Police in Scotland will always have an important role in society in relation to supporting those who are in crisis or distress due to experiencing poor mental health.
This role in protecting and supporting people experiencing poor mental health, however, needs to be as one part of a whole system approach also involving health and social care, states a report published today (Wednesday, 18th October).
The importance and scale of safeguarding and ensuring the wellbeing of people experiencing poor mental health is such that no single agency is able to meet their often complex needs, according to HM Chief Inspector of Constabulary in Scotland.
The primary theme emerging from the HMICS Review of Policing Mental Health in Scotland is that mental health is a cross-cutting issue which is not only a matter for policing, but is one that requires a whole system response to ensure the best possible service for those in need.
Mr Craig Naylor, HM Chief Inspector of Constabulary in Scotland, said: "'Police Scotland will always have a key role in supporting those experiencing poor mental health. This should, however, be within a wider structure which includes other emergency services, health and social care where, upon review, the care is provided by the agency most skilled and qualified to address the circumstances presented. Such decisions must always be based on the wellbeing of the person experiencing poor mental health rather than which resource is available.
“HMICS believes that mental health is a health and social care issue to be managed primarily by Scotland’s health and social care services, in line with the recently released Scottish Government strategy (Mental health and wellbeing strategy - gov.scot (www.gov.scot)). People should be supported and treated to prevent them from acting in a manner that could be harmful to themselves or others.
“Police officers and staff should not be filling the gaps and performing the roles of other agencies. It is critically important there are effective referral processes in place to ensure people receive the most suitable assistance from health professionals at the earliest juncture.”
There is a perception that the mental health demand on Police Scotland’s time and resources is limiting its effectiveness and efficiency to perform its traditional role of keeping the peace and preventing, investigating and detecting crime.
Calls associated with mental health are a daily occurrence for officers on the front line and have increased significantly in the past five years. It also adversely impacts on their job satisfaction.
“Police involvement in mental health related incidents should not be to the detriment of those in crisis, its officers, staff or the wider needs of Scottish localities and communities. Officers should not routinely be performing welfare checks or sitting in hospital waiting rooms for lengthy periods of time. When doing that, they cannot be in their communities dealing with issues of local concern," said Mr Naylor.
HMICS is concerned Police Scotland’s leadership has no mechanism to effectively assess the demand generated by mental health related calls while police officers themselves are divided over whether they should respond to only life-threatening and high risk matters or should fill the gaps in the system. Many told the review team it is not unusual for half of the deployable front line uniformed officers to be on mental health related calls and one such call can engage two officers and a vehicle for an entire shift.
They also believe that the organisation is risk averse which results in officers remaining with a person in crisis until they are either accepted into the care of the NHS or a family member.
Discussion with agencies who respond to those experiencing poor mental health shows they generally support the concept of effective partnership working and a wide-reaching review of mental health in Scotland.
“In the absence of such a review, or until one is undertaken, organisations such as Police Scotland must ensure they provide the best possible support to the public. I do not consider it sustainable for the police service to continue without an agreed and published mental health strategy. Nor do I consider it reasonable for them to wait for the conclusions of a review of the whole system which depends on political and institutional will.
“In the short term, Police Scotland needs to establish its strategic position on mental health and ensure its officers and staff are aware of that position and have relevant training which is consistent across the service. They need clear guidance on what they should and should not be doing,” said Mr Naylor.
The review team found many examples of local policing officers working innovatively with partners who were positive about collaborative working arrangements at local and national level. A whole system review would consider which partner should conduct which role, based on suitability to deliver an effective outcome for the individual rather than availability.
There was also evidence of service advisors in the Contact, Command and Control centres receiving good support from their supervisors when trying to determine if a call requires a police response. This support was often based on the supervisor’s experience rather than on training received and in the full knowledge they could be investigated if there was an adverse outcome.
During the review, HMICS sought input from VOX (Voices of Experience) Scotland which provided insight into the lived experience of people with poor mental health. It was highlighted that, despite the best efforts of police officers, their involvement can sometimes have a detrimental impact on the well-being of those experiencing a mental health crisis. HMICS would like to thank VOX Scotland for their input.
HMICS sought guidance from an independent advisory panel and would also like to thank them for their support. HMICS believes that Police Scotland should work with the advisory panel in the design of its strategy and to deliver the 14 recommendations contained within the report.