Summary/Findings

• The methodology of the review consisted of interviews with officers and staff from across Police Scotland, the Authority, staff associations, trade unions, partner organisations and key stakeholders. Focus groups were also conducted in the following Divisions: Edinburgh (E Division), Ayrshire (U Division), and Tayside (D Division). Furthermore, a self-evaluation was issued to PS which allowed the review of documentation including policies, procedures, plans, and training materials. An advisory panel was also set up to provide advice and support, to test proposals and findings.
• VOX Scotland - a national membership-led charity run by people with lived experience of mental ill health – was also involved in the review to provide insight and learning from those with lived experience of mental health and police response. Alongside HMICS’ report VOX have also published a Lived Experience Report to supplement the findings.
• The review team routinely heard about a perceived increase in demand to support vulnerable people meaning a re-focus from dealing with traditional policing matters (e.g. crime and anti-social behaviour). Many officers believe addressing mental health has become the most significant aspect of their work.
• Th 83-page report provides findings, recommendations, and outlines further areas for development. The findings and recommendations are presented below, however the areas for development can be found in Appendix A.

The review compiles key findings across broad themes:

• Whole system approach: Recognising the complexity of mental health and that it should not solely be a policing matter but an issue requiring a whole-system response to improve services and outcomes for those experiencing poor mental health. Over last 5 years PS has faced an increase in demand associated with mental health, with a perception among some of the workforce that PS are “filling gaps” and performing the role of NHS.
• Leadership and vision: With no strategy in place for providing mental-health related policing services the role of PS needs to be clearly defined and articulated to the workforce, partner agencies, and the public. Whilst there is a strategic commitment to work with partners in addressing public health and wellbeing, the review finds the need for clear guidance and training on the police’s role in mental health. HMICS found a potentially risk-averse culture (driven by senior leaders focus on ‘safe outcomes’) resulting in officers being fearful of decision making in mental health related incidents - compounded by potential investigation by PIRC. Since sergeants manage mental health-related incident risks, there are concerns about temporary sergeants being asked to manage high levels of risk without adequate training. The C3 supervisor structure was found to be supportive, proving helpful for service advisors to make decisions on policing response. Locally, innovative work is being carried out with partners to delivery improved outcomes for people experiencing poor mental health. It is recognised that the Authority is aware of increasing mental health demand however PS is unable to clearly articulate scale to the Authority (and other stakeholders), highlighting a need for better strategic oversight and co-ordination of initiatives adopted across Scotland.
• Delivery: Officers and staff highlighted a training gap for policing mental health, with workforce relying on tacit experience. Moodle mental health training packages were not widely known about, and those who had completed them considered them not to be effective. The findings suggest that a lack of training and a risk-averse culture creates mental health demand for partner organisations. Officers and staff are unclear on policing’s role in mental health: with people unsure when to signpost/refer to a more appropriate agency. Better data is needed for assurance around disproportionate impacts of police powers on under-represented groups; and for recording ‘place of safety orders’ across Scotland. Better arrangements should be made between PS and partner agencies; particularly around handover processes, and Psychiatric Emergency Plans (PEP) across different health board areas. Effective partnership working is stifled by barriers associated with information sharing. The Enhanced Mental Health Pathway (EMHP) was noted to be effective with Phase 1 and Phase 2 being evaluated.
• Outcomes: It was recognised that police carrying out welfare checks on behalf of other agencies could be detrimental for people and may lead to escalation and criminalisation of people experiencing poor mental health. Stakeholders described compassion displayed by officers responding to people in distress, despite clear difficulties. Officers entering organisation have expectations often not aligned to the reality of role, as majority of time is spent dealing with mental health and vulnerability. It was also found that policing mental health is adversely impacting job satisfaction among officers and staff.

There are 14 recommendations presented as part of the review. Those with particular relevance to the Authority are as follows:

• Recommendation 1: Scottish Government should commission a whole system strategic review relating to mental health, involving a range of scrutiny bodies.
• Recommendation 2: With advisory panel support and engagement, PS should develop and publish a mental health strategy (and delivery plan) articulating its purpose and vision in dealing with mental health-related incidents. Allowing the recommendations and areas for development highlighted in this review to be progressed.
• Recommendation 3: PS to establish and implement internal governance arrangements to achieve its mental health strategy and delivery plan.
• Recommendation 4: Police Scotland and the SPA should develop, and report on, a performance management framework setting out how it will police mental health in Scotland.
• Recommendation 9: OS to review use of recording of place of safety orders to achieve consistency of approach across organisation and ensure reporting is included in performance reports to SPA.
• Recommendation 10: PS and SPA to take clear steps to establish clear demand picture for policing mental health.
• Recommendation 14: PS and SPA to put in place measures to monitor progress on development and implementation of mental health strategy, this review’s recommendations, and outlined areas for development (including recommendations from VOX lived experience report).
• Other recommendations: R5: Provision of guidance and training in line with mental health strategy; R6: PS engagement to partner agencies to develop leadership training; R7: Conduct a full training needs analysis for policing of mental health; R8: Monitoring and reporting of disproportionate impacts of police powers on under-represented groups; R11 and R12: Review of PEP with stakeholders and consistent approach across divisions; R13: Encourage iVPD use by Scottish BTP colleagues.