1. Suicide The BTP Approach Mark Cleland Detective Inspector

2. The Rail Network A draw for the vulnerable Transient population Equality Issues (access to services) –Immigration status –Homelessness –Learning difficulties –Alcohol & substance misuse –Race and culture

3. BTP National Analysis 350 fatalities a year 84% believed to be suicides 41% of deceased had a mental health history 1700 incidents a month which involve mental health issues 2700 incidents of suicidal behaviour per year 680 suicide prevention plans opened in one year Evidence of vulnerable people travelling great distances to attempt suicide and importing demand for services In a 3 month period only 5 out of 11 people involved in suicidal incidents in Camden lived in the Borough London North hotspot area with 30% of suicides & 37% of all related incidents

4. National Suicides

5. Railway Suicides 2009/10 baseline 5 year average 2008-2013 2010/20112011/20122012/20132013/2014 Suicides/ suspected suicides per fiscal year 234227203242239232

6. Suicidal Incidents 01/04/12 - 31/03/13 2738 incidents 296 suspected suicides 89 injurious attempts 313 non injury attempts or life saving interventions 44 reconnoitring 796 threats with no attempt 630 third party reports 570 Para-suicide events

7. BTP Approach 2010 new Suicide Prevention Policy and SOP Vulnerability assessment tool & structured suicide prevention plans Public Protection Units & Mental Health Liaison Officers Close working with Rail Industry Partners and the Voluntary sector However barriers to effective working identified - –Unfamiliarity with local Health & Social Care services and structures –Reluctance of many agencies to share information –Lack of medical oversight of police decision making –Differences in local Health and Social Care service provision –Inconsistency in clinical judgements Need for a new approach to overcome these barriers Need to secure appropriate diversions & free up police officer time

8. Operation Partner Combined Public Protection Unit BTP operational & analytical resources Supported by Mental Health Professionals Key elements; –Medical operational review of BTP interventions and PIER plans –Support to BTP custody –Outreach interventions & assessments –Fast access to data –Transition from Crisis to Care

9. Operation Avert – Proactive Suicide Prevention Overview

10. OP AVERT Aims to reduce suicides, attempt suicides and trespass Reduce impact on the infrastructure 110 life saving interventions

12. Suicide Investigation Fatality Manual of Guidance HYDRA courses Area based fatality investigators Liaison with the Coroner Minimum Standards

13. Contact with Bereaved Fatality Identification of Bereaved Visit with Bereaved Interaction & Assessment Controls Police will visit NOK to deliver death message & conduct enquiries, investigations with other family members, friends & associates. Bereavement Pack to be distributed A death occurs & police will make an assessment of the likely circumstances based on available evidence & information Police will identify people that are most likely to be affected by the death; consider and prioritise: NOK, other family members, close friends and associates Officers will be particularly observant re the vulnerability of the Bereaved & any information which suggests that they themselves may present a risk of self harm or suicide Where there are concerns for the safety of the Bereaved, officers should take necessary initial action & inform the duty officer. A PIER management plan should also be completed

14. Samaritans and Network Rail Training Courses Awareness Campaign ESOB Postvention

15. Managing Suicidal Contacts Acknowledge difficult feelings and circumstances Convey understanding Provide emotional first aid Break a suicide plan and make an effective referral

16. Trauma Support Training Identify what trauma is Understand why people react differently to traumatic events Provide first aid in emotional support to colleagues Consider individual coping strategies

19. Early Recognition “We were impressed with the approach taken by the British Transport Police (BTP) who have a strategic suicide prevention team at headquarters and a tactical team for the area of highest demand in north London. They include police specialists and they work alongside a mental health professional. They provide advice on the ground in emergencies and in custody suites and they help with case management. “The BTP have a Standard Operating Procedure (SOP) on suicide prevention, a joint training programme with the Samaritans and Oxford University, and accessible guidance for frontline officers. “This…approach …combines a corporate centre of strategy and expertise, together with teams to assist frontline officers.” Lord Victor Adebowale’s Independent Commission on mental health and policing – May 2013