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'They used to grab people around the neck. That's not allowed any more, of course. They have to use the minimum force necessary.'

Sergeant Marcus Griffiths of National Police Training, Harrogate, has a firm grasp of the theory on police restraint techniques and the treatment of mentally disordered offenders. Yet restraint remains one of the issues which continue to dog the public image of the police.

The Police Complaints Authority is currently investigating the death of Roger Sylvester in January. Mr Sylvester, who was diagnosed as clinically depressed, suffered a respiratory collapse in hospital after eight officers visited to carry out a sectioning order.

A public inquiry into the fatal stabbing of policewoman Nina Mackay by paranoid schizophrenia patient Magdi Elgizouli last month called for a review of arrangements to deal with potentially violent mentally ill people.

The inquiry report, headed by Ken Dixon, an associate member of the Association of Directors of Social Services, criticised the lack of any prior risk- assessment of Mr Elgizouli.

It questioned whether the police had paid enough attention to their own guidelines on dealing with mentally disordered people.

Mental health charities, including Mind and the National Schizophrenia Fellowship, have responded by calling for new guidelines and 'more and better' police training. Yet information on current guidelines and training provision is hard to come by.

'It's not entirely clear if there are any guidelines on issues such as the use of force,' says Mind policy officer Jenny Willmott.

The National Police Library says: 'We can't find any national guidelines, and there don't seem to be any from the Home Office.'

Ms Willmott blames the 'fierce independence' of the 43 separate forces for the lack of police cohesion in addressing mental health issues. She says: 'There is a lot of variance on different issues on which some forces are good and some are pretty awful.'

Along with NSF, Ms Willmott has been involved in 'informal talks' with the Metropolitan Police on topics including the use of CS gas, risk- assessment and restraint.

Inter-agency work to divert mentally ill offenders from the police system and increased use of specialist rapid-response teams are also on the agenda.

The Met declined to provide HSJ with current guidelines on responses to mentally ill people.

In a statement, it says social factors, such as increased drug abuse, have made it 'harder for police officers to know how to deal with' incidents involving mental illness.

Ideas being examined with health authorities and local councils recognise the 'need to look for a different response' to the conventional one of a number of officers attending the scene and either taking the person to hospital or to a police station.

Ms Willmott agrees that 'local protocols' setting up partnerships with health and social services are the best way to tackle the issue.

'The police system is so decentralised. One can't imagine anything imposed unilaterally from the centre is going to be that effective,' she says.

Approaches to mental health training are similarly random.

New police recruits receive 'training in mental health disorders and the powers of the Mental Health Act' during their first five months of national training, says Sgt Griffiths, who helps design the curriculum at the national police training college in Harrogate. After that, it's a question of geography.

Ms Willmott flags up the problem, highlighted by a Police Complaints Authority report last year, of the lack of training for custody officers who are accountable for those in their charge.

Custody Officer Training - investing in safety found that half of all forces provided less than two and a half hours' training on all medical issues. Only six forces provided more than four and a half hours' training on medical issues, and 10 provided none at all.

Sgt Griffiths points out that the Harrogate college offers training for new custody officers, as well as refresher courses, and that mental health issues feed into other training areas.

But forces are not required to take up these courses.'It is up to the individual forces to pick and choose,' he admits.

NSF has trained 5,000 officers throughout the country on courses lasting a day and a half.

Julie Traynor, NSF national training facilitator, was seconded from the Department of Health to run the scheme in 1997. Question and answer sessions involving someone diagnosed with schizophrenia are a central part of the NSF training sessions.

Ms Traynor says: 'A man with schizophrenia can explain to officers: 'Just don't rush at me, don't come at me from behind.'

'One of the major problems with the police is the same as that with the public, and that is the image of a schizophrenic. Often police arrive expecting to meet a knife-wielding maniac - not somebody sitting quietly in his bedroom.'

Although supportive of the need for local protocols, Ms Traynor calls for a national register of diversion schemes to spread good practice. She wants to increase the number of police services able to transfer mentally ill people out of police custody at the earliest stage - the point of arrest.

Peter Edwards, director of the Institute of Mental Health Law and a Liverpool solicitor, provides a half day of training on mental health issues for all new recruits to Merseyside Police.

Mr Edwards believes that a gap in provision for those patients 'the hospitals don't want, who aren't dangerous enough for forensic services' leaves police doing a job they are ill-equipped to handle.

'Often they have no training, no experience, and a police cell is a singularly unsuitable place for a mentally ill person.

'The police end up as a drip tray for all the problems society does not want.'