MPA Joint Review on Policing and Mental Health - far reaching recommendations for improvements to services and co-ordinated leadership

52/05
24 October 2005

Lack of co-ordination in leadership, the need for improvements in services and understanding of mental health issues are identified in a joint review to be published by the Metropolitan Police Authority (MPA). The joint review was conducted by the MPA with senior representatives of health, social care services and police.

A full copy of the review, including the Chairs’ forward, summary and recommendations can be found at www.mpa.gov.uk/committees/mpa/2005/051027/11.htm

Richard Sumray, MPA member and co-chair of the joint review said:

“The joint review has highlighted key issues, particularly the relationship between police and health agencies. It is though just the beginning of a programme to increase mutual understanding and co-operation between agencies.

'Mental health problems are all too often made worse by ignorance and prejudice, which can harm those with mental health care needs, their relatives and those who provide public services.

“We recognise that people who experience mental illness are far more likely to be a victim of crime than a perpetrator. We have an obligation to take the lead to challenge preconceptions and myths that have developed in relation to mental illness.

“Through the joint review we have been able to build a consensus on how the challenges facing mental health, social care and police policy makers and service deliverers should be progressed. We have also recommended a pan- London alliance of all key stakeholders to provide crucial leadership to drive through good practice.

“We are committed through our joint group to ensure that our recommendations are followed through. There are a great many improvements that need to take place – this is just the starting point.”

The joint review makes a total of 33 recommendations relating to the criminal justice system, skills and training, information sharing and the management of violence.

Recommendations include the need to:

ensure training and awareness programmes highlight the need to eliminate discrimination and stigma to all communities and that all programmes are subject to full equality impact assessments;
establish a pan – London alliance to provide strategic leadership to activities of partner agencies and achieve some ownership of shared objectives and outcomes;
address the current protocols that exist when detaining a person for their own or other people’s safety including: identifying a place of safety that meets requirements of the code of practice and pan –London protocol; how detainees who appear to be intoxicated are dealt with; handover procedures to ensure all relevant information is passed to clinical staff; identifying designated health facilities including those for people who are extremely agitated and in need of restraint for their or other people’s safety;
develop a network of appropriate places of safety across London that are able to meet all the needs of people experiencing a mental health crisis;
ensure that If someone with mental health support needs commits an offence, it should be followed up through the criminal justice system. At the same time, it is important their mental health needs should be assessed and addressed appropriately, which may involve diversion to the mental health system and
establish a joint group to monitor the implementation plan and their findings to be reported to the MPA on a six monthly basis.

Notes to editors

1. Press briefing will be held on Wednesday 26 October at 10 Dean Farrar Street, London SW10 HNY at 1pm. Richard Sumray and other members of the project board will be available to answer questions.

2. Background

In July 2004, members of the MPA agreed there was a need to examine the approach taken by the MPS towards people with mental health support needs. Due to the complexities of the subject and the interdependencies with health and social care providers, MPA members agreed that key stakeholders should be invited to form a project board to undertake the work.

The project board met monthly between September 2004 and June 2005 and received oral and written evidence from a wide range of participants including policy makers, service deliverers, user groups, Community Police Consultative Groups, Independent Custody Visitor Panels, Criminal Defence Service, police officers, London Ambulance Service.

Key stakeholders provided essential support and challenge to the project board throughout the review period.

3. Project Board

A project board was established to oversee the review. Its membership was as follows:

	Name
MPA	Richard Sumray (Co-chair) Reshard Auladin Kirsten Hearn
NHS	Prof David Taylor (co-chair) Chair, Camden and Islington Mental Health and Social Care NHS Trust Alison Armstrong Director of London-wide Programmes on behalf of the 5 London strategic health authorities Stuart Bell Chief Executive South London and the Maudsley Mental Health Trust (Chair of the London Mental Health Chief Executives Group until July 2005) Greater London Association of Directors of Social Services (GLADSS) Vivienne Lukey Director of Specialist Services, Westminster City Council
MPS	DAC Brian Paddick, ACPO lead on Mental Health
Additional advice support and guidance has been provided by:	David Grant, Mental Disorder Programme Manager, MPS Bruce Frenchum, Mental Health lead, Strategic Disability Team, MPS Peter Horn, London Development Centre for Mental Health Linda Van Den Hende, Director, Strategic Disability Team, MPS (Retired March 05)

4. Scope and objectives

The joint review sought to add value to the MPS and NHS response to mental health related problems and develop closer links with the partners working in this area. This involved understanding the existing pattern of services across London and the relevant working arrangements and organisational cultures in place before deciding which areas to focus on for improvement. In agreeing the objectives outlined here all members of the joint review panel committed their organisations to share information for the purposes of the review and to progress the recommendations of this final report.

The objectives of the joint review were as follows:

To identify potential improvements in current services and facilities delivered by the MPS, NHS and other stakeholders to improve the safety, security and quality of care provided to people with mental health support needs.
To identify communication channels and information gathering and exchange processes between agencies including any established protocols with a view to assessing how they could be improved.
To explore lessons learned from recent cases, which may not have been handled appropriately, as well as examples of innovative practice to develop recommendations for improvement.
To identify areas in which changes in process or policy would benefit service users and eliminate discrimination, particularly for key groups such as young black men, who may be experiencing more problems accessing mental health services, particularly where dual diagnosis is an issue.
To clarify the human rights issues relevant to both public protection and individual mental health service users.
To elucidate the myths and realities around the predictability of behaviour and claims that a proportion of violent and related undesired events associated with mental health problems could be avoided proactively.
To create an action plan to address the issues identified, using the suggestions for improvement developed through consultation, including identified leads, deadlines and completion measurements and a monitoring system to track improvements.

5. Key exclusions

The project board recognise that people with mental health support needs are far more likely to have contact with the police as victims of crime. However, they have concentrated on those who come into contact with police either because the symptoms of their illness indicate they, or other people, are in need of protection or because they have committed a crime. They have done this because this is where they believe there greatest gains are to be made by a joint project board of this type.

The Project Board recognised at an early stage that in order to achieve the objectives set out above, it would need to place some limitations on the areas it would cover. The following areas were excluded:

The availability of mental health services. This recently the subject of a review by the GLA called Availability of Mental Health Services in London. In addition, the subject of housing and mental health was explored by the GLA in July 2003 in a report published as Getting a Move on - Addressing the housing and support issues facing Londoners with mental health needs.
The subject of restraint was not covered in depth as it has already been explored by an internal MPS review of restraint practices (published in September 2004). The joint review considered the recommendations and learning from that review.
The review has not considered young people as a separate entity. However, we do believe there is a piece of work to be done to ensure that young mental health service users receive the level of care and support they need when they come in to contact with the police.

6. Joint Review – Policing and Mental Health

The full review can be found at www.mpa.gov.uk/committees/mpa/2005/051027/11.htm

Further media information

For further information, please contact the MPA press office.