PARTNERSHIP WORKING IN RELATION TO MENTAL HEALTH
A discussion with representatives from Denbighshire County Council’s Social Services, Betsi Cadwaladr University Health Board and North Wales Police on their partnership working arrangements in relation to Mental Health matters.
11.15 A.M- 12.00 P.M
The Lead Member introduced the Partnership Working in relation to Mental Health business item to the Committee. It was stated that the Council, BCUHB and North Wales Police (NWP) were all regularly working partnership in this particular area.
The Joint Interim Head of Community Support Services explained to the Committee that the three organisations worked in partnership together and gave a brief outline of the role of the Council within the partnership.
He explained that the three organisations worked together in a variety of situations and primarily they work within the statutory functions in which they had to deliver. This mainly included issues around the Mental Health Act and the Mental Capacity Act. This involved working with people who had mental health difficulties and required intervention, this regularly required all three partners to work together.
The following example was given: -
If a member of the community needed their mental health assessing, Social Workers and Doctors would be involved in the assessment and would visit the resident. If the resident was in a specific area in which they were difficult to reach, the Local Authority would make contact with the Magistrates Court to obtain a warrant in which North Wales Police would be asked to assist. The Police had powers under the Mental Health Act, meaning that they could detain individuals who appeared to have Mental Health difficulties. The Police would liaise with the Local Authority and the Health Board and then the three organisations would work together to ensure that that person received the assessment, support, and care that they needed.
He continued to explain that there were Community Mental Teams, and these were primarily Health Board and Local Authority employees. They worked with people who had been referred to the Mental Health Service and needed ongoing care and support.
The Head of Operations and Service Delivery Central (BCUHB) explained the work of the Health Board in the partnership. There were integrated teams predominately all working together. The Health Board had statutory obligations to deliver under the Mental Health Act, Social Services and Well-being Act. The Health Board had a dedicated Criminal Justice Liaison Service which supported 999 calls by giving support and direction should there be any mental health requirements. Co-located Health Board Teams were also based within the Local Authority.
The Head of Operations continued by stating that there were significant increases in Mental Health Referrals during and since the COVID pandemic. There were continued issues with recruiting and retaining staff which had an impact on the services which could be provided, and the workforce already in place. Discussions to address this were ongoing.
The Health Board was looking at other services available to help people without the need for them to be referred to Statutory Services. Recently the 111 Press 2 service was launched, currently operating 7 days per week 8.30am-11pm. This Service was going to become a 24-hour service in the future and was available to all members of the Community who required support. If any of the calls received to this service were deemed as urgent then an ambulance or the Police would be dispatched. The Health Board utilises co-working and deemed it vital to the successful of the partnership.
The Head of Operations stated that it was crucial that the partnership work between the Local Authority, Health Board and North Wales Police continued.
The Chair thanked The Head of Operations for her presentation.
Detective Sergeant, Vicki Keegans, explained the role of North Wales Police within the Working Partnership and her role within the Protecting Vulnerable Persons Unit.
The Detective Sergeant reiterated that the partnership worked well across all three organisations.
There was a close working relationship between Police Personnel, the Mental Health Lead within the Health Board, and other agencies to ensure there was compliance with legislation and National Guidance.
The Detective Sergeant expressed that Mental Health was very important and that it should be of a concern for everyone within the community.
It was explained that the Police responded to persons in crisis to ensure that no harm was caused to the individual or the people around them. Calls were received in the control room and it was determined if positive, urgent reactions were needed to ensure the safety of everyone involved.
The calls that came into the Control Room amongst others were:
· Suicidal ideation
· Self-harming with weapons
· Public concerns of persons putting themselves in danger.
Acting on calls that were received, ambulances would be dispatched, and further communication would be made with health partners and the Co-located Criminal Justice Health Nurses.
The Criminal Justice Health Nurses had been involved in delivering training to Police Officers on the front line and office staff regarding mental Health. The Nurses also offered support and safeguarding advice at crisis point. In many cases there was the need to support the person involved to hospital safely to be assessed and treated.
The Detective Sergeant continued to explain that the Police had the authority to detain vulnerable members of the Community under Section 136 (Mental Health). This was acted upon with careful consideration to enable them to be taken to a place of safety.
All Police Officers would submit a referral regarding the person at risk which would then be shared with other agencies, for example Social Services and the Community Mental Health Team to aid in care and support being given. The referral would then be subject to further review to decide upon a suitable response to support the individual which may involve a multi-agency strategy discussion under the All Wales Procedures Legislation. All persons detained under the Mental Health Act were reviewed by the Mental Health Act Office and statistics and data were shared with the Welsh Government and North Wales Police to improve service delivery.
The Detective Sergeant stated that Officers had regular access to training, this included Dementia training. 86% of North Wales Police Officers had received in house Mental Health training. In the coming months Officers would be attending a Young Person Mental Health Course hosted by the Child and Adolescent Mental Health Service (CAMHS).
The Chair thanked representatives from all three organisations for their detailed explanations regarding their valuable work undertaken.
Members discussed the following in further detail: -
· Councillor Martyn Hogg queried whether any improvements could be made to the referral process and whether the integration of services worked well. Officers stated currently there was a tender out looking at changing the referral system to a system called Pronto. This would take the reliance off emailing, instead an automated report would be sent to agencies to ensure that no important information was lost. There was a Single Point of Access (SPoA) Service in place which was a multi- agency team trained in reviewing Mental Health referrals, to establish the most suitable service and support for the individual involved.
· Questions were raised as to where individuals who had been detained were held and whether these places were deemed as sufficient for a person with Mental Health Issues. Responding Officers clarified that an individual detained under a Section 136 would be detained in one of the Section 136 Units at the hospital as a place of safety.
· It was queried as to how sensitively Dementia was dealt with within the Community and the importance of families receiving support. Officers stated that the Health Board was currently working on a Dementia Strategy which included a pathway for accessing support for carers and families. Once a diagnosis of Dementia was given, depending on the level of need, patients would be seen by Community Services and a support plan would be determined for outside agencies to get involved such as MIND.
The Chair thanked officers for the information they provided to the Committee and welcomed future progress updates.
At the conclusion of the discussion the Committee:
Resolved: to receive the information provided on the working practices of the Council’s Social Care Service, Betsi Cadwaladr University Health Board and North Wales Police in relation to mental health matters, including their partnership working arrangements aimed at ensuring the safety of individuals in crisis and the provision of appropriate support to those who required it.