinical Commissioning Group (CCG). The street triage is functional every night between 19.00 to 03.00. Throughout those hours, police and custody officers have direct access to specialist mental health staff, who advise on appropriate action (or in some cases may intervene). This short film may help explain the process a little further.
The programme deservedly won a national award from the Health Service Journal. We have just produced a new report (2019), which will be available to view soon. A new PhD programme is due to start in Autumn 2019, focusing on the benefits of the Dorset CJLD, in comparison to other models of intervention In the UK and across Europe).
Mental health training (and police officer welfare)
Initial findings from the street triage show promising outcomes, with significant reductions in mental health detainment and fewer Section 136 orders. I will be part of a larger evaluation team, looking at these, and many other, important aspects (such as service user experience, and long term prognoses).
In the meantime, it is essential that police officers, custody teams, and support staff, receive mental health training. This training needs to focus on several key areas: understanding mental health and mental illness; dealing with vulnerable people with mental health problems; compassionate and empathic policing; but also needs to show how officers can look after their own mental health and that of their colleagues. My colleagues at Dorset Mind are now providing support and education to police officers (and other emergency service personnel), as part of the Mind Blue Light programme.
Challenges and opportunities
I am not saying that street triage is the whole answer to dealing with mental health crises, either in public or in police custody, but it is a start. Having access to mental health staff, and providing officers and custody staff with quality mental health training, does not ensure that a referral to mental health services is going to be possible on every occasion. Furthermore, those services are not available 24/7. Among the biggest challenges are going to be funding and capacity. As Inspector Michael Brown said on Twitter (@MentalHealthCop):
The best mental health training on this planet for UK police officers will not solve our problems unless there are accessible MH services.
I could not agree more. I would love to see fully funded 24/7 mental health crisis response team across the UK. This is something I would willingly campaign for. In the meantime, I will do I can to help by providing some mental health training for officers and custody staff, and support the street triages that we do have. This is a step in the right direction, but there is a long way to go. I would welcome feedback and ideas from anyone who has an interest (for example, police staff, commissioners, politicians, service users, carers, and mental health campaigners. Together we can press for services that support the most vulnerable people in our society, ensure that they (and the general public) are properly protected, and that Police resources are used more efficiently.