Not Protectively Marked
FORCE PROCEDURES
Procedure Reference Number: 2009.46
Procedure Author: DC D Clarke, Strategic Public Protection Unit
Procedure Review Date: September 2010
At the time of ratifying this procedure, the author is satisfied that this document complied with relevant legislation and Force requirements.
Sign and date
……………………………………
(Author(s))
Procedure Index
ELECTRONIC NAVIGATION: - move the cursor over the page number in the index or blue underlined text until a hand appears. Click the left mouse button once and it will jump to the specified part of the document.
1. Responsibilities 4
ACPO Lead 4
HQ Strategic Lead – Detective Chief Superintendent, Crime Operations 4
Area Commander 4
Area Public Protection Unit 4
Area Mental Health Liaison Officers 4
Targeted Patrol Team and Neighbourhood Policing Unit Staff 4
Centralised Custody Unit Staff 4
2. Guidance 5
2.1 Introduction 5
2.2 Identifying Mental Health Issues 5
2.3 Divisional Mental Health Liaison Officers 5
2.4 The Mental Capacity Act 2005 6
2.5 Power to Remove a Person to a Place of Safety 7
Section 136, Mental Health Act 1983 7
2.6 Transfer between Places of Safety 8
Section 44, Mental Health Act 2007 8
Authority to Transfer 8
Assessment at the New Place of Safety 8
Documentation 8
2.7 Warrants to Search / Remove Patients in Private Premises 9
Section 135(1) of the Mental Health Act 1983 9
Section 135(2) 9
2.8 Support to Partner Agencies 10
Police Response to Mental Health Incidents (Request from an Approved Mental Health Professional or from Hospital Premises) 10
2.9 Multi Agency Conveyance by Ambulance Protocol 10
2.10 Conveyance of Patients by the Police 11
2.11 Criminal Justice Liaison (Suspects or Offenders with Mental Health Issues) 11
2.12 Persons with Mental Health Issues who are Reported Missing 11
2.13 Persons subject to the Mental Health Act who have Escaped or are Absent without Leave 11
2.14 Potentially Dangerous Persons 12
2.15 Custody Services 12
Police Custody 12
Mentally Disordered or otherwise Mentally Vulnerable Suspects under the Police and Criminal Evidence Act 12
Mental Health Assessments in Custody 13
Custody Exit and Aftercare Strategies 13
2.16 Police Role in Supervised Community Treatment Orders 13
2.17 Information Management and Information Sharing 14
2.18 Diversity 14
2.19 Partner Agencies 15
3. Procedure Aim 15
Priorities 15
Key Principles 15
4. Appeals 16
5. Review 16
1. Responsibilities
ACPO (Association of Chief Police Officers) Lead
1.1 The Assistant Chief Constable (Investigation) is responsible for the strategic direction and the development of the Public Protection Unit functions for those persons with mental health issues.
HQ Strategic Lead – Detective Chief Superintendent, Crime Operations
1.2 The Detective Chief Superintendent, Crime Operations is responsible for the implementation and development of policy and procedures relating to the minimum standards of response to persons with mental health issues.
Area Commander
1.3 The Area Commander is responsible for ensuring that all staff fulfil their responsibilities as set out in this procedure and are supported with the appropriate training and knowledge to do so.
1.4 The Area Commander will appoint an Area Mental Health Liaison Officer.
Area Public Protection Unit
1.5 Area Public Protection Units have responsibility of receipt, assessment and further response to notifications of issues involving vulnerable persons.
Area Mental Health Liaison Officers
1.6 Area Mental Health Liaison Officers are responsible for ensuring appropriate police response to persons with mental health issues at Area level.
Targeted Patrol Team and Neighbourhood Policing Unit Staff
1.7 Targeted Patrol Team and Neighbourhood Policing Unit staff will respond to all operational issues involving persons with mental health issues as per their Standard Operating Procedures and associated protocols.
Centralised Custody Unit Staff
1.8 Custody staff are responsibility for dealing with those persons with mental health issues who come into police custody as per the Police and Criminal Evidence Act 1984 Code C and the National Policing Improvement Agency Guidance on the Safer Detention and Handling of Persons in Police Custody.
Click Here to Return to Index
2. Guidance
2.1 Introduction
2.1.1 The police have a key role to play in providing an appropriate response to people with mental health issues and facilitating access to a range of other agencies. People with mental health issues who are affected by service delivery responses by the police include victims, witnesses, members of the public seeking a service from the police, suspects, offenders and the families and carers of people with mental health issues. Police responses are key to increasing confidence in the criminal justice system and ensuring justice for all.
2.2 Identifying Mental Health Issues
2.2.1 The police are crucial in the early identification of mental health issues of suspects, victims and witnesses and others. This will ensure effective and timely communication with other agencies. Identification will also help ensure appropriate Criminal Justice System responses and assessment by trained mental health practitioners where necessary.
2.2.2 All staff who are involved in service delivery should have adequate training to be able to identify situations which appear to indicate a person with mental health issues but may actually involve physical illness or injury (e.g. head injury, encephalitis, urinary infection, diabetes, epilepsy or sickle cell disease) or drug or alcohol misuse.
2.2.3 The initial police response to an individual with mental health issues can provide the gateway to positive engagement with health, social care and children’s services. Those involved in the first response include Call Management Bureau, Helpdesk Staff, Targeted Patrol Team Officers and Neighbourhood Policing Unit Teams.
2.2.4 Communication styles and general interviewing techniques may need to be adjusted when dealing with people with mental health issues.
See Office for Criminal Justice Reform (2007) Achieving Best Evidence in Criminal Proceedings: Guidance on Interviewing Victims and Witnesses, and Using Special Measures, Vulnerable Witnesses: A Police Service Guide for further detail.
2.2.5 Where an officer or other member of staff deals with or has concerns regarding a person who is or appears to have mental health issues then he / she should submit a Vulnerable Person Notification Form (form 200040a) to the relevant area Public Protection Unit.
2.3 Area Mental Health Liaison Officers
2.3.1 Area Commanders will appoint an Area Mental Health Liaison officer:
· To provide the Area Commander with a point of reference and liaison for all other statutory and voluntary agencies.
· To liaise with representatives of :-
o Local Authority Social Care
o Probation, and
o Health
· To represent the Area Commander at a local level in all aspects of Mental Health.
· To ensure that local agreements with statutory and voluntary agencies reflect Force Procedures.
· To maintain liaison with the HQ Strategic Public Protection Unit.
· To provide appropriate statistical information.
· To review with other statutory agencies the local protocol and procedural agreements, especially relating to the operation of Sec. 136 Mental Health Act 1983 and Local Mentally Disordered Offender Schemes.
2.4 The Mental Capacity Act 2005
2.4.1 Whilst the Act is primarily aimed at health professionals and carers when making decisions about a person’s welfare, it will in some circumstances be applicable to police officers when dealing with members of the public.
2.4.2 There are five principles of the Mental Capacity Act 2005:
1. A person must be assumed to have capacity unless it is established that they lack capacity.
2. A person is not to be treated as unable to make a decision unless all practicable steps to help her/him to do so have been taken without success.
3. A person is not to be treated as unable to make a decision merely because she/he makes an unwise decision.
4. An act done or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in her/his best interests.
5. Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action.
2.4.3 The Act only applies to people who lack mental capacity or who are reasonably believed to lack mental capacity. It applies to public and private locations. When officers encounter a person, whom they reasonably believe to lack mental capacity, they should consider taking action to safeguard the person’s best interests, having regard to how that purpose can be achieved in a way that places the least restrictions on the person’s rights and freedom of action.
2.4.4 The Act will be of primary importance to policing when officers deal with someone lacking mental capacity in an emergency situation, whose life may be at risk or who may suffer harm if action is not taken. An example in the context of this procedure is a person attempting or threatening suicide. Police occasionally come across individuals with serious injuries that may result in serious harm or death, but who decline medical aid. If such a person has the mental capacity to make this decision there is no power to compel her/him to accept medical treatment. If an officer reasonably believes that a person lacks mental capacity then the Act will apply and that person may be treated in their best interests. Officers should weigh up the risks of forcing help on an unwilling person against the benefits it may offer.
2.4.5 Unlike medical and ambulance personnel, police officers are not trained in the assessment of mental capacity. Where police are the only service on scene it may be necessary to make an assessment and act accordingly before other services arrive, where the seriousness or urgency of the situation dictates. When a doctor, member of the ambulance service or appropriate service arrives on scene, or is already present, police will defer to their expertise and provide support as appropriate.
2.4.6 Any power to restrain a person as a result of this Act does not interfere with any existing powers of arrest for criminal offences, or under section 136 of the Mental Health Act 1983.
2.4.7 The Act does not expect perfect scientific decisions. It protects decision makers where they take reasonable steps to assess someone’s capacity and then act in the reasonable belief that the person lacks capacity and that such action is in their best interests. In some cases Independent Mental Capacity Advocates (established under the Act) may assist individuals to make decisions relating to the criminal justice system.
2.5 Power to Remove a Person to a Place of Safety
Section 136, Mental Health Act 1983
2.5.1 Section 136 (1) of the Mental Health Act 1983 (as amended) states:
If a constable finds in a place to which the public have access a person who appears to him to be suffering from mental disorder and to be in immediate need of care or control, the constable may, if he thinks it necessary to do so in the interests of that person or for the protection of other persons, remove that person to a place of safety.
2.5.2 Section 136(2) Mental Health Act 1983 states:
A person removed to a place of safety under this section may be detained there for a period not exceeding 72 hours for the purpose of enabling him to be examined by a registered medical practitioner and to be interviewed by an approved mental health professional and of making any necessary arrangements for his treatment or care.
2.5.3 A place of safety is defined as ‘hospital, police station, mental nursing home or residential home or any other suitable place’. The Mental Health Act 1983 Code of Practice states that a police station should only be used as a place of safety as a last resort.
2.5.4 Cheshire Police have agreed protocols with the following NHS Partnership Trusts giving guidance to those who take part in the care and treatment of persons subject of detention under section 136 of the Mental Health Act 1983 and should be consulted when necessary:
· Cheshire and Wirral Partnership NHS Trust (Eastern and Western Police Areas)
· 5 Boroughs Partnership NHS Trust (Northern Police Area, separate protocols for Halton and Warrington)
2.6 Transfer between Places of Safety
Section 44, Mental Health Act 2007
2.6.1 The Mental Health Act 2007 has amended the 1983 Act to enable the transfer of a patient detained under section 136 from one or more places of safety to another within the 72 hour period.
2.6.2 Transfer may take place:-
· before assessment has taken place
· whilst assessment is in progress
· after assessment has been completed and arrangements are being made for subsequent care or treatment
Authority to Transfer
2.6.3 The decision to transfer a patient to another place of safety will be made in agreement with the Approved Mental Health Professional, the doctor in attendance, or a senior section 12(2) doctor (except in an emergency situation).
2.6.4 Transfer should not take place unless the new place of safety is also in agreement with the transfer.
2.6.5 Examples of circumstances that may require transfer:
· Patient is initially detained in a police custody suite and it is agreed that transfer to a hospital is appropriate in the patient’s best interests
· Patient is initially detained in a hospital but is violent and unmanageable by staff, requiring transfer to a police custody suite
Assessment at the New Place of Safety
2.6.6 A decision will be made whether it is more appropriate for another Approved Mental Health Professional and doctor to complete the assessment once the patient has been transferred.
Documentation
2.6.7 Where a patient is transferred from one place of safety to another, the original section 136 paperwork must be taken with the patient to the new place of safety so that details are available and records of assessment can be continued and completed.
2.7 Warrants to Search / Remove Patients in Private Premises
Section 135(1) of the Mental Health Act 1983
2.7.1 Where there is evidence that a vulnerable person is in need of immediate care and control an Approved Mental Health Professional can make an application to a Magistrate on the grounds that there is: