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Are mental health cars the solution we have been looking for?

In her latest blog, Alison talks about working in partnership and mental health Joint Response Units.

Are mental health cars the solution we have been looking for?

I've talked a lot recently over the years about the enormous challenge faced by our police force and our partners in health when it comes to dealing with mental illness.

In 2018 Devon and Cornwall Police estimated that about 40% of its frontline activity was linked to dealing with people who were suffering with bouts of mental unwellness. Sadly there is evidence to suggest that the coronavirus scheme is significantly worsening what was already an acute situation for some people.

If you have been reading this column or tuned in to the local news you will likely know about the Safer Summer Scheme which I have allocated up to £500,000 to. This is now well established, with marshals providing a reassuring and helpful presence at locations around the peninsula, supporting neighbourhood policing and helping residents and visitors at the height of a tourist season that is quite unlike any other.

Running alongside this is the police operation, funded with an additional £400,000 from my office, to provide additional resource to the front line in a number of ways during our peak season. A new service that provides expert help alongside police to households where domestic violence has been reported is one of the projects we are trialling this summer.

A similar approach is being taken to mental health. For the last few weeks three mental health Joint Response Units have been set up in partnership with the social enterprise Livewell South West and the Devon Partnership NHS Trust. These are operating in Plymouth, Torbay and Exeter.

Each car is crewed by a police officer and a mental health practitioner and means that those on the front line have direct access to NHS patient data, meaning they can make much more informed decisions when a request for service comes in. When this approach was thought up it was hoped that it would allow police to be less reliant on their powers to detain people under the Mental Health Act.

Section 136 of the act allows officers to detain people for their ‘care or control’ so they can be taken to a place of safety when experiencing a crisis. Places of safety are really only for those who are diagnosed as mentally unwell, and the alternative is often a police cell, and although officers will use care, consideration and judgement to look after any detainee, police custody units are less than ideal for people who are experiencing some form of health crisis.

The good news is that an interim report on this project, completed this month, shows promising results.

Between July 10 and August 4 the three units completed 34 shifts, influencing the decisions made at 65 mental health incidents. Comments submitted by police officers show that they feel they have dealt with people better and helped more than they would have without a mental health professional beside them.

Real time access to police and NHS systems has led to better informed decisions and more appropriate courses of action taken at the scene.

Face-to-face coaching by a mental health professional at incidents has had a positive influence on service users. On a couple of occasions direct referrals to local services for follow up appointments were possible from the scene of the incident.

Instances of ongoing psychosis, personality disorders and one instance of dissociative personality disorder have been identified. The scheme has also helped to figure out where mental health is not a factor.

By working in partnership with the health service the report also suggests that a more efficient service is being delivered. It is estimated that 45 minutes per attended incident is saved by effective decision making, recording, efficient onward referral and resolution of an incident.

And critically, despite a worrying year on year rise in mental health incidents that is almost certainly due to the coronavirus pandemic, since the July 10 launch of this project fewer people in Devon, Cornwall and the Isles of Scilly have been detained by police officers.

That is better for the individual and the police service which has many other demands on its time and better for the public.

A full evaluation of the scheme will take place after the summer policing operation comes to an end. I am confident though that this exercise has identified ways of working that improve the service delivered to some of our most vulnerable residents and will be working with partners in health to ensure that a longer-term, force-wide sustainable solution is found.

Alison Hernandez