Police Superintendents’ Association of England and Wales Annual Conference 2013

Leadership & Partnership in Policing and Mental Health

Supt. Paul Bartolomeo, Hampshire ConstabularyInsp. Michael Brown, West Midlands Police

1 in 4 (x 4?)+

20-30%

What is the scale of the problem?

Why is it important?• Lord Adebowale “core police business”• Vulnerability – how to protect? • Resource - 20-25% of all police work• Demand – not reducing (23k s.136 detentions in 12/13)• Risk – IPCC, reputational• Crime – those who commit crime and have a mental health illness

Governance

• Police– CC Simon Cole (Leics) – ACPO lead

– Regional Reps • North West: ACC Andy Rhodes (Lancs)• North East: DCC Michael Banks (Durham)• East Midlands: CC Simon Cole• West Midlands: ACC Garry Forsyth (WMP)• Eastern: ACC Tim Newcomb (Suffolk)• London & South East: Cmdr Christine Jones (Met)• South West: ACC Sharon TAYLOR (D&C)• Wales: DCC Matt Jukes (South Wales)

The NHS….

• Health & Social Care Act 2012– Strategic Health Authorities, Primary Care Trusts.– New Health & Wellbeing Boards, new Clinical Commissioning Groups.– Commissioners and Providers

• Hampshire example– Was 1 x SHA and 1 x PCT – Now 4 x HWB and 8 x CCGs

Plus…Local Authorities• Provide both Adult and Child Services which are essential in

dealing with most mental health related demand.• Under 18’s – joint commissioning?

How can you influence?• Representation on Health & Wellbeing Boards• Know your CCG MH lead and lead GP• Know your mental health provider, it is not just a public protection

matter

Michael Brown’s ‘Senior Officer Checklist”

Policing and Mental Health

• Two areas of business –

• Policing and the Mental Health Act • Crime and Custody

Policing and the Mental Health Act

• Place of Safety operations – needed 23,000 times a year, (estimate).

• Operation of informal exclusion criteria – drugs / alcohol / aggression … and children!

• Lack of proper commissioning of PoS services.• Difficulties in data gathering – no-one is counting it properly!• Police use of the power – links to training of officers.• NHS integration of Ambulance and A&E into 136 pathways.

Assessments, AWOLs and Conveyance

• Section 135(1) MHA – the “warrant or not warrant debate” – misunderstanding by AMHPs about legalities / police powers.

• AWOL patients account for over 10% of missing people – para 22.13 MHA CoP and NHS duties to recover patients.

• The role of ambulance service in commissioned arrangements for conveyance – a role for CCGs to ensure provision.

Crime and Custody

• Research indicates 12-15% of those arrested are thought by the police to have mental health issues – we know this under-estimates the prevalence.

• Comparing arrest data with patient date (Sussex) suggests that 40-50% of those arrested are secondary care patients.

• We know that “diversion” is determined by MHA admission criteria – not by potential legal liability.

Diversion Decision-Making

• 10,000 custody records

• 1,076 – “flagged” as involving mental ill-health• All seen by the FME in custody.• 512 – “flagged” by the FME for NHS assessment.• 415 – not requiring admission to hospital, but referral made: GP or

CMHT.• 97 – requiring hospital admission.

Admission criteria

• 97 offenders for substantive offences requiring admission.• 8 admitted under s3 MHA – for treatment.• 17 admitted informally / voluntarily – for treatment / assessment.• 72 admitted under s2 MHA – for assessment / treatment.

• Prosecutions / use of bail = ZERO.

• What happened to these patients?

Internally• Post incident procedure – what about predictive/preventative• Who is leading in your force?• How many of your staff/leaders are absent due to mental illness?• Return to work and ongoing support?• Time to change

– How to talk to colleagues– How to support them back into the workplace– Role models to talk about their experiences

In Hampshire

• Medium sized force –1.9M pop, 3200 officers• Cost – at least £1.5M per year • Dedicated resource• Chief Constable chairs oversight board• PCC interest & priority • Mental Illness Liaison Officers• Autism Support Group• Joint Police/MH patrols• Control room

Challenges• Get involved….partnership working• Allocate resources• Influence partners• Understand your demand• Training – both tactical and strategic• Manage upwards

The result?

• Less demand• Less risk & better risk assessment• More effective partnerships • Healthier workforce• Better outcomes for patients, police and the public.

Thank you

Paul Bartolomeo – 07880 783206 - @SuptPaulMichael Brown – 07890 540094 - @MentalHealthCop