Part of the debate – in the Senedd at 4:24 pm on 22 January 2020.
I thank the committee for undertaking this report. Whilst the Welsh Government has accepted seven of its 11 recommendations, I urge the committee to monitor the actions proposed by the Welsh Government where it has only accepted recommendations in principle.
Section 136 of the mental health Act is designed to allow police officers to remove from a public place, for their own or the public's safety, someone who they believe is undergoing a mental health crisis and to take them to a place of safety. As the report states, the use of police custody as places of safety has fallen significantly over the past four years. Additionally, the chair of the mental health crisis care concordat assurance group stated that there has been a 90 per cent reduction in the number of individuals detained in police cells who are in mental health crisis since the introduction of the crisis care concordat in 2015. As the report adds, this, and the subsequent passage of the Policing and Crime Act 2017, marks significant reductions in the use of police stations as places of safety, despite the general trend of rising section 136 detentions. However, as we've heard, the number of detentions in other units have gone up between 2017-18 and 2018-19. We therefore need a better understanding of why certain force areas saw differing rates of increase in these detentions and to see if lessons can be learned from police force areas such as Gwent, where figures actually fell.
The figures also demonstrated different approaches in the way that mental health triage schemes were implemented. These schemes are intended to bring police and mental health practitioners together to jointly assess a mental health incident in order to reduce the use of section 136. Although North Wales Police saw a 70 per cent increase in section 136 detentions between 2014 and 2019 to 795, mental health clinicians are working alongside North Wales Police to provide a new triage service based at the force control centre. This aims to help people identified as being in mental health crisis and to improve the flow of information between North Wales Police and Betsi Cadwaladr University Health Board.
The Welsh Government accepted recommendation 2, which states that better understanding is needed on which model of joint working between the police and health staff is helping to provide people in crisis with the right help and support, which can contribute to reducing the use of section 136 overall. The National Police Chiefs' Council evidence in the report suggested that provision of health-based places of safety is patchy across Wales, both in terms of geographical spread and times of access.
Health boards pointed out that many had suitable facilities but these were not adequately staffed or that their irregular use may mean that staff used in these facilities did not have the right skills to deal with complex cases involving patients presenting different forms of emotional distress. Evidence received by the committee detailed a range of good practice models such as the scheme in Aneurin Bevan University Health Board that had developed a single point of contact accessible 24 hours a day for individuals, family or professionals.
The Welsh Government accepted recommendation 5, which outlines the need for additional health-based places of safety to be developed where required. However, it is then relying on the health boards to provide assurance that their current capacity is meeting demand in order to help them and their partners understand which elements of the crisis pathway need to be strengthened. We therefore need assurance that the associated costs will be met should additional health-based places of safety be required.
Autism is not a mental health condition, but many autistic people develop separate mental health problems that stem from a lack of appropriate support and mean that autistic people can develop more significant needs. However, although the proportion of autistic people in UK prisons is thought to be more than double that in the general population, the UK Government strategy on autism includes prisoners, and HMP Parc prison has been awarded the National Autistic Society autism accreditation, I can find no reference to autism in this report. Worryingly, the Inns of Court College of Advocacy planning to question someone with an autism spectrum disorder, including Asperger's syndrome guidelines, applicable to both witnesses and defendants, are all too often ignored. But as these state—and a message for everybody—consideration must be given not just to the types of questions asked but also to the manner in which this is done. Thank you.