My Lords, this group of amendments addresses the crucial relationship between mental health and the criminal justice system. I make it clear at the outset that I support the objective of banning the use of police cells as a place of safety for adults. My comments are in the context of my own independent report published in 2009, which reviewed people with mental health problems and learning disabilities in the criminal justice system.
In the report I made over 80 recommendations for change, at least two of which are relevant to this debate. First, I recommended the establishment of multidisciplinary liaison and diversion teams composed of people with a variety of skills, including psychiatric nurses, learning disability nurses, drug and alcohol workers and many others, all working alongside the police in police stations to identify and assess vulnerable people and to support the custody staff at the first point of contact with the criminal justice system. This programme is being rolled out nationally. Currently, 55% of the country is covered. Additional money from the Treasury was allocated in July of this year to enable 75% of the country to be covered by 2018-19, with a view to 100% coverage by 2020-21.
Alongside this, and now properly integrated with liaison and diversion teams, is street triage. That is where the police and NHS staff work together in their local communities. It works best where there is a dedicated vehicle and they sit together, often with their separate laptops—we hope to link technology at some point—so that they can immediately assess the needs of vulnerable persons and stop them hitting against the criminal justice system. These are often the people who may be sectioned under Section 136 of the Mental Health Act, and this is where the second recommendation in my report is relevant today. I said then that, “All partner organisations”—by which I meant principally the police and the NHS,
“involved in the use of Section 136 of the Mental Health Act 2007 should work together to develop an agreed protocol on its use. Discussions should immediately commence to identify suitable local mental health facilities as the place of safety, ensuring that the police station is no longer used for this purpose”.
The recommendation was accepted by the then Labour Government and each subsequent Government—we are on to the fourth now—have committed to this objective.
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As we have heard, good progress has been made in many parts of the country with excellent new place-of-safety facilities, often established alongside mental health trusts. The best of these places of safety now extend their facilities as proper crisis centres, so not only people detained under Section 136 but vulnerable people in crisis on our streets are taken to the facility because it is the proper environment in which to make an assessment of their needs. I encourage all noble Lords interested in this to visit some of these excellent new facilities, such as those in south Birmingham where liaison and diversion personnel at the police station and NHS staff in the mental health trust work in an effective way to support the most vulnerable.
Of course the banning of the use of police cells for children in this Bill is another major step forward, but we can and must complete the banning of the use of police cells as soon as possible and bring new momentum to ensure that there is full coverage as regards proper places of safety across the country. I believe that we need a fresh and independent review of places of safety to ensure that every local area can provide such a facility, with an agreed protocol between the NHS, the police and other agencies. The review could look at the good practice that I find when I travel around the country and, crucially, it could identify the gaps which we have heard about in the debate that still exist. We must build up capacity in proper places of safety so that police cells are not required. The Government should initiate such an independent review immediately with an agreed timescale for the development of the final pieces of the jigsaw to ensure comprehensive coverage of places of safety.
I acknowledge that huge progress has been made, but I remember talking at a conference held in the West Midlands where in the previous year police cells had been used as places of safety 4,000 times. After proper consideration of the issue along with dialogue between all the relevant agencies, in the year that I was there the incidence had dropped down to six times. That is what can be done given the will and the commitment. If we put an emphasis on this programme, the final part of it can be achieved, but in the meantime I worry that without proper protocols the default position is to use, for example, A&E departments as places of safety. They are totally the wrong environment for people in crisis and not the right place to make a proper assessment of their needs. There is also no clear view about what the next steps should be for those vulnerable people when they leave the A&E department. So we must and can do better by using liaison and diversion and street triage, along with the progress that has been made on places of safety as the building blocks to ensure comprehensive coverage in
the period ahead. I hope that the Government will consider my proposal and be positive in their response. If they want to consider it further, we can discuss this again on Report.