a partnership approach Mark Smith Head of Suicide Prevention and Mental Health Fundamental Issues Mental Health and Vulnerability Vulnerability and Risk Risk and Consequence Victimisation Criminality amp criminalisation ID: 382497
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Suicide Prevention – a partnership approach
Mark Smith
Head of Suicide Prevention and Mental HealthSlide2
Fundamental Issues
Mental Health and Vulnerability
Vulnerability and Risk
Risk and Consequence
Victimisation
Criminality & criminalisation
Danger to others
Danger to self
Impact on families & communities
Impact on resources
Economic impact
Liability issuesSlide3
The Rail Network
A draw for the vulnerable
Transient population
Equality Issues
(access to services)
Immigration statusHomelessness Learning difficultiesAlcohol & substance misuseRace and cultureSlide4
BTP National Analysis
350 fatalities a year
84% believed to be suicides
41% of deceased had a mental health history
1700 incidents a month which involve mental health issues
2700 incidents of suicidal behaviour per year680 suicide prevention plans opened in one year Evidence of vulnerable people travelling great distances to attempt suicide and importing demand for servicesIn a 3 month period only 5 out of 11 people involved in suicidal incidents in Camden lived in the BoroughLondon North hotspot area with 30% of suicides & 37% of all related incidentsSlide5
Suicidal Incidents
01/04/12 - 31/03/13
2738
incidents
296 suspected suicides
89 injurious attempts313 non injury attempts or life saving interventions44 reconnoitring796 threats with no attempt630 third party reports570 Para-suicide eventsSlide6
BTP Approach
2010 new Suicide Prevention Policy and SOP
Vulnerability assessment tool & structured suicide prevention plans
Public Protection Units & Mental Health Liaison Officers
Close working with Rail Industry Partners and the Voluntary sector
However barriers to effective working identified - Unfamiliarity with local Health & Social Care services and structuresReluctance of many agencies to share information Lack of medical oversight of police decision makingDifferences in local Health and Social Care service provision
Inconsistency in clinical judgements
Detention under S136 often ineffective in reducing risk
Need for a new approach to overcome these barriers
Need to secure appropriate diversions & free up police officer timeSlide7
2013 - New Partnerships
January - BTP & Network Rail (NR) agree a 3 year project to better coordinate activity in relation to Mental Health and Suicide Prevention which includes closer working with Samaritans
February - BTP, NR and NHS London agree 3 month funding to provide a pilot joint health and police intervention capability – ‘Operation Partner’
April - NHS England (London) agree further 6 month funding for Operation Partner
April - BTP and London Underground agree a 12 month project to join and enhance Operation Partner
September - BTP join ‘Street Triage’ programme funded by Department of Health and will seek to re-create Operation Partner outside LondonSlide8
Operation Partner
Combined Public Protection Unit
BTP operational & analytical resources
Supported by Mental Health Professionals
Key elements;
Medical operational review of BTP interventions and PIER plansSupport to BTP custody Outreach interventions & assessmentsFast access to dataTransition from Crisis to Care
689 people reviewed in 2013 – Only 1 later completed suicide on the railway and 1 away from the railwaySlide9
A New Model
Identifying Vulnerability
Assessment tool
Custody Screening
Analysis – people & places
Joint Intervention Team
Managing Risk
Intervention
Diversion
Situational solutions
Providing Care
Care Plan
Family support
Information sharing
Escalation processSlide10
A life saved – Op Partner
09/03/13 - Male seen acting strangely at station by rail staff
13/03/13 - Male returns – rail staff report to BTP
who attend, gain CCTV images & circulate to rail staff
14/03/13 – PPU circulate Image to all local GPs and local police. MHP circulate to all local Mental Health Units
15/03/13 - Male returns - rail staff call BTP who detain him under S136. Suicide note found in subject’s pocket and he tells officers he was going to do it ‘today or tomorrow’ MHP liaised with hospital and after assessment he is further detainedMHP have maintained contact with hospital re ongoing treatment and statusOne life saved – one railway fatality prevented
Suicide Prevented at Twyford Railway Stn 15/03/13Slide11
Key Benefits
Early access to relevant information
More informed and robust decision making
Support to frontline officers assisting them to access places of safety/services
Better outcomes for vulnerable people
Savings in police officer/staff time within the PPUSavings in Officer/PCSO time on the front lineDefined progression from Crisis to CareUp-skilling of PPU staffMany examples of MHP intervention being invaluable in breaking down organisational boundariesSlide12
Life Saving InterventionsSlide13
Key Issues
Funding challenges
Transport Health Needs Assessment – transient demand
Most people presenting in mental health crisis or with suicidal behaviour are not offenders
Commissioning – strategic fit
Care Bill requirements for vulnerable adultsConcordat commitmentsS136 improvement plan for London