Agenda item

Please note this is a verbal update – Members will receive a presentation at the meeting

The Chair welcomed Keith Pople, Director – Alexander, Catherine Wevill - Programme Manager, Clinical Commissioning Group, Chief Superintendent Geoff Wessell, from Avon and Somerset Constabulary (force mental health lead) and Maria Hamood, Adult Principal Social Worker - Bristol City Council.

Following a Care Quality Commission inspection rating of ‘inadequate’ and ‘requires improvement’ the Avon and Wiltshire Mental Health Partnership NHS trust asked Keith Pople to lead am independent review across partners to consider the approach to Section 136 of the Mental Health Act.  The work would also assist in preparing partners for the Police and Crime Act which would be enacted towards the end of May 2017.  Future work would need to be cost neutral.

Background information

·         If a police officer finds any person in a public place who they believe could be mentally ill and in need of immediate care, or control, the officer is allowed to remove them to something known as ‘a place of safety’. This is known as being ‘sectioned’.

• Once section 136 has been enacted the person would be detained for 72 hours. During this time, mental health professionals could conduct a Mental Health Act assessment. 

• The law says that a place of safety should usually be an area within a hospital, set up for the purpose of allowing people detained by the police to be assessed.  For young people, it could also be within a children’s home or youth centre.  On an exceptional basis, it may be necessary to use a police station. 

• The Police and Crime Act would change the law and stop the detention in police cells of children and young people under 18 who are experiencing a mental health crisis (and restrict the circumstances when adults can be taken to police stations) by reforming police powers under sections 135 and 136 of the Mental Health Act 1983.

Presentation and questions

The Committee were provided with a power point presentation (appendix A to the minutes) which provided an overview of how information had been gathered, a summary of the finding and a proposed approach going forward. 

Councillors were invited to ask questions and the following was noted as part of the discussion:

·         The Section 136 act would be enacted if a person had been deemed a danger to themselves or someone else but there had been no criminal incident.  A person would not be taken into a custody suit unless in exceptional circumstances. If a person had committed a crime a different process would be followed.

·         The review had covered a large area including Bristol, North Somerset, South Gloucestershire and Bath and North East Somerset.  Partners included the Local Authorities, the Police, NHS Trusts including the Ambulance service.  At a recent joint governance meeting it was agreed that the proposed programme would be implemented over the whole geographical area.    

·         Police officers were not mental health professional and tended to be risk adverse.  As part of a trial mental health nurses were available for police officers to contact in the control room.  The nurse could ask questions and provide the police officer with advice on the correct course of action based on the persons case files and the information ascertained.   Even if a person was not detained the police would still have a duty of care to ensure the person was safe. 

·         80% of people taken to the section 136 suite would not go on to be detained under the Mental Health Act which suggests they should not have been detained initially.

·         The number of people detained under S136 was representative of the community in terms of ethnicity. 

·         Information from people who had been detained under S136 suggested that sometimes the detention had been more traumatic that the mental health issue itself. 

·         A specific work stream would be developed for people under the age of 18.  No evidence suggested that a specific place of safely for people under 18 were beneficial.  Young people tended to be detained out of hours: evenings and weekend.  Responses needed to be considered carefully. 

·         More national data was required on the challenges.  Some evidence suggested that delays were because of a lack of doctors which was not related to the AWP provision. 

·         A two year pilot was 50% funded by the Police and Crime Commissioner and 50% funded by Bristol CCG included the provision of a triage nurse at the control room between 7 am and 10pm.  Funding across the partners would be required to increase the service to 24/7.  For investment to be transferred from crisis to prevention leadership within the partner organisations would be required.  Anecdotal evidence from nurses working in the control room suggested that the role was very rewarding. 

·         Street triage was also available in Bristol –qualified mental health staff attended call outs both independently and with the police.  In 9 months 75% of the people seen were diverted to another service away from the 136 suite. 

·         In the last six months the control room triage received 4000 incidents were reports, 10% of these were people in crisis.  Professionals intervened in 178 cases where officers were about to use S136. 

·         All the current places of safety are managed by AWP on behalf of commissioners. 

Councillors were invited to attend scenario testing in April and May. Further information would be provided.  (Action – Keith Pople).   Additional information would also be provided on the current process (appendix B).

The Chair thanked the guests for the informative presentation.