'Street triage' to help the vulnerable
Police forces across the country report increasing numbers of 999 calls asking them to help a person with a mental health issue. It often leads to an arrest under the Mental Health Act. But a team in Cheshire is trying a new way of working.
PC Mark Jenkins and mental health nurse Jane Unsworth have been called to the house of a 15-years-old with a long history of mental health issues.
"I just want to die", she says. "I just don't want to be here anymore.
"I feel worthless. I feel like self-harming all the time.
"My mind goes blank, and I don't know what I'm doing. I want help.
"I just want to be happy again and get on with my life, go to school and have an education."
Her mother says she "just exists".
"It kills me inside," she says. I just want to take her pain away and put it inside me. Let me deal with it.
"She needs to get specialised help. She has deteriorated over the past year and a half.
- In 2012, Cheshire Police arrested 445 people under Section 136 of the Mental Health Act
- In 2012-13, arrests under Section 136 increased by 25% in Cheshire
- In 2014-15, the street triage pilot has reduced Section 136 arrests by 80%
- Cheshire Police receives an average of 150 "mental health" incidents per month
- Less than half of all police forces across the UK have street triage teams responding to mental-health related 999 calls
Source: Five Boroughs Partnership NHS Foundation Trust and Cheshire Constabulary
"Her behaviour, the self-harming has become more extreme, her emotions are more extreme, and we are just stuck in the middle of a time zone, just waiting."
This family, desperate for help, call the police every time there is a crisis.
They call again, the same night.
The teenager has tried to cut herself and has had to be physically restrained and handcuffed to stop her from doing it again.
"We've been here many times," says PC Jenkins.
"It's always the same situation.
"We are just stuck in a revolving cycle, going round and round in circles.
"What she needs is residential care."
Until that happens, PC Jenkins expects to be called back to the house sooner rather than later.
"Police officers aren't trained, they're not mental health practitioners, but I think, specifically mental health, it's so complex," he says.
"I often though it was unfair to expect a police officer to make those type of decisions what maybe doctors would be expected to make."
The idea of the street triage team is the police and NHS work together, sharing information.
Police time is used more efficiently and the patient receives appropriate care.
Cheshire Police recognised too many mental health patients were being arrested under Section 136 of the Mental Health Act,
This is a way to protect a vulnerable person, but it also means detention for up to 72 hours in hospital - or in a police station.
Ms Unsworth says: "We don't want that cycle to happen, people being arrested, going in for assessment, being discharged and a month or two later being arrested again.
"And we underestimate the demand on the police dealing with vulnerable people who may or may not be mentally ill. The demand is huge."
Another emergency call comes in. A woman in her 20s has absconded from hospital and told staff she wants to die.
Several police teams have been scrambled to look for the woman because she has already harmed herself and is threatening to jump off a bridge.
A police officer who reached the scene first wanted to section the woman. But PC Jenkins and Ms Unsworth know her. They decide the best outcome is a trip to A&E to dress her wounds.
Explaining how she feels, the woman - who doesn't want to be named - says: "I was absolutely desperate. I felt like there wasn't any hope in the world. I felt like there was no other option than to hurt myself."
She says she has forgotten the number of times she has been sectioned by the police.
"I'm definitely, definitely worse when I'm sectioned. Being handcuffed and leg restraint and all that sort of thing, it's absolutely terrifying," she says.
But she says speaking to a nurse, rather than a police officer, at a time of crisis makes a huge difference.
"That was incredible, because nice as the police often are, it's quite intimidating with the uniform and with all that sort of thing going on," she says.
"We ended up going from me wanting to jump of a bridge to having a joke and I never thought that would happen."
Ms Unsworth says: "Working together is the future because I don't think the police in isolation can do it and I don't think mental health services at the moment can do it.
"We need to work together to deal with what's happening currently."