Calls for Better Care for those in Mental Health Crisis

Following the announcement by the Care and Support Minister Norman Lamb last week of a new agreement between the police and the NHS in England that seeks to improve mental health crisis care, the Police and Crime Commissioner for Gwent, Ian Johnston, is calling for a similar approach to be adopted in Wales.

The agreement in England - called the Crisis Care Concordat - has been signed by more than 20 national organisations in a bid to drive up standards of care for people experiencing crisis such as suicidal thoughts or significant anxiety. It aims to help cut the number of people detained inappropriately in police cells and drive out the variation in standards across England.

Led by the Dorset PCC, Martyn Underhill, the Concordat was driven forward by the Police and Crime Commissioners in England. It has been signed by 22 organisations including NHS England, the Association of Chief Police Officers and the Royal College of Psychiatrists. It sets out the standards of care people should expect if they suffer a mental health crisis and details how the emergency services should respond.

It challenges local services to make sure beds are always available for people who need them urgently and also that police custody should never be used just because mental health services are not available.

In 2013 an average of 25 people a month were detained by Gwent Police under the Mental Health Act and 58% of them were taken to police custody for assessment rather than a health facility, both of which are deemed to be a Place of Safety under the Act.

According to Mr Johnston there is a need to review the situation in Wales as a whole and he believes the matter can be resolved by working effectively in partnership and adopting a similar unified approach to England. Mental health crisis care will be high on his agenda when he meets up with representatives from the Aneurin Bevan Local Health Board in Gwent and with the other Police and Crime Commissioners and the four Welsh Chief Constables next month. It will also be included as a focus in his revised Police and Crime Plan which sets out his key strategic objectives for police and crime in Gwent over the next three years.

Highlighting the need for a new and collaborative approach, Ian Johnston, the Police and Crime Commissioner for Gwent, said: "In Gwent, existing public service partnerships to improve the response to people in mental health crisis are strengthening and are having considerable support from the Welsh Government. The Independent Police Complaints Commission (IPCC) is also lobbying for alternatives to police custody detention to be identified in order to reduce the risk of harm and stigma for this vulnerable group."

"However, much more needs to be done and there is no reason why some of the principles of what has been agreed in England can't be utilised here in Wales."

"People in mental health crisis are some of the most vulnerable members of our community and they need specialist care and attention. We are talking about people in their greatest hour of need who are at their most vulnerable. They also bring additional challenges to the officers in charge of our custody units."

"They should not be detained in police custody, especially as many have not committed a crime. We need to work effectively with our local partners, the Local Health Board, the Welsh Ambulance Service and the Welsh Government to ensure that we have appropriate structures in place to support people in a mental health crisis. We all need to work together to deliver on this and drive it forward. We are currently looking at all the options available to us here in Gwent."

According to Mr Johnston, the recent success of the partnership between North Wales Police and its local health board also demonstrates how fruitful a collaborative approach adopted by all Forces in Wales could be. North Wales Police, which signed a cooperation agreement on mental health arrests with its local health board last year, has seen a significant reduction in the number of detentions under the Mental Health Act.

"There is an ongoing evaluation of how North Wales Police have managed to significantly reduce the percentage of detainees being taken to police custody in 2013 and also of initiatives piloted in six English police force areas last year where health staff patrolled with Police Officers, resulting in reduced numbers of people being detained and taken to a place of safety," explained Mr Johnston.

Welcoming the news and reflecting the Commissioner's comments, Judith Paget, the Chief Operating Officer and Deputy Chief Executive of Aneurin Health Board, said: "We welcome the Police and Crime Commissioners comments highlighting the need to ensure that we have appropriate services in place locally to support people in a mental health crisis and that by working in partnership we can support individuals to have appropriate interventions.

There are a number of initiatives already in place to support those with mental health problems in crisis including introduction of Crisis Resolution Home Treatment Teams, provision of a hospital based Place of Safety, and Out of Hours Assessment Service and a Court Diversion Scheme.

However, there are opportunities to improve what we do and we are fully committed to working with partners to build on current service provision. As part of this we will explore the experience of others in identifying best practice to see if there is anything from their learning that we can apply locally."