Kim Moore

Kim Moore

Kim Moore, Lecturer in Mental Health, Birmingham City University’s Faculty of Health

The government announced this week that five more police forces are to pilot a scheme whereby mental health nurses will accompany officers on call-outs. The new scheme aims to provide police forces with the support of health professionals who are able to provide the necessary skills needed to treat vulnerable people appropriately in times of crisis.

However on closer inspection of the scheme it appears that there are a lot of questions that need to be answered.

The pilot scheme appears to be funded by the Department of Health which potentially means money taken out of an already stretched mental health budget (although it does have full backing by the police).

The crux of the issue seems twofold, first the issue that police raise about not being able to diagnose mental health problems and the inordinate amount of time spent managing mental health issues in the community. The problem is that a mental health nurse is not able to “diagnose” but can triage according to the clustering classifications established for funding community mental health services. This type of joint outreach work is not, as yet, factored within many of the mental health services commissioned funding and payment schemes.

The second critical issue seems to be linked by police to the use of section 136 of the Mental Health Act and detention within custody cells rather than the dedicated suites. Admittedly there are problems with national standards for 136 assessment suites with some areas in the country under resourced, however this may link to another recent publication on the increasing use/ overuse/ misuse of the Mental Health Act (MHA) detentions and as a means of accessing inpatient services.

This leads to the question of where the staff are coming from. Having mental health staff with the police in emergency or crisis situations suggests that existing crisis teams are potentially not working to their full potential or that these teams are working with insufficient staffing levels to be able to accommodate additional crisis working with police colleagues. What about the police custody and liaison teams? Again there may well be issues of accessibility of these staff who are already working with police in custody suites to provide an enhanced service.

From the available information there is a lack of clarity about the role that ambulance and Approved Mental Health Profession (AMHP) staff play in this new venture. In mental health crisis assessments the use of the MHA working with the police and ambulance service is often critical to enable assessment in an assessment suite. However, if mental health nurses are going out with police, what are their conditions of working? Will they have the same safety equipment when out on call? Are they seconded to the police force? I wonder if this will promote positive mental health management or work as an additional barrier and the individual concerned has “yet another assessment” as a mental health act assessment is requested?

The pilot seems somewhat one-sided, and unless there is truly joint partnership between police and mental health services with joint ownership, joint funding and joint management and responsibility, there is a potential risk that nurses are being asked to act as mental health police. I suspect this project might have a cost saving for the police, however this may not be the case for mental health services which are in significant restructuring and cost saving exercises.

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Kim Moore

Kim Moore

Lecturer in Mental Health, Birmingham City University’s Faculty of Health