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Improving the system of care

officer1A NEW agreement to improve the system of care and support for people in a mental health crisis has been signed by the Welsh Government, police forces, the NHS, councils and other agencies. The crisis care concordat commits the organisations which have signed up to work together to intervene early and, if possible, to reduce the likelihood of people posing a risk to themselves or others as a result of a mental health condition. A key part of this approach are new proposals to reduce the use of police custody for people suffering with mental health problems. People with suspected mental health issues who are detained under the Mental Health Act should be assessed within three hours and not be held in police custody for more than 12 hours.

All organisations which sign the concordat have made a commitment to find the most appropriate support needed for people in whatever situation and whichever service a person turns to, making sure that any intervention is carried out without any unnecessary or inappropriate placement; for example within police custody. Other commitments include: People under 18 who experience a mental health crisis should never be held in police custody unless in exceptional circumstances; Police vehicles will rarely be used to convey people in crisis, except the most violent of individuals and only in exceptional cases to transport people between NHS facilities; NHS transport or other health vehicles, but not necessarily an ambulance, should be commissioned to take people in a mental health crisis to hospital; If a young person under 18 is detained under section 135 or 136 of the Mental Health Act and taken to a police station for assessment, a case review will be held within seven days to determine whether this could have been avoided in order to learn from that incident; Monitoring groups within health boards will review every section 135 and 136 detention within police custody to determine its appropriateness.

Health and Social Services Minister, Mark Drakeford said: “This new agreement is about providing the most appropriate care and support to those facing a mental health crisis, whatever the time, every day of the year. “It is about all those who have signed up working closely together so we avoid people being wrongly kept in a police cell and instead being given access to the right treatment for them. I am delighted this deal has brought together so many organisations that have a vital role to play.” Jon Stratford, assistant chief constable, South Wales Police said: “Too many people end up in police cells when detained for their own or others’ safety under the Mental Health Act instead of receiving appropriate support and help. We welcome the development of the crisis care concordat. “The signing of today’s agreement is an important step in improving how all agencies work together to protect vulnerable people.” Sara Moseley, director of Mind Cymru and chair of the Wales Alliance on Mental Health, said: “When you are in crisis you are at your most vulnerable. You may be experiencing delusions or hallucinations, you might be suicidal or self-harming, it can be very frightening – you need the right help urgently.

“A police cell is a completely inappropriate environment in which to receive that care and support. Mind has been campaigning for action on reducing the use of police cells for people in crisis for many years. Bringing together so many agencies including the police, the NHS and the third sector is a great achievement and shows how determined we are to create change. “This is a crucial first step. There’s a lot more to do to make sure that anyone experiencing a mental health crisis gets the right care. We need to make sure that mental health services can cope with demand and get people the help they need early on to prevent them reaching crisis point in the first place. Great crisis care exists but we need to make sure it exists for anyone in Wales who needs it.” Dyfed-Powys Police and Crime Commissioner Christopher Salmon said: “I welcome this Concordat. “I raised this issue with Welsh Government two years ago and I’m glad that Dyfed-Powys Police and Hywel Dda University Health Board have led the way.”

Explaining how Dyfed Powys Police had taken steps to anticipate the Concordat, Mr Salmon continued: “I’m delighted that – a year after we launched our Street Triage scheme to help those in mental distress during police incidents – the Concordat will recognise the importance of treating mental illness as a health issue, not a police one. “The work of all those involved in delivering our local service is to be applauded; a huge amount of effort and expertise has resulted in a great new project.” Mr Salmon concluded: “In the past, many people have been locked in police cells when what they’ve really needed is health treatment. Across the Hywel Dda area – Carmarthenshire, Ceredigion and Pembrokeshire – they now get that treatment. “The Concordat has been a long time coming but will put clear responsibility on health services to treat mental health cases. The police will be there to help, not the other way round. It’s a great example of work between the police and the health board.”

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Dayne Stone

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