Mental health index

Introduction and strategic considerations

1 International and national legal frameworks

1.1 Mental health law

2 Equality

2.1 The Equality duty

2.1.1 Reasonable adjustments

2.2 Understanding the challenges

3 Definitions and terminology

3.1 Specific terminology

3.2 Terms that describe people

4 Strategic oversight and management

4.1 Mental health and policing

4.2 Responses by the most appropriate agency

4.3 When do the police have a duty to respond?

5 Force mental health policy

5.1 Portraying mental health in the media

6 Multi-agency working

6.1 Commissioning of mental health care services

6.2 Information sharing

6.2.1 ‘Need to know’ information

6.3 Problem solving – working together

6.4 Mental Health Act 1983 codes of practice protocols

6.5 Local multi-agency protocol development

6.5.1 Development considerations

6.5.1 Requests for police assistance from healthcare partners

6.5.2 Establishing a mutually agreed risk criteria

Mental vulnerability and illness

1 Decision making

1.1 Gather information and intelligence

1.1.1 Sources of information

1.1.2 The individual as an information source

1.1.3 Information from parents, carers, family and associates

1.1.4 Police information systems

1.1.5 Other agencies

1.1.6 Medical and social care records

1.1.7 Contact information

2 Communication

2.1 Attitude, patience and empathy

2.1.1 De-escalation

2.1.2 Providing reassurance

2.1.3 Asking the right questions and terminology

2.1.4 Autism

2.1.5 Learning disabilities

2.1.6 Language

3 Assess threat and risk, and develop a working strategy

3.1 Behaviour

3.2 Signs of mental ill health or learning disabilities

3.2.1 Indicators of general concern

3.2.2 Risk indicators

3.2.3 Recognising mental vulnerability in children and young people

3.2.4 Recognising mental vulnerability, learning disabilities and other needs

3.3 Medical emergency

3.4 Alcohol and drug intoxication

3.5 Acute Behavioural Disturbance

4 Referral and risk management

4.1 Referral of offenders within the criminal justice system

4.2 Referral for assessment of needs under the Care Act 2014

5 Further information

Mental health – detention

1 Mental Health Act 1983 hospital admission provisions

2 Police powers to enter and detain

3 Warrants

3.1 Issue of a warrant for the recall of a patient to hospital

4 Section 136 MHA – power to detain a person in a public place

4.1 Relevant definitions

4.1 The decision to use section 136 MHA 1983

4.2 Explanation of detention (avoid the use of ‘arrest’ terminology)

4.3 Children and the use of Section 136 of the Mental Health Act 1983

4.4 Calculating the period of detention

4.5 Transfer to a health-based place of safety as a result of section 136 detention

4.6 Alcohol and drug intoxication

4.7 Handover to the health based place of safety

4.8 Lack of space or hospital beds

5 Restraint

6 Hospital patients presenting healthcare management problems

6.1 Is police deployment appropriate?

6.2 The police role and duties

6.3 Exceptional circumstances and legal powers

6.3.1 Administering medicines

7 Searching Mental Heath Act detainees

8 Transfer and supervision

8.1 Transfer between places of safety

8.2 Transport requests from external agencies

9 Mental health applications from police custody

10 Appropriate adults

10.1 Role of an appropriate adult

11 Assessment

11.1 The outcome of the assessment

12 Options when there is no legal authority to hold a vulnerable detainee that requires further support

Mental capacity

1 Definition of mental capacity

2 Principles

3 Purpose of the Mental Capacity Act 2005

4 Police role applying the Mental Capacity Act 2005

4.1 When is police intervention appropriate?

4.2 Assessing capacity

4.2.1 Questions to ask

4.3 Removal to hospital and deprivation of liberty

4.4 Restraint and use of force

4.5 Recording decisions about mental capacity

AWOL patients

1 Definition of ‘absent without leave’

2 When will the police get involved?

2.1 What role will healthcare staff play?

2.2 Powers to re-detain an AWOL patient

2.3 Re-detention of absconded patients

2.3.1 Absconded inpatients held under section 5 MHA

3 Multi-agency protocols on missing or AWOL patients

3.1 Analysis and demand management

3.2 Risk management and response considerations

4 Police involvement in transporting AWOL patients

5 Problem solving

6 Patients who fail to return after a period of leave from medical facilities

6.1 Powers and responsibilities

7 Cross-border absconding

Safe and well checks

1 Planning for medical care following a ‘safe and well’ check

2 When a person seems to be experiencing mental illness and is in need of care

3 When a person is found at their home address

Crime and criminal justice

1 Mental health and the criminal justice system

2 Responding to mentally vulnerable victims

2.1 Referral

2.2 Investigation

2.3 Hate crime

3 Witnesses who are mentally vulnerable

4 Suspects with mental ill health and vulnerabilities

5 Liaison and diversion services

6 Investigation

6.1 Home Office circular 66/90 Provision for mentally disordered offenders

6.2 Bail during mental health assessment

6.3 Evidential considerations

7 Prosecution decisions

7.1 Diversion from prosecution

7.2 When prosecution is appropriate

8 Offences within psychiatric inpatient units

8.1 Arrest decisions in psychiatric inpatient wards