Lesson 4.2 - Mental Health And Suicide Intervention

Question 1

When engaging with someone who appears to be going through mental health distress you use the mnemonic

A L E R T

What does this stand for?

Answer 1

Ask - whats troubling them, are they thinking about suicide

Listen - listen actively, show you care

Encourage - them to get help and support them to do so

Reasure - reasure and give info

Take - take all signs of distress seriously, take action

Question 2

How do you actively listen?

Answer 2

Active listening - use open questions, and simple, direct language

Speech - slow, clear simple

Empathy / trust - show personal concern

Let them vent - useful for further dialogue

Don’t argue

Be honest - dont make promises you can’t keep

Firm non-intimidating tone

Question 3

What is community triage?

Answer 3

Available in most parts of scotland

Allows cops who are dealing with an incident to obtain advice from mental health services (phone or face to face)

Local community triage services (if available) should be used in the first instance to help provide the most appropriate response to someone in a mental health crisis.

Question 4

What happens if offences are commited by someone having a mental health crisis?

Answer 4

Police not mental health professionals, so cannot determine a persons mental capacity to commit a crime.

Deal with them as you would anyone else regardless of perceived mental disorder (unless there are exceptional circomstances, being minor crime or not in public interest to prosecute)

Example of minor crime - breach of the peace where circomstances are linked to their distress/ mental disorder

Always ask custody sargent if you arrest them

Question 5

NOTE

Appropriate adult

Answer 5

Appropriate adult must always be considered for a prisoner suspected of having a mental health disorder

Question 6

What is the definition of mental disorder?

Answer 6

S.328 Mental Health (Care and Treatment) (Scotland) Act 2003

“Any mental illness; personality disorder; or learning disability, however caused or manifested”

Question 7

Section 328(2) says what is not mentally disorder?

Answer 7

Sexual orientation

Sexual deviancy

Tran-sexualism

Transvestism

Dependence on, or use of, drugs or alcohol

Behavior that causes, or is likely to cause, harrassment, alarm or distress to any other person; or

By acting as no prudent person would act

Question 8

What is a public place for the purposes of the act?

Answer 8

“A place to which the public, or any section of the public, has, or is permitted to have, access (whether on payment or otherwise); and includes the common parts of a building containing two or more seperate dwellings”

Question 9

What is a place of safety defined as?

Answer 9

“A hospital, premises which are used to provide a care home service or any other suitable place (OTHER THAN A POLICE STATION) where the occupier is willing to temporarily recieve a person with mental disorder”

As a last resort if no place of safety is available you can use a police station

Question 10

How long can a person be detained at a place of safety under the Mental Health (Care and Treatment) (Scotland) Act 2003?

Answer 10

24 hours

To allow a doctor to examine and make arrangements for his or her treatment

Question 11

What is the role of a Mental Health Officer? (MHO)

Answer 11

Specially trained social worker who has the training, education, experience and skill to work with people with mental disorder.

They carry out statutory duties for the local authority, primarily in relation to the “Mental Health (Care and Treatment)(Scotland) Act 2003” and “Adults With Incapacity (Scotland) Act 2000”

Duties : assessing for detention and obtaining and utilising warrants

Question 12

What is the role of the Mental Welfare Commission for Scotland?

Answer 12

Monitoring and promoting best practice in the use of mental health legislation

Visiting individuals who are receiving compulsory treatment

Conducting investigations and enquiries into deficiencies in care and treatment

Providing advice and information to professionals and service users

Challenge policy makers and Service providers

NOTE The mental welfare commission will receive notification of all the detentions in hospitals and the use of place of safety orders.

Question 13

What is involved in a Compulsory Treatment Order?

Answer 13

Person is:
•Detained in hospital or
•Kept in the charge of an authorised person or
•Reside at a specified place or
•Obtain the approval of a Mental Health Officer prior to changing adress

If they fail to comply they can be taken into custody by: Mental health officer, constable, member of staff at hospital

Where they are traced to a place a constable may legally be, they can be taken into custody

Question 14

What happens if a voluntary patient absconds?

Answer 14

They can be asked to return on a voluntary basis

Or using police emergency powers if refused (s297)

Or detained by a doctor if in a private place

Question 15

What happens if a compulsory patient absconds?

E.g. Detained under the Act and held in hospital against their will, subject to a compulsory treatment order

Answer 15

Constable may return them to the place where they were receiving care and treatment.

THESE POWERS CAN BE USED IN PUBLIC AND PRIVATE PLACES

HOWEVER, where a person is traced within a private dwelling and entry is refused a warrant is required to force entry (obtained by Mental Health Officers or health professionals)

Option to force entry is available if there is an immediate risk to life or property

Question 16

What does “Section 292 - warrant to enter premises for purposes of taking a petient” allow

Private place

Answer 16

Authorised person (MHO or other health professional) may recieve a warrent to let the MHO, health professional or constable to enter premises, open a lock fast place to do so and to take or retake a patient to a place they should be

Question 17

What do “section 293 and 294 Removal Orders” do?

Private place

Answer 17

MHO may apply for a removal order authorising an MHO specified in the order, other persons specified in the order and a constable to remove a person with mental disorder to a place of safety.

THIS ALLOWS FOR CONTINUED DETENTION FOR A PERIOD NOT EXCEEDING 7 DAYS.

SHERRIF WITH AUTHORISE THE ORDER TO BE EXECUTED WITHIN 72 HOURS

Allows constable to open a lock fast place on the premises if necessary to gain access

S294 similarly is a removal order however used where urgent application to Justice of the Peace is necessary as application to a Sharrif would be impracticable.

Question 18

What is a s.35 order?

Answer 18

Person 16+ who has a mental disorder and is living in a community in such circomstances that they may be suffering ill treatment or neglect, or is living alone or without care and unable to look after themselves or their property or financial affairs. A sherrif or Justice of Peace can grant warrant to enter premises where that person is.

This can be done by MHO, any other person and constable. ALLOWS PERSON SUBJECT TO THE WARRANT TO BE DETAINED FOR NO MORE THAN THREE HOURS TO CARRY OUT A MEDICAL ASSESSMENT BY A MEDICAL PRACTITIONER

Warrant expires in 8 days from when granted

Constables can open lock fast place

No power to detain and move a person to a place of safety.

Question 19

Persons with a mental disorder in a public place

S297 of the Mental Health (care and treatment) (scotland) Act 2003

When can a person be removed from a public place?

Answer 19

Police officer may remove a person to a place of safety from a public place when:

They reasonably suspect that a person in a public place has a mental disorder and

That person is in need of immediate care or treatment and

That it is considered to be in the interest of that person or necessary for the protection of any other person to remove the person to a place of safety

THEY CAN ONLY BE REMOVED TO A PLACE OF SAFETY FOR 24 HOURS FROM INITIAL REMOVAL BY CONSTABLE

Question 20

What must a constable record in their notebook, on VPD and incident log in relation to someone being removed under s297?

Answer 20

Whether removed under s297 or on a voluntary basis

Name and address

Date and time removed from public place

Address of place of safety + and subsequent places of safety and reason for more than one

Circomstances why removed to place of safety

If they were moved to police station, why

Reason why you have been unable to inform the nearest relative/person residing with or carer

Disposal e.g. admission to hospital, release from police custody

Once psychiatric assessment has been carried out at a place of safe, a decision will be made whether to admit to hospital or not. Once admitted (voluntary or detained) or released- s297 power stops

To comply with statutory responsibilities the constable should ensure that the aforementioned info is recored on police systems

Question 21

Section 298 of the Act says when someone is removed under s297, three differant people should be infomred. Who?

Answer 21

1) local authority in whose area the place of safety is situated
2) the persons nearest relative ASAP
3) Mental Welfare Commission within 14 days of the relevent person being removed under s297

Question 22

What are the removing officers responsibilities in relation to s297?

Answer 22

• Ensure relevant persons “nearest relative” is informed or carer or person they reside with
• if unable to do this the reason must be recorded on iVPD concern form and Place of Safety Form (POS1)

Question 23

Removal of a person suspected of having a mental disorder in a private place to a place of safety for psychiatric assessment by a constable is unlawful unless…….

Answer 23

……..
•Person leaves volintarily
•Person has committed a crime or offence and officers are using their power
•Immediate risk to life i.e. house fire, cut wrist etc
•officers use power of removal order (s293 or s294) obtained by MHO