Derbyshire Constabulary
Mental Health Steering Group
Assistant Chief Constable
Gary Knighton
Derby Street Triage Pilot
Gary Parkin – Superintendent
Tracey Holtom - Service Line Manager
Alexa Sidwell - Clinical Lead
Laura Barker - Police Officer
Why do we need this service?
Gary Parkin- Superintendent
Department of Health (DoH) response
backed by the Home Office
Part of the Governments response to people with
mental illness that come into contact with the Criminal
Justice System
• DoH Funding - £200,000
• 9 Pilot Forces
• Police-led partnership
• 12 month project
• Cleveland, Leicester, Hants.
Aims of the service
• More appropriate signposting for people who
present to police and are in need of mental
health services
• Preventing people with mental illness being
detained in the wrong environment
• Avoids people being assessed under
Section 136 unnecessarily
• Improves multi-agency working and decision
making
The Derbyshire Pilot
• Secondary resource, dedicated Street Triage Car
• 1x Police officer and 1x mental health nurse
working in collaboration
• Based at Radbourne Unit, Derby
• Operating 4pm to midnight – 7 days per week
• Mobile data information from 3 databases (Health,
Police and Social care records)
• Taking police referrals from D Division
• All age service
Progress to date
Activity data
Triage attendances by month
Number of S136 during Triage
hours
Initial findings
Total 8 people s136 Feb- May 2014 (Inc)
• 1 person 1st February 2014- Triage had not
started
• 1 ED presentation – needing physical
intervention
• 1 person presented at police station 23.55hrs
• 2 were detained on section MHA
• 1 open to Crisis and admitted informally
• 1 slipped through – 18th February
• 1 open to services plan was in place.
Number of S136 outside triage
hours
136 custody
Initial findings
Total 2 people section 136 in custody in
April 2014 during operating hours
- 1 person charged with offences –
violent
and aggressive
- 1 person intoxicated
Custody suites
Activity data by patient local authority
Triage attendances by time periods
Activity data by day of the
week.
Triage attendances by age and gender
Training
The team have received the following additional training:
• MHA Law
• VARM
• Suicide prevention
• Child and Adolescence
The team have delivered training/briefings to:
• Reactive Sergeants
• Call centre staff
• Partner agencies, eg Street Pastors, YMCA
Establishing links with partner
agencies
•
YMCA
• Samaritans
• Focusline
• Derbyshire Healthcare United
• EMAS
• CINTRA – Language Line
• Ron Brooks Toyota
• Other policing, healthcare and
social care services
Case Vignette 1
Lady known to mental health services, was persuaded from
jumping off a bridge by member of public. Highly agitated and
distressed.
• Triage attended and completed comprehensive assessment
• Family had complex issues including financial concerns
resulting from serious assault on father – hospitalized with
head injury
• Agreed action plan with family to manage her overnight.
• Nurse concentrated on addressing mental health issues, ie
treatment review
• Officer concentrated on security and witness intimidation
concerns, security assessment and support from local beat
team.
• Food parcels were sourced from social care and crisis team.
• Difficulties were dealt with rapidly, and anxieties quickly
reduced.
• Good joint working with local community officers and mental
Case Vignette 2
Triage asked to look into numerous repeat calls from a member of
the public who was complaining of frequent assaults. Police attended
numerous occasions found no evidence of any criminal offences
• CareNotes reviewed - Person not been in MH services for past 10
years
• Triage nurse reviewed Police reports and suspected mental illness
was evident
• Triage team visited person at home address and nurse completed
mental health assessment. Serious mental health concerns
identified
• MHA assessment requested from Care Line
• Triage provided follow up and encouraged engagement into
services until MHA assessment was carried out
• Person was admitted on s2 MHA
• Risks managed safely
Case Vignette 3
Male reported missing after a note had been left to his father saying that
he was sorry, that he had to complete his investigation as he was a
scientist. Father worried that his son was unwell.
• Male well known to mental health services and care plan in place.
• Triage nurse weighed up the information given by response officers and what
was contained on the healthcare database.
• Section 136 detention under the Mental Health Act advised.
• Male was transported by police to the Radbourne Unit. Male was found to be in
possession of a number of bladed articles and retractable chainsaw.
• Full mental health act assessment conducted and the male was admitted to
hospital informally.
• Quick decision from nurse enabled officers to resume to their other duties within
a few minutes
Partner agency feedback
The best thing about the
service is;
Changes that I would make to
the Street Triage Team would be;
Partner agency feedback
I have nothing but positive things to say about Triage that night. Before
Triage were in operation, that job would have meant us arresting the
female under s.136 and sitting with her up the Radbourne Unit for a
number of hours. Instead, triage team were waiting for us at the hospital
and the initial assessment was very quick and painless. The female in
question was able to return to a safe address with family support a lot
sooner than she would have been able to before. I have found that
hanging around at the hospital for hours can often increase the anxiety
and symptoms the patient is already experiencing. I fully support Triage
and would like to see it stay. It frees up officer time, which is generally
in short supply, and the patient gets access to the right help quickly.
I cannot think of anything specific Triage could do to improve the
service although I would be interested to see how it would work if Triage
could be first response in some cases, and lose the need for section to
attend altogether.”
PC3299 Hayhurst, Derby North 760 3134
Service User feedback
The best thing about the
service is;
Changes that I would make to
the Street Triage Team would be;
Points to consider
• Diverse range of presentations - Learning disability,
young people, older adults
• Hours of operation – is it right?
• Geographical cover – diversity of area will need
consideration if service rolls out county-wide
• Ability to provide follow up / seamless service
• Ability to provide more robust packages of support
•
•
•
•
•
Understanding of roles - clarified
Efficiency of working together
Enjoyment of partnership working
Pooling of resources
Shared training
Options for development
•
•
•
•
•
Increase/adjust hours of operation.
County-wide service
Advising custody re detained persons
Monitor pre-arrest calls
Yearly/6 month secondment for police
onto Triage car
• Triage Officer to develop process from
local officers to work with care teams for
people identified with risks and
vulnerabilities
• Explore potential to initiate a project to
target ‘repeat callers and presenters’ to
emergency services.
Next Steps
Superintendent Gary Parkin
Service Line Manager Tracey Holtom