1. Police Superintendents’ Association of England and Wales Annual Conference 2013 Leadership & Partnership in Policing and Mental Health Supt. Paul Bartolomeo, Hampshire Constabulary Insp. Michael Brown, West Midlands Police

2. 1 in 4 (x 4?) + 20-30% What is the scale of the problem?

3. 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

4. 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)

5. 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

6. 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?

7. 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”

8. Policing and Mental Health Two areas of business – Policing and the Mental Health Act Crime and Custody

9. 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.

10. 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.

11. 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.

12. 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.

13. 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?

14. 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

15. 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

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

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

18. Thank you Paul Bartolomeo – 07880 783206 - @SuptPaul Michael Brown – 07890 540094 - @MentalHealthCop