Sunday, 4 January 2015
ICV Annual Conference 2014 at Birmingham ICC Saturday 21 November 2014
I arrived at Birmingham ICC for the Annual ICC conference at 10am. Upon arrival I signed in and collected my Identity badge and welcome pack. I then continued into a large room set up with refreshments and pastries, helping myself to a much needed coffee and warm apple pastry. This room would be used by fellow delegates throughout the day for lunch and refreshments.
At 10:20 I made my way to the designated conference room. This was a theatre like room with comfortable fitted chairs. There was a clear view of the stage and the room was well lit with good acoustics.
At 10:30am the conference was opened by Martyn Underhill (ICVA Chair). Martyn began with some general housekeeping for the day (which I will not bore you with), before introducing the first speaker, David Jamieson.
David Jamieson- West Midlands Police & Crime Commissioner
Custody Visiting in the West Midlands
David Began by complimenting the city of Birmingham. He recommended a visit to the local Christmas Market and Symphony Hall. David informed us that the first ever ICVA meeting was held at this location in the 1980's. David moved on to explain the importance of our role. He discussed Police brutality in the 80’s/90’s, particularly the ill treatment of those accused of the Birmingham Bombings 20 years ago. (These men were covered in bruises etc.) David followed on with a poignant quote "A mark of a civilised society is not how they deal with the civilised, but how they deal with the transgressed.”
David moved on to discuss how many Custody Suites are in the West Midlands alone, providing figures for how many ICV visits have been conducted in the past 6 months. David explained that in recent months there has been a new approach to ICV’s being introduced to detainees in the West Midlands. ICV's are now introducing themselves to detainees, rather than the custody staff introducing them. This has proven successful with 90% of detainees accepting visits from ICV's, compared to the previous 60%. From personal experience I know that this practice has also been adopted in custody facilities in Northamptonshire.
David moved on to discuss new challenges that West Midland Police face. For example Birmingham is the largest exporter of terrorists in the country to Iraq and Syria, particularly girls. West Midlands Police also have the responsibility of running the Custody Suite at Birmingham Airport, with the Border Agency.
In David's closing speech he encouraged all delegates to network during the event to share their experiences as ICV's. I found this very useful for gaining insight into the broad talented backgrounds that ICV’s possess. It also allowed me to identify how ICV schemes vary across the country, unlike the uniformed approach of Lay Observers etc.
Martin returned to the stage to welcome Eddy Johnson.
Eddy Johnson-West Midlands Police
Custody in the West Midlands
Eddy commenced by emphasising David's previous advice on delegates utilising the day to network with other ICV's to identify whether we have the same concerns and how we all take different approaches to reach a resolution.
Eddy discussed Custody Suites in the West Midlands. He examined the difficulties that are faced working in old listed buildings, as physical changes to the facilities cannot be made. He showed delegates pictures of a Custody Suite in Birmingham that is set across three floors and looks like an old Victorian Prison. When observing the pictures I could identify hazards and ligature points, including external pipe work in the corridors. Eddy concluded his presentation with pictures of a new Custody Suite being built in the West Midlands. Delegates were shown architects designs and other pictures of the work in progress.
Martyn Underhill -ICVA Chair
The Tides of Change
Martyn explained that there have been huge debates on mental health within the criminal justice system. Subsequently New Home Office standards have been introduced. We were informed that the New Home Office standards have been added to future ICV training material. Copies will be distributed shortly to all ICV's. Martyn also informed delegates that a new website for ICV's is currently being designed. Hopefully the new website will promote the work of ICV's to the public.
Delegates were also informed that there are plans to register the ICVA as a charity. This will allow transparency and improve access to further funding. Interestingly we were also notified about a planned review of NAAN (National Association of Appropriate Adults) and the role of Appropriate Adults. One area the review will be looking at is that it is currently compulsory for children to have an Appropriate Adult present in interviews, but this is not the case for adults. The review of NAAN may mean that it becomes compulsory in 2015 for adults to have an AA too.
Martyn moved on to described the three key principles of the ICV scheme as; independence, community participation and transparency. Therefore it is important that funding continues for ICV's. The role of ICV's is continually being discussed with the Home Office. It has been previously suggested that ICV's could conduct visits without the need for an accompanying ICV, similar to Lay Observers. In response to this suggestion Martyn has fought to ensure that this is not implemented, preserving the safety of ICV's during visits. Martyn believes that it is important that ICV's continue to conduct visits in pairs to maintain impartiality and encourage self-esteem. Interestingly I know from other sources that Lay Observers are actually reviewing the way their visits are conducted independently and they are considering following ICV's and conducting visits it pairs. Martyn moved on to highlight the importance of ICV's not getting involved in police appraisals. He also highlighted the importance of adapting interviews while in custody and not allowing them to become scripted. For ICV's to be effective it is important that visits are tailored to each individual detainee. Martyn concluded by inviting delegates to celebrate the role of ICV's in making custody a safe place.
After Martyn's speech there was an opportunity for questions from delegates.
One ICV asked what action has been took to support people in custody with mental health needs? In response to this question it was confirmed that people who have mental health needs who have not committed an offence should have access to treatment, instead of being detained in police custody. However this is not always possible due to limited availability of services. This has been improving nationally and the number of these people going into custody has been dropping rapidly. This topic was addressed further by other speakers later on in the day at the conference, including Professor Siobhan O'Neill and Stan Sadler.
Another ICV asked if the West Midlands ICV scheme would be privatised like Staffordshire who use G4s. We were informed that they had no intentions of privatising West Midlands ICV scheme. They stated that it should continue to be directly accountable to the ICV Chair and PCC’s.
Another question raised was whether ICV's should have the right to access custody records without the consent of detainees with mental health conditions. Heather explained that Ill mental health does not stop everyone with a mental health condition from having the capacity to provide consent. Nevertheless some people will never have the mental capacity to consent. ICV's must remember that it is not about whether they have general mental capacity, but whether they have the capacity to consent to the specific decision in question.
At 11am we stopped for a 30 minute refreshment break. A selection of refreshments and biscuits were available for delegates. This break was a good opportunity to network with other ICV's. I got talking to an ICV from the London area who also works for Community Legal Services. It was interesting to find out how different ICV schemes are organised, in comparison with Northampton.
At 11:30 Martyn returned to the stage once again, to introduce Heather Hurford.
Heather Hurford -Lead Inspector for HM Inspectorate of Constabulary
Protecting Vulnerable People in Police Custody – Thematic Inspection
Heather confirmed the importance of custody visitors introducing themselves to detainees, instead of the Police. In her experience the take up of detainees was significantly increased when visitors introduced themselves. Heather echoed Christine Jones quote questioning "Why is it in 2014 that if we recognise that a person with a broken leg needs A&E, why can we not recognise that a person with a broken mind needs medical help and not custody?"
Heather emphasised the vulnerability of young children in custody and an increase in deaths of young BME males in custody. She moved on to discuss the influence this has had on reviews and reports. Some of the reports she discussed included;
'Who's Looking out for the Children? (2011)'
'A Criminal Use of Police Cells (2013)'
'A Joint Inspection of the Treatment of Offenders with Learning Disabilities within the Criminal Justice System (2014)'
Heather expressed how extraordinary it is that there is no national data on numbers and demographics of people held in local custody, unlike stop and search data etc. Heather then went on to discuss her recent research project which identified frequent reoccurring risks during the detainees journey, mapping risks against each stage of the custody process. Heather explained that more data is needed on what happens in custody to confirm proportionality and misconduct. More research needs to take place to identify more appropriate ways of hearing detainee’s voices. It is difficult for detainees voices to be heard during the custody process due to various factors including intoxication, stress caused by the situation and drug consumption.
Heather moved on to discuss the definition of vulnerability and how anyone can be vulnerable, not just people from ethnic backgrounds or people with medical and mental disabilities. People can be vulnerable from the moment they are cautioned and arrested, all the way through the custody process, until they are arrested. Therefore custody should be defined as during this whole process. When carrying out her research Heather decided to observe the treatment of three key vulnerabilities, with the presumption that if the police are getting it right for these three groups of people, they are probably succeeding with all detainees.
Heather moved on to discuss the effectiveness of custody and how failures and lack of funding for mental health authorities results in added pressures on the police. The police end up being called to replace mental health services, particularly when the police are available 24/7.
There was a 90 minute break for Lunch, before returning to hear from professionals with experience in mental health.
Mr Stan Sadler -Team Leader & Mental Health Practitioner for Dorset Healthcare
Dorset Mental Health Triage Service
Stan informed delegates that there are currently 26 street triage’s in the country, commissioned by NHS England. Dorset’s scheme has been running since the 27 June 2014, on a Friday-Sunday night 19:00-8:30.
Stan discussed the vulnerability of detainees and reaffirmed their vulnerability throughout the criminal justice process, not just while in custody.
20% of Police time is spent responding to people with mental health problems. “In some circumstances this will be necessary and unavoidable; the police are often the first point of call for people in distress, crisis and emergency. However, in cases where a person has committed no offence and is principally in need of a medical intervention or the support of health and social care services, it is not likely to be in their interests to find themselves being dealt with by police officers; nor is it in the interests of the police or public, to have police officers taken away from their core front line duties unnecessarily.”
Stan moved on to discuss the Department of Health report, ‘No Health without Mental Health (2011). This report provides a strategy and implementation framework to increase: the amount of people recovering from mental health problems, the physical health of people with mental health problems and patients experiencing a positive experience of care and support. It also aims to reduce the number of people who suffer avoidable harm and from stigma and discrimination.
According to the Lord Bradley Report 2009, 40% of BME are more likely to access mental health facilities through the criminal justice system, compared to white British people with mental health conditions.
Stan agreed with the Department of Health who stated that “No-one experiencing a mental health crisis should ever be turned away from services”. In this paper the Department of Health promised to “introduce a national liaison and diversion service so that the mental health needs of offenders will be identified sooner and appropriate support provided.”
However, there has been “far too many examples of public services failing to respond effectively to people experiencing mental health needs.” In 2012-2013 there were 22,000 detentions under s.136 Mental Health Act 1983.
San explained that the Police and Department of Health are trying to overcome all of these issues with a health triage service where trained mental health professionals work with police officers, as a first-line response. Stan explained that “if the police are called to an incident where a person is suicidal or self-harming, creating a disturbance or upsetting others, but has not committed a crime, they can ask the mental health professional to conduct a rapid needs assessment and direct the individual to the most appropriate source of help.” However, results may vary as there is no uniformed approach used across each street triage service.
Stan moved on to discuss Dorset Street Triage Service which was the first triage service to be set up. He discussed how Dorset’s Street Triage had grown over the past year, since it was set up in 2014.
Stan moved on to discuss Lord Bradleys Report and how he had identified the need for assessment, liaison and diversion to meet the needs of people in need of mental health services.
You can find a copy of Lord Bradleys 2009 Report here - www.mac-uk.org/wped/wp-content/uploads/2013/03/Dept-of-Health-Bradley-Report-Exec-Summary.pdf
Stan recommended the following reading:
· HM Government – ‘No Health Without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of all Ages’ (2011)
· NHS England – ‘An Operating Model for Liaison and Diversion Services across England’ (2013)
· Department of Health and Concordat Signatories (2014)
· Mental Health Crisis Care Concordat –‘Improving Outcomes for People Experiencing mental health Crisis’.
· Social Care, Local Government and Care Partnership Directorate (2014)
· ‘Closing the Gap: Priorities for Essential Change in Mental Health.’
· Home Office – ‘Supporting Vulnerable People who Encounter the Police: A Strategic Guide for Police Forces and their Partners’ (2014)
· Care Quality Commission-‘A safer Place to Be: Findings from our Survey of Health-Based Places of Safety for People Detained under s.136 of the Mental Health Act’ (2014)
Professor Siobhan O'Neill-Professor of Mental Health Sciences
Topic- Applying Psychological Theories of Suicide to Suicide Prevention
Siobhan began by explaining different theories on suicide. She discussed Durkheim’s Theory, Schneidman’s Theory of Suicide, Integrated Motivational-Volitional Model and Joiner’s Interpersonal-Psychological Theory of Suicidal Behaviour. This was useful for aiding ICV’s in identifying people who may be a risk to themselves.
· Durkheim’s Theory (1897/1951)-Believed that suicide is a social issue due to imbalances in social integration and moral regulation. Siobhan identified four types of suicide belonging to Durkheims Theory: egotistic, altruistic, anomic and fatalistic.
· Schneidman’s Theory of Suicide- Believed that suicidal tendencies were a goal orientated behaviour and not an illness.
· Joiner’s interpersonal-psychological theory of suicidal behaviour (2005)- Thwarted belongingness,
perceived burdensomeness, and acquired capability for suicide.
· O’Connor- Integrated Motivational-Volitional Model (2011)
Siobhan explained that it is important to have counselling over medication. This is because the patient is at higher risk when they start a course of medication, as the medication gives the patient the energy to plan and act on suicidal thoughts.
Siobhan explained that some people become accustomed to pain and fear from repeat exposure. For example soldiers and doctors. They self-harm to release pain.
Northern Irelands Suicide study of Characteristics of the deceased 2005-2011 revealed that:
· 77% of suicides are by males
· Rates high across all ages-from 20-60 years.
· Highest proportion was single-39.1% female and 48.3% were male.
· Almost a third lived alone when they died (31.4%).
· 22.8% lived in the parental home (this included younger victims and those who returned to the family home in adulthood).
· More than a fifth lived with a spouse (21%).
· 35% were employed at time of death, compared to 50.3% who were classified as unemployed or “other”.
Siobhan believes that suicide can be prevented by:
· Creating a culture of social integration and connectedness.
· Looking at emotional responses to life events.
· Evidence based treatments for mental disorders.
· Seeking help is a sign of strength.
· Considering acquired capability and access to means (including cognitive access to means).
· Improving the validity of the data on suicide.
The ICVA Conference 2014 was an enlightening event that raised my awareness of identifying vulnerable detainees and treating mental health needs. The Police and health services need to continue to work together to ensure that custody is only used for those who commit an offence. People with mental health needs should be offered support by mental health service providers. However this can only be effective if sufficient funds are available to support these services, from what is already described as a struggling health service.
 Findings from an Independent Commission on Mental Health and Policing in London (May 2013)
 Lord Bradley’s Review of People with Mental Health Problems or Learning Disabilities in the Criminal Justice System (2009)
 ‘Closing the Gap: Priorities for Essential Change in Mental Health and Set out Immediate Ambitions (February 2014)