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Response to the HMIC Report A Criminal Use of Police Cells? (The use of police custody as a place of safety for people with mental health needs) Office of the Police and Crime Commissioner for Sussex This response is submitted on behalf of the Sussex Police and Crime Commissioner (SPCC). It focuses on the extent to which police custody is used as a place of safety under Section 136 of the Mental Health Act 1983, and how the principles of best practice for those people suffering from mental illness who, for their own safety, are detained in police custody, are deployed in Sussex. Introduction The SPCC welcomes the HMIC Report and recognises the difficulties faced in finding appropriate help for people who are suffering from mental health issues and are clearly in need of some immediate care. There is a high number of detainees in Sussex who have mental health issues and there is a concern that it should not simply be the responsibility of the police to deal with this problem. The Use of a Police Station as a Place of Safety The Police & Crime Commissioner recognises that a police station should be used as a place of safety only on an exceptional basis or in exceptional circumstances. Police Use of Section 136 The number of people detained under Section 136 during 2011 (the reporting period) in Sussex was 2,163, of which the percentage brought into police custody as a primary or secondary place of safety was 55% (approximately 1300). This figure represents 15% of the country’s reported total number of Mental Health Act detentions in police stations. From March 2012 to April 2013 the number of people detained under S136 of the Mental Health Act 1983 in Sussex is 1568. Of those 941 were detained in Police custody, 518 were detained in a hospital based place of safety and 109 were transferred between both custody and hospital places of safety. There is accurate recording of the reasons for detention in Sussex, and Sussex Police can be proud of the attitude of its employees when dealing with mental health detainees in its care. The Commissioner has been supportive of the pilot scheme funded by the Department of Health to have a mental health nurse accompany a police officer to incidents where police believe people need immediate mental health support. Sussex was selected to take part in this pilot project, which has been welcomed by the Commissioner, whose key objective is to achieve the best possible outcome for individuals and the community, and alleviate the strain currently put on police officers. Strategic Oversight and Direction Compliance with the Codes of Practice is robust and effective. The Mental Health Strategy was created to facilitate good working relationships between all parties involved in implementing the protocols and policies of the Mental Health Act 1983. It provides operational guidance to all officers when dealing with a detained person with a mental health illness. A jointly agreed protocol for the assessment of persons under Sections 135 and 136 of The Mental Health Act in respect of those brought by the police to a place of safety is in place. The Force has a dedicated Mental Health Liaison Officer who works with the Mental Health provider and provides training and guidance to custody staff. A new programme will be in the Force soon, with more systems being replaced by Niche. There are real benefits to the new system in the custody environment, enabling intelligence and medical records to be seen at the same time. Mobile policing will allow the system to be accessed remotely. Recommendations The Police & Crime Commissioner’s response to the 11 Recommendations are listed below, to include those Recommendations to other agencies, so that the Police & Crime Commissioner can hold partner agencies to account: Recommendation 1 The Codes of Practice should be amended to bring detention times for those detained in police custody under section 136 in line with those in the Police and Criminal Evidence Act 1984, which allows up to 24 hours in police custody (out of the maximum of 72 hours for which they can be detained overall). Amendment of the Codes of Practice would be welcomed. An amendment as above would have affected 49 mental health detainees’ cases in 2012. Recommendation 2 Health and Social Care Information centre to alter data collection. Recommendation 3 The College of Policing, the Royal College of Psychiatrists, the College of Social Work, police forces and mental health service providers should work together to develop and deliver joint training to staff. This should incorporate information on legal powers and local protocols, and include regular refresher training. The Police & Crime Commissioner for Sussex is a Board Member of The College of Policing and will use her position to work together with relevant agencies to ensure training at different levels on the issues faced by mental health detainees is delivered to staff. Sussex Police is looking at developing the national training framework, building on the NCALT awareness course, as well as developing the processes and procedures needed. Recommendation 4 Clinical Commissioning Groups and local social services should make sure that they have commissioned sufficient capacity to meet the demand for assessment under Section 136, and that multi-agency working is effective. This includes commissioners in local social services authorities with responsibility for ensuring that the number of AMHPs is sufficient to meet the need for assessments under the Mental Health Act 1983. Sussex Police meets on a regular basis with other agencies under the umbrella of The Mental Health Act Monitoring Group. The issues of capacity, and staffing levels, of all professionals involved is raised here. Recommendation 5 NHS England and Local Health Boards in Wales should ensure that local commissioning of mental health services is appropriate, and that they provide sufficient capacity and resilience to meet demand. This should be in line with those areas where police custody is currently only used on an exceptional basis. Sussex Police can provide data to NHS England about the times and places S136 patients are detained. Recommendation 6 Commissioners and providers of social services and health services should ensure that they identify periods of demand for the reception and assessment of persons detained under Section 136, and that they effectively manage resources to meet this demand. The introduction of the pilot scheme mentioned previously, whereby a mental health nurse accompanies a police officer to situations where there is believed to be a need for their expertise, will help to manage resources in an effective manner. Recommendation 7 Health and Wellbeing Boards in England should include Section 136 provision as part of their Joint Strategic Needs Assessment. The Commissioner has extended an offer to sit on each of the three Sussex Health and Wellbeing Boards, East Sussex having offered an observer position in order to support better the strategic link between health and crime and disorder issues. Recommendation 8 The Office for Standards in Education, Children’s Services and Skills (Ofsted), HMIC, CQC, HIW, HMI Probation, HMIP and Her Majesty’s Crown Prosecution Service Inspectorate (HMCPSI) should examine and highlight as part of their multi-agency inspections of child protection arrangements the inappropriate use of police custody as a place of safety for children under 18 years who are detained under Section 136. This has been noted. Recommendation 9 The CQC … should use their combined powers under the Mental Health Act 1983 and the Health and Social Care Act 2012 to develop a robust approach to the regulation of mental health providers. The objective must be to hold services to account for their responsibilities under the Codes of Practice – in this instance, to ensure that places of safety in healthcare settings for the reception and assessment of individuals detained by the police under Section 136 are appropriately staffed and secure. This has been noted. Recommendation 10 Police custody officers should ensure that a full explanation is recorded in the custody record as to why a person detained under Section 136 has not been accepted into a health-based place of safety. This is now in place. This was not previous practice within the Force, but an instruction has been sent out to all custody officers mandating this to be included in the circumstances of detention. This may be then part of the review of each MH detention that is carried out on each centre. Recommendation 11 …We will closely monitor the use of police custody as a place of safety in our joint police custody inspections, and if we do not find a significant reduction in its inappropriate use by April 2016, we will seek the implementation of the following recommendation: The Mental Health Act 1983 should be amended to remove a police station as a place of safety for those detained under Section 136, except on an exceptional basis. This has been noted.