Mental Health Demand

Total Closed Ongoing – on track Ongoing - delayed
13013

All recommendations are currently on track with two recommendations (13 & 14) with approaching timescales for completion in September 2024 and an additional three recommendations (R2; R4 & R7) due January 2025.

Progress since the last update 

Recommendations 2, 3, 4 and 14

In June 2024, Chief Constable Jo Farrell directed that a Mental Health Task Force be formed, under the ownership of DCC Speirs, to drive work in this priority area, at pace.  The Taskforce will co-ordinate and balance Police Scotland’s response to Mental Health and will seek to address and coordinate the response to all HMICS recommendations. The taskforce will develop and embed referral pathways such as the NHS Mental Health Pathway and Distress Brief Intervention, as well as operational guidance on how to access community triage, so the public get the right response from those best able to give people the help they need and deserve.
The taskforce will also build on training to give our people the knowledge, skills and confidence to support that balance around the care, support and monitoring in our day-to-day policing.

The Mental Health Strategic Oversight Board has been established to provide strategic leadership and governance for matters relating to the policing response to incidents involving mental health and suicide prevention; and to support and influence relevant external bodies and groups. 

A communications strategy has been developed around MH Workstreams to develop and embed a strategic approach to communicating about Police Scotland’s response to mental health incidents in support of the mental health strategic oversight board’s terms of reference and objectives. 

A Partnership Delivery Group (time limited delivery group across Scottish Government, Police Scotland, and the Scottish Police Authority) was established and has developed a Framework for Collaboration (FfC) to support increased partnership working in responding to and supporting people in distress. The FfC will be supported by an action plan which will set out the vision and actions that will support an ongoing cross-sector collaborative approach to responding to those who are in distress. The action plan will also provide oversight and monitoring of the FfC’s effectiveness. The FfC is currently out for consultation until 20th September 2024. 

A Mental Health Working Group, chaired by CS Matt Paden, has been established and is progressing Mental Health Workstreams at a tactical level. This group reports into the Strategic Oversight Board. The aim of the working group is to develop a framework to provide governance, approval and oversight of national commitments towards the policing of mental health, distress and vulnerability.  The group will provide an overview of themes, identify priorities and offer direction in terms of mental health and wellbeing demand.

The inaugural meeting of the newly formed Mental Health Reference Group was held on 15th August 2024 at Edinburgh Futures Institute where representatives from third sector mental health organisations, and academia colleagues met to discuss new collaborative opportunities to improve person centred support in our communities. Representatives agreed to future participation solely focused on providing Police Scotland with the voices of professional, expert and lived experience to support the development of new, and improved, person centred approaches across Scotland.  A Terms of Reference will be developed and agreed by the group at the next meeting scheduled for 24th October 2024.

Recommendations 5, 6 and 7

Training needs analysis considerations undertaken by the Mental Health Taskforce and an options paper regarding training considerations was presented to the Mental Health SOB on 28th August where approval was granted to commence the development of a formal training need analysis after extensive scoping in last 24 months.  A short life working group has been created to support moving this area of priority forward in the coming months. 

Recommendation 8 

Review of Mental Health and Place of Safety SOP with support from the Mental Welfare Commission is progressing towards conclusion. 

Recommendation 10 
Externally, prior to sharing data, Police Scotland are in the process of ensuring the framework for methodology, within the Mental Health Dashboard, used to quote data, is accurate, sustainable and quality assured.  This is being completed through Police Scotland analysts and Demand and Productivity Unit (DPU).  Conscious of the importance of accuracy, this is a key piece of work that requires completion prior to sharing. A short life working group has been established between the Mental Health Taskforce and DPU. 

Recommendations 11 and 12

Police Scotland are supporting the Mental Health Unscheduled Care Network in creating a national template for PEPs. A PEP review working group, chaired externally by Doctor Alistair Cook, Principal Medical Officer, Mental health Director, Scottish Government, will develop a national template of guidance with the aim of promoting consistency, accessibility and multi-agency working.  The projected completion date is November 2024.

The Working Group will provide direction to NHS Scotland Health Boards, HSCP partners, emergency services, local authorities, and other agencies as required on the objectives that need to be progressed to develop an effective and efficient local PEP. The group will drive a national approach that recognises regional and local differences. 

Other Progress

Ongoing collaboration with Public Health Scotland and Scottish Government partners to support the potential roll out of a suicide review portal, delivered using QES software. Ongoing checks with Information Assurance, Cyber Security regarding due diligence etc supported by a formal approach by PHS / SG to request Police Scotland support of programme. Police Scotland’s Suicide Notification form has been recently approved at and will support ongoing information sharing with relevant partners regarding local suicide deaths will support force wide consistency and a level of uniformity. 

Mental Health Index

The Mental Health Index for Police Scotland (MHI) has been developed to support individuals in mental health crisis or distress and ensuring a person-centred approach whilst at the same time, reducing the significant demand on officers and staff. The Mental Health Index is designed to enhance officers’ confidence, enabling, and empowering them when dealing with a mental health related incident. The Scottish Government have been working in partnership with Police Scotland, all National Health Service (NHS) Health Boards and the Scottish Ambulance Service to create the Mental Health Index to ensure accuracy of service provision, provide guidance, support, and consistency by way of a point of reference for unplanned access to urgent mental health assessments. The MHI is scheduled to go live to nationally mid-September 2024. 

Mental Health Pathway

The Mental Health Pathway (MHP) continues to operate in C3 Division in collaboration with NHS 24.  Work is ongoing to ensure the pathway is used to full capacity, whilst maintaining appropriateness and quality of referrals to NHS 24.  An average of 370 referrals per month were passed to NHS 24 over 3 months (June/July/Aug) and there has been a total of 4141 since Phase 3 commenced on 5 Sept 2023. This has allowed 20,202 officer hours to be reallocated to other tasks. 

The MHP team and seconded NHS 24 nurses continue work under the Mental Health Taskforce to ensure optimum quantity and quality of referrals, ensuring our callers receive the best support from trained NHS 24 staff at the earliest opportunity, whilst reducing the number of Police deployments.  This work is concentrating on missed opportunities, particularly in Service Centre, alongside exploring MH-related contact with entering the organisation through the “Contact Us” platform and work around repeat contact/high intensity users.

Mental Health Unscheduled Care Workshops

The final draft of Mental Health Unscheduled Care Workshop 3 report by Police Scotland Service Design is under review with plans for an online prototype presentation event with partners scheduled to take place later this year. The intention is to seek support from the Unscheduled Care Network, Partnership Delivery Group and newly formed Mental Health Reference Group in having the perspectives of professional, expert and lived experience represented in discussions working towards the vision of a pilot initiative.   

Distress Brief Intervention

Monthly DBI governance meetings have been established to support Police Scotland divisions and will be promoted via the Mental Health Working Group to ensure continued learning and compliance. A ministerial visit and media attendance is scheduled for 26th November 2024 with DBI Central and Scottish Government to positively promote DBI. Police Scotland have volunteered to host this visit at Dalmarnock.

Challenges and Risks 

This work is being managed as part of business-as-usual activity and there has been a turnover in the Divisional Management structure and people contributing towards the improvement activity.

There are dependencies with other work - there has been limited progress with BTP access to Police Scotland IVPD system due to competing demands within Digital Division. The DPIA covering this work has been updated to reflect the technical solution being deployed and has been sent to IA for assessment.

The main risks relate to not having our overall approach to dealing with incidents of mental health, understanding and managing demand, ensuring our people have all the skills and training required to carry out their responsibilities and lack of governance and oversight in relation to performance. 

Themes 

All recommendations are allocated a theme at point of recording within our tracking system. This enables us to draw out learning about organisational performance and put in place measures to act on these findings.
 

Governance - Leadership of decision-making, culture, controls, accountability, oversight and management of performance.

Guidelines - Need for development of strategies, organisational approaches and plans, improvements to written procedures, policies, and guides.

Compliance - To deal with non-compliance of prescribed procedures, rules and standards.

Resources – Right people, right place, with the right skills, tools and resources to support them carry out their duties. Physical and people assets.

Human Error - Where mistakes have occurred.

Better Practice - Opportunities to improve to attain best practice or greater efficiency and effectiveness.

The themes from the recommendations featured in this report have been analysed and a summary of the key themes is included below and are relatively broadly similar to other recommendations recorded against HMICS activity.