FOR too long the line between police business and mental health matter was blurred leading to hundreds of vulnerable patients being detained against their will for hours and often days on end, writes MARION SAUVEBOIS.

At last, this is all about to change thanks the Swindon Street Triage, a new partnership between Wiltshire Police and AWP, the region’s mental health service, formed to prevent unnecessary arrests or detentions under the Mental Health Act.

As part of the pilot, which officially launched last month, a team of mental health professionals is now working alongside officers, offering real-time advice on how to deal with distressed individuals before situations escalate, and helping them to consider all options before taking people into custody or to a “place of safety”.

“The idea of the triage service is to offer an alternative to having people detained,” explains Celia Moore, service manager for AWP.

“Nationally between 70 and 80 per cent of people detained are actually released without any follow-up. But they were detained because the police initially assumed they were so severely mentally disordered they had to be taken into custody.

“These kinds of projects have been piloted elsewhere in the country. All have been successful and improved the experience of people with mental health problems who came to the attention of the police and reduced the detentions under section 136 of the Mental Health Act.”

Section 136 gives the police the power to remove a person from a public place, when they appear to be suffering from a mental disorder, to a place of safety.

They can be kept for assessment under the act for up to 72 hours.

After being assessed by health professionals, they may then be sectioned under the Mental Health Act. Many, however, are released without further action.

Most often a place of safety will be on a mental health unit or at the A&E Department. As a last resort and if a person is presenting a risk to other people the police station can be used as a place of safety.

A collaboration of sorts had already begun behind the scenes between AWP and Wiltshire Police to help officers make informed decisions before defaulting to a Section 136 detention.

No data is available for the people detained in health-based places of safety before 2014.

But it is clear the informal arrangement had a significant impact on the number of people held in police custody. The figure steadily dropped from 129 in Swindon and Wiltshire to 61 in 2014-2015. The number of patients taken to health-based place of safety last year was 319.

Anything from a domestic disturbance call, a person threatening to take their own life or causing a public disturbance can potentially lead to a detention under the Mental Health Act. While some are justified, some could easily be avoided.

Earlier this year, the mental health services and the police decided to formally collaborate and introduce a dedicated triage team. They were awarded £300,000 by NHS England towards the year-long pilot.

The partnership has allowed the police to overcome a major hurdle – confidentiality.

Before the pilot, officers were sent out virtually “blind”, that is with no or very little information about the people involved.

The triage service resolves this issue.

Unlike officers, nurses on the triage team have access to mental health records and can check if the person the police are dealing with is known to health services.

If so, they can advise officers on the best course of action, contact families or carers and speak to the person experiencing a mental health crisis and try to appease them.

“One of the bonuses of the partnership is information share,” says PS Mike Hughes, Wiltshire Police’s mental health liaison officer.

“Up until now we would receive a call about an incident but we didn’t have any access to the individual’s mental health records, quite rightly.

We were going into an incident blind. Now we get a more informed picture to insure that people get the best possible care.”

Four nurses now split their time between Gablecross station and the control room at the police’s Devizes headquarters.

They can be contacted directly by officers in need of help and even asked to speak to a patient.

They also have access to the emergency calls log and if they spot a familiar name, identify a mental health related matter or think they can “de-escalate” a situation they will immediately let officers know.

“Someone could be upset and distressed and come to the attention of the police,” adds Celia.

“The police could then call the triage team and ask for help instead of taking them to a place of safety or even arresting them for breach of the peace.

“That decision-making time is time consuming for the police. They shouldn’t be the ones making these decisions.

“Often these people don’t need to be with the police. They are not criminals. It’s about treatment, not punishment.”

In cases where the person experiencing a mental health crisis is not known to AWP, the triage nurses can arrange a swift referral to the Sandalwood Court ward in Stratton and for them to be assessed within 24 hours instead of being detained.

In the three days which followed the Street Triage launch, Maurene assisted police on more than 26 calls.

The goal of the pilot is not only to drive standards but to ease the burden and responsibility falling on officers.

While in retrospect some detentions may not have been wise, without any knowledge of the person’s medical background or any mental health training, few officers are equipped to deal with someone experiencing a mental health crisis.

“There is no getting away from it – some Section 136 detentions have been used because officers felt backed into a corner,” admits Mike.

“They were unable to get any advice or assistance. Now they have mental health professionals available to them to make sure they make appropriate choices.”

It is also hoped the pilot will free up police to attend to ‘real’ crimes.

“We want to reduce detentions and free up the police to attend emergencies,” says Celia.

“It saves them time, it saves money and the outcome is better and more appropriate.”

Although the service operates seven days a week, limited resources mean nurses are only on hand to help officers between 2pm and midnight, the period when incidents are most likely to occur.

Going forward it is hoped funding will be renewed and the scheme increased to 24/7 operation, if necessary.

“Quite often in this day and age life can be tough and some people can behave impulsively,” says Maurene.

“We want to give them hope that there’s help out there. It’s about being proactive and caring.”