When the police are called to an incident involving someone having a mental health crisis in public they often have to detain them under Section 136 of the Mental Health Act.
In many cases the only place of safety for the person to be detained is the police custody suite – not the best solution for the person in crisis or the police.
Dorset HeathCare’s Criminal Justice Liaison and Diversion Service, Dorset Police and their partners wanted to reduce the number of people in crisis being detained in police custody.
Most importantly they wanted to reduce the distress of patients who found themselves in this situation, improve their wellbeing and aid their ongoing recovery.
The service was accepted to help trial a new NHS England model for liaison and diversion. And it also worked with Dorset Police and others to develop an innovative street triage service giving officers access to support and advice from mental health colleagues to help manage these incidents.
Reshaping the service meant co-locating mental health practitioners in places like custody suites and courts to build collaboration and trust between teams.
Funding from various sources was pooled to build the service that was needed, with a new workforce being recruited and trained.
The new service brought a range of improvements including:
• An age-appropriate response for anyone over the age of criminal responsibility
• Advice and support available seven days a week, 7am to 3am
• Coverage of a range of health issues and vulnerabilities, including mental health, physical health and learning disabilities
• Improved access to healthcare and support services for vulnerable individuals, reducing health inequality
• Diversion of service users, where appropriate, out of the youth and criminal justice systems into health, social care or other supportive services.
Crucially, the changes have included training for police officers which help them to deal with people compassionately when in mental health crisis. It can also support officers to look after their own mental health and that of their colleagues.
Sharing information across agencies helps better manage a patient’s care and reduces their distress, giving them a better chance to recover effectively. It also helps resolve issues quickly and has resulted in cost savings across all organisations.
The 2016 inspection of Dorset Police Custody by HM Inspectorate of Prisons, HM Inspectorate of Constabulary and CQC reported:
• A large reduction in the number of people brought into custody under S136 of the Mental Health Act and significant progress in improving outcomes for this vulnerable group
• Improved mental health provision, which was rated excellent
• A reduction in reoffending or escalation of offending behaviours.
Since June 2016 police custody suites in Dorset have not been used for S136 detentions. Vulnerable people are assessed in hospital-based places of safety.
• Putting the patient’s needs first
• Working across organisational boundaries with partners
• Using a national model to reshape services
• Using data and strong continuous evaluation.