Quality statement 4: Risk management during transfers

Quality statement

Adults who have a mental health risk management plan and are transferring within the criminal justice system have their plan reviewed by the receiving service.

Rationale

When adults with mental health problems are being transferred to different services (for example, transfers by prisoner escort services to court custody, into prison, between prisons or when people move into the community under the care of probation services) it is important to check if they have a risk management plan and ensure that it is implemented. This will help to maintain their safety, particularly if they are at risk of self-harm. It will also help to keep other people within the criminal justice system safe, for example by ensuring that people who could present a risk are not placed with others in cells, holding areas or prisoner escort vehicles. People working in the criminal justice system and community mental health will also be safer because they will be prepared and aware of any risks before coming into contact with people who could present a risk.

Quality measures

Structure

a) Evidence of local arrangements for mental health risk management plans to be reviewed by the receiving service when adults are transferred between services within the criminal justice system.

Data source: Local data collection, for example local information sharing and risk assessment protocols, transfer policies and community mental health services transfer of care policies.

b) Evidence of local arrangements to implement mental health risk management plans.

Data source: Local data collection, for example evidence of availability of individual cells in police, court and prison custody, and suitable safe transport.

Process

Proportion of transfers between services within the criminal justice system in which mental health risk management plans were reviewed.

Numerator – the number in the denominator in which mental health risk management plans were reviewed.

Denominator – the number of transfers between services within the criminal justice system.

Data source: Local data collection, for example review of custody, probation and community mental health records and prison escort records.

Outcome

a) Number of assaults within the criminal justice system.

Data source: Local data collection, for example audit of incident reports.

b) Number of self-harm incidents within the criminal justice system.

Data source: Local data collection, for example audit of incident reports and medical records.

c) Number of assaults committed by adults under the care of probation services.

Data source: Local data collection, for example audit of incident reports and reoffending rates.

d) Number of self-harm incidents involving adults under the care of probation services.

Data source: Local data collection, for example audit of incident reports and medical records.

What the quality statement means for different audiences

Service providers (such as police, prisoner escort, court custody, prison, probation and community mental health services) ensure that processes are in place for mental health risk management plans to be reviewed and acted upon when people are moved between services within the criminal justice system. This includes sharing information between services and ensuring that people are not placed in transport, holding areas, cells or in accommodation in the community until the plan has been reviewed.

Criminal justice and mental health professionals (such as police officers, custody sergeants, court custody officers, prison escort officers, prison officers, probation officers and mental health professionals) ensure that they review and act upon mental health risk management plans when people are moved between services within the criminal justice system and into the community. This includes checking the requirements of the plan before booking transport and confirming any relevant information, such as the need for someone to be transferred individually or to be placed in a single cell on arrival.

Commissioners (police and crime commissioners, local authorities, NHS England and clinical commissioning groups) ensure that the services they commission review and act upon mental health risk management plans, sharing information across services to do so.

Adults who have a mental health risk management plan have their plan checked and any actions carried out to reduce risks when they are moved between different services within the criminal justice system, for example from police custody to court, prison or the community. A mental health risk management plan is developed for people who may be a risk to themselves or to others. It outlines ways that the risks can be reduced.

Source guidance

Mental health of adults in contact with the criminal justice system (2017) NICE guideline NG66, recommendations 1.4.4 and 1.4.5

Definitions of terms used in this quality statement

Mental health risk management plan

This should be completed and implemented for people who are assessed to be:

  • a risk to themselves, including self-harm, suicide, self-neglect, or to their own health, or vulnerable to exploitation or victimisation

  • a risk to others that is linked to mental health problems, including aggression, violence, exploitation and sexual offending.

The plan should:

  • include protective factors that may reduce risk

  • integrate with or be consistent with the mental health assessment and plan

  • take an individualised approach to each person and recognise that risk levels may change over time

  • set out the interventions to reduce risk at the individual, service or environmental level

  • take into account any legal or statutory responsibilities which apply in the setting in which they are used

  • be shared with the person (and their family members or carers if appropriate) and relevant agencies and services subject to permission from the person where necessary

  • be reviewed regularly by those responsible for implementing the plan and adjusted if risk levels change.

[Adapted from NICE's guideline on mental health of adults in contact with the criminal justice system, recommendations 1.4.2 and 1.4.4]

Transfer within the criminal justice system

These are times that adults in contact with the criminal justice system are moved between services. Most commonly, this will be time spent with prisoner escort services, in court custody, at initial reception into prison, during transfers between prisons and moving into probation services.

[Expert opinion]

Receiving service

This is the service that will be immediately responsible for the person's care. This can include, but is not limited to:

  • police services

  • prisoner escort services

  • court custody

  • prison

  • probation services

  • GPs

  • community mental health services.

[Expert opinion]

Equality and diversity considerations

Adults in the criminal justice system who have a mental health risk management plan should be aware of how it will be shared with relevant services when they are transferred to ensure they receive ongoing support and care.

Adults with 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) may need additional support and this should be noted in the plan and acted upon.

If adults are being released from prison into homelessness or temporary accommodation, probation services, community mental health services and the local authority should work together to find permanent suitable accommodation to ensure the person's safety.