Quality statement 1: Responding to mental health problems

Quality statement

Adults in contact with the police because of a suspected offence have any features of mental health problems responded to in a way that reduces the risk of anxiety, self-harm or aggression.

Rationale

It is important that police officers recognise features of mental health problems in people who are suspected of committing an offence. They should know how to respond if a person is behaving in a way that suggests a mental health problem, so that they keep them calm, reduce their anxiety and, if their behaviour is aggressive, minimise the need for restrictive interventions such as restraint. Police officers may see the same person on several occasions, so developing and maintaining safe boundaries and constructive relationships will help to reassure the person and reduce the risk of anxiety, self-harm or aggression when they are with the police.

Quality measures

Structure

a) Evidence of arrangements to ensure that police officers are given induction training in responding to features of mental health problems.

Data source: Local data collection, such as induction training plans and audits of induction training records.

b) Evidence of arrangements to ensure that police officers are given regular update training in responding to features of mental health problems.

Data source: Local data collection, such as audits of annual performance reviews.

Process

a) Proportion of adults at risk of self-harm or suicide and in contact with the police because of a suspected offence for whom initial safety precautions are taken.

Numerator – the number in the denominator for whom initial safety precautions are taken.

Denominator – the number of adults at risk of self-harm or suicide and in contact with the police because of a suspected offence.

Data source: Local data collection, for example attendance and custody records and risk assessments.

b) Proportion of adults behaving aggressively and in contact with the police because of a suspected offence who are calmed using de-escalation techniques.

Numerator – the number in the denominator who are calmed using de-escalation techniques.

Denominator – the number of adults behaving aggressively and in contact with the police because of a suspected offence.

Data source: Local data collection, for example custody reports.

Outcome

a) Number of adults with mental health problems in contact with the police because of a suspected offence who are referred to liaison and diversion services.

Data source: Local data collection, for example audits of attendance records and custody reports.

b) Number of assaults on police officers by adults with mental health problems.

Data source: Local data collection, for example audits of incident and custody reports.

c) Number of assaults on other detainees by adults with mental health problems.

Data source: Local data collection, for example audits of incident and custody reports.

d) Number of self-harm and suicide attempts by adults in contact with the police because of a suspected offence.

Data source: Local data collection, for example audits of incident and custody reports.

What the quality statement means for different audiences

Service providers (police services and training providers) ensure that training in responding to the features of mental health problems is provided for police officers. This ensures that police officers understand the causes and implications of mental health conditions. It also means that officers are confident when they are in contact with adults with mental health conditions and ensures the safety of these adults and themselves. Initial training is provided at induction, with regular update training provided subsequently.

Police officers attend training at induction and have regular updates in responding to the features of mental health problems. They are confident to safely support the adults with mental health problems they have contact with. By developing and maintaining safe boundaries and constructive relationships, officers may be able to keep people calm and minimise their anxiety. Officers can help adults who present with symptoms of aggression to minimise the need for restrictive interventions such as restraint.

Commissioners (police and crime commissioners, local authorities, NHS England and clinical commissioning groups) ensure that the police and health services they commission work together to provide training to frontline staff that includes responding to the features of mental health problems in adults. The police services they commission ensure that frontline staff are given time to attend this training.

Adults suspected by the police of committing an offence are looked after by police officers who have an understanding of mental health problems. The police officers will work with adults who may have a mental health problem to keep them calm, reassure them and reduce the risk of anxiety, self-harm or aggression while they are with the police.

Source guidance

Mental health of adults in contact with the criminal justice system (2017) NICE guideline NG66, recommendations 1.9.3 and 1.9.4

Definitions of terms used in this quality statement

In contact with the police

Adults are in contact with the police when they are taken into custody or they voluntarily attend a police station because they are suspected of committing an offence. At these times, the police service has responsibility for their wellbeing.

[Expert opinion]

Features of mental health problems

These are behaviours or aspects of appearance that suggest a person may have mental health problems. The College of Policing's Authorised professional practice gives details of features of mental health problems that should alert police officers to the possibility of a mental health problem in people who are in contact with the police.

[Expert opinion]

Responding to features of mental health problems

Responding to features of mental health problems includes but is not limited to:

  • taking initial safety precautions when there is a risk of self-harm or suicide

  • using de-escalation methods to minimise the use of restrictive interventions

  • developing and maintaining safe boundaries and constructive relationships

  • avoiding judgemental attitudes and inappropriate terminology.

[Adapted from NICE's guideline on mental health of adults in contact with the criminal justice system, recommendations 1.9.2 and 1.9.4 and expert opinion]

Equality and diversity considerations

When adults who may have mental health problems voluntarily attend a police station on suspicion of committing an offence or are taken into police custody, consideration should be given to the possibility that they may have a learning disability, cognitive impairment (for example brain injury, dementia or autism) or a communication difficulty (for example, language, literacy, information processing or sensory deficit). If this is the case, they may need additional support both while they are with the police and following release or transfer within the criminal justice system.