New guidance on police support for incidents on mental health wards

Staff who work on mental health wards, particularly psychiatric intensive care units, will be trained in de-escalation and control and restraint.

Exceptionally, healthcare professionals will require the assistance of the police to provide care safely to people experiencing acute mental illness.

These types of incidents most commonly occur either during the course of an assessment of the person for detention under the Mental Health Act or whilst the person is acutely unwell following detention and whilest being detained on a PICU.

Any mental health ward managers as well as other staff will be interested to read the Memorandum of Understanding on the Police Use of Restraint in Mental Health & Learning Disability Settings.

The development of the MoU had significant input from members of the Royal College of Psychiatrists, MIND, the Royal College of Nursing and the College of Policing.

The MoU aims to clarify the role of the police in responding to incidents, specifically in mental health and learning disability settings and how police who attend should work with care providers.

It highlights, through case studies, when the police in attendance might take the lead and when they ought to hand management back over to care staff.

The MoU recognises that care staff will manage the vast majority of incidents of violence and aggression but at the same time that appropriate responses to mental health related incidents are “core police business”.

Ultimately the success of the MoU will depend on clear communication and cooperation at a local level.

MIND facilitated the important input of service users’ views to those who worked on the MoU during its two years of development. The MoU emphasises that the risks associated with restraint are significant, so the MoU aims to improve patient safety as well as staff safety by ensuring the best response to patient safety incidents.

On the ground, this will depend on the effectiveness of local protocols between health providers and police services and urges all local teams to review such protocols.

Local Protocols

The MoU highlights some of the matters that these protocols should cover, including:

• Staffing in both health and policing to enable the discharge of respective legal duties
• Effective communication between police and health in particular in relation to the assessment of risk
• Clear escalation procedures in both police and health to problem solve at both an operational and stategic level; and
• Provision for the joint review of individual cases

Examples and Case Studies

The MoU provides some helpful examples of circumstances that would require a police response and talks through a number of case studies, explaining how police input might best be managed in tandem with the provision of effective health care during and following an incident.

MIND facilitated the important input of service users’ views to those who worked on the MoU during its two years of development.

Importantly the MoU focuses on how parties involved might work together to learn lessons from individual cases and how health providers ought to ensure proper scrutiny and review of all such incidents, which may require reports to be made under Health and Safety legislation, under the NHS Serious Incident Framework and to the Care Quality Commission.

Ultimately the success of the MoU will depend on clear communication and cooperation at a local level.

For further reading, please follow this link.

Errol Archer is senior associate solicitor at Ridouts Professional Services