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STATES OF JERSEY
Health, Social Security and Housing Scrutiny Panel
Child and Adolescent Mental Health Service
(C.A.M.H.S) Review
THURSDAY, 13th FEBRUARY 2014
Panel:
Deputy J.A. Hilton of St. Helier (Vice Chairman) Deputy J.G. Reed of St. Ouen
Witness:
Head of Crime Services Public Protection Unit
[10:28]
Deputy J.A. Hilton of St. Helier (Vice Chairman):
Welcome to the panel. As you are aware, we are conducting a review into the child and adolescent mental health service. I am Deputy Jacqui Hilton.
Deputy J.G. Reed of St. Ouen : I am Deputy James Reed.
Deputy J.A. Hilton:
If you could introduce yourself for the tape?
Public Protection Unit:
Detective Sergeant David Hill from Public Protection Unit.
Head of Crime Services:
Detective Superintendent Stewart Gull, I am the Head of Crime Services at the States Police.
Ms. J. Hales (Scrutiny Officer): Janice Hales , Scrutiny Officer.
Deputy J.A. Hilton:
Welcome. Firstly, I would like to give the apologies of the Deputy of St. Peter , who is our chair, who is unwell at the present time. Thank you very much for coming today. For the sake of the public who are here at the moment, we do have a notice up on the wall about behaviour in a scrutiny setting. Also can I draw your attention to the notice in front of you both? Could I start by asking you what happens if the police are called to a disturbance and there is a child under the age of 18 with mental health or serious behavioural problems at the scene?
Head of Crime Services:
I guess one of the challenges for an operational police officer is they do not often know what they are responding to. You say mental health problems but of course a police officer is not a qualified medical practitioner so the officer will deal with an incident as it presents itself to them. Did you say violent?
Deputy J.A. Hilton:
Well, in what circumstances generally speaking would the States of Jersey Police be called ... does it happen very often that you are called to an incident involving under 18s, probably involving violence or potential violence?
[10:30]
Head of Crime Services:
Again, are we talking within a public area or in a domestic setting?
Deputy J.A. Hilton:
No, in the domestic setting.
Head of Crime Services:
Okay, David can speak for himself in a moment but from my experience I get a sense that parents will often call us as a last resort perhaps because they feel that they do not know where else to go. I think sometimes they think that the consequences of calling the police are quite severe and as a last resort, recognising, I guess, the threshold that they are now crossing into, potentially criminal matters, and that is the last thing they want to do with their son or daughter. But I guess it demonstrates perhaps their ... you know, where else do they go?
The Deputy of St. Ouen :
You said earlier the police did not necessarily know what to expect when they are called to an incident, when it is an incident that is happening within the home environment, do you require or request information when you are first contacted by a parent or another party?
Head of Crime Services:
Our force control room would elicit as much detail as possible from the caller and that information would be communicated to the responding officer.
The Deputy of St. Ouen :
Why I ask the question is that is it likely that your officers would have a sense of what sort of incident they were going to be attending prior to them arriving on the scene?
Head of Crime Services:
Yes. But of course that would be dependent upon the circumstances and how much information the control room had elicited from mum or dad who had called.
Deputy J.A. Hilton:
If they have not elicited the information but the officer arrives on the scene and they are informed by whoever is there that the personal involved in the incident or the young person involved in the incident has a mental health issue or has a diagnosis of maybe autism or some other problem. How would the officer then proceed? Is there a different way of proceeding?
Head of Crime Services:
The officer would proceed in exactly the same way as they would do with any individual who perhaps presented with some special needs, whatever they might be. Because, as I indicated earlier, despite the information that you are getting, you know, we train officers to approach incidents of that nature with an open mind. But certainly within a domestic setting very conscious of approaching an incident that way, certainly not heavy handed, very balanced, certainly trying to defuse and de-escalate any tension or violence that may be being demonstrated. That is something that we train our officers in as part of their regular training, officer safety training.
Deputy J.A. Hilton:
Do your officers receive any specific type of training in how to deal with situations which involve young people, say, for instance on the autistic spectrum?
Public Protection Unit:
I am not aware of specific training in relation to dealing with that type of person, but they are trained obviously to deal with various situations. It might help if I could give you an example. There is a situation currently, a family that we are dealing with, and the police were called out a couple of weeks ago to a disturbance that the child was causing at the family address. As it happened the child had left the address before the police had got there and was spoken to subsequently by the police. That was dealt with in a way that unfortunately because of the child's behaviour at the police station he had to be arrested. The family did not want prosecution, did not want to bring the child down that route. The police respect that. We will be looking at alternative roads to take in order to help that child. I met with the father of that child just in the last couple of days because there are obviously issues because the child is open to social services. I should say the child is now an adult, he is 18. The phrase that the father used to me was that the police showed emotional intelligence when dealing with the child, because the police had dealt with the child previously. So you talk about whether the police have had training specifically to deal with a child that has autism, there is not that training that I am aware of but they have got an awareness of how to deal with people and situations in whatever the context. He was able to say that the officers were able to show that emotional intelligence when dealing with the child in order to deal with it the way he wanted it dealt with. The police are there to protect obviously and deal with the incident as it is happening. It is the way we approach that incident and deal with it, then we will look to deal with whatever comes out of there, whether there are wider issues, such as if the person has autism or a mental health issue or any other issue that the police can refer on to other agencies.
Deputy J.A. Hilton:
So generally speaking, in those sort of situations where a young person is either arrested at the scene or arrested somewhere else and taken into custody at police headquarters, you said in that instance the family did not want to press any charges because of the circumstances surrounding the incident. What support did you get from other agencies in dealing with that situation? Because obviously you must have had an individual who was probably presenting in quite an anxious state, so what support did you feel that you got from other agencies in dealing with that, at that time?
Public Protection Unit:
In respect of that incident the young person was released from custody without further charge and that person is independent and he can live an independent life. However, he is under the care of adult social services. What we would do in that instance, we would create a referral and we would pass the information on to social services so they have that information and they can put whatever measures in place as a result of the information that we provided.
Deputy J.A. Hilton:
So who makes the decision when a young person can be released from police custody if they have been arrested or detained in those circumstances?
Public Protection Unit:
The custody officer, the custody sergeant, is responsible for anybody that is brought to the police station and they are obviously duty bound to ensure the welfare of someone who is leaving the police station. If there is someone at the police station and they have concerns in relation to their mental health, they would be conducting a risk assessment in order to ensure that that person is fit and well enough to leave the police station. If they are not, then obviously they will be looking at getting the person medically assessed and getting advice from the medical examiner.
Deputy J.A. Hilton:
With regard to individuals under 18 years old, who would be involved in that risk assessment with regard to releasing them from custody with mental health issues?
Head of Crime Services:
The custody sergeant is trained to undertake a risk assessment with any individual, as David indicates, before leaving custody. History tells us that is the right and proper thing to do. You cannot just release people from custody. You go through a formal risk assessment, as David indicated, just to make sure that they are not going to come to any harm.
Deputy J.A. Hilton:
Okay, but are there any agencies involved in that decision? I know ultimately it rests with the custody sergeant but would he involve any other professional agencies in coming to that decision when you have got a young person presenting with mental health issues?
Head of Crime Services:
Yes, absolutely. We would access, certainly out of hours, the on-call social worker and as appropriate we would get our force medical examiner involved and/or, depending upon the circumstances, a psychiatrist would come into custody as well from the Health Department.
Deputy J.A. Hilton:
Would that normally involve C.A.M.H.S. (Child and Adolescent Mental Health), that decision making, with an 18 year-old?
Head of Crime Services:
Our point of access to C.A.M.H.S., I think I am right to say is always through social services or certainly in duty hours through our M.A.S.H. (Multi Agency Safeguarding Hub) you may have heard a little about now.
Deputy J.A. Hilton:
So you approach to C.A.M.H.S. would only ever be through a social worker? So you would not have ...
Public Protection Unit:
I think predominantly we would say we do not necessarily do ... the police, sorry, do not necessarily do referrals to C.A.M.H.S., we would do it through a social worker. However, if someone is in custody, especially a young person, and that young person is open to social services, we are gathering information all the time and if there is an indication that the person is open to C.A.M.H.S. and specifically under a psychologist or psychiatrist at C.A.M.H.S., we would seek to bring that person in to assist in that risk assessment process.
Head of Crime Services:
That does happen periodically, somebody from C.A.M.H.S. would come to ...
Deputy J.A. Hilton:
So C.A.M.H.S. is available to you 24/7 to help with those risk assessments?
Head of Crime Services:
I am not sure that it is 24/7, I think out of hours it would be through the on-call arrangements at the hospital. That is how we would receive support in respect of mental health assessment, not directly to C.A.M.H.S.
The Deputy of St. Ouen :
Generally would you say that most of the calls to incidents happen out of hours, or is it balanced?
Head of Crime Services:
It is a mixed bag, I think, David, is it not?
Public Protection Unit: Yes.
Deputy J.A. Hilton:
Is out of hours outside of 9.00 a.m. to 5.00 p.m.?
Head of Crime Services:
Yes, so overnight effectively. That does often present additional challenges. Most healthcare is delivered during core hours and when we are responding to incidents of this nature outside core hours, so overnight, it inevitably can present some additional challenges to us.
The Deputy of St. Ouen :
We certainly appreciate that obviously as a force aimed at ensuring law and order it must be a challenge when presented with incidents that involve youngsters with issues. Is there any policy in place at the moment specifically targeted at dealing with young people who are under age, under 18s, if they are present at an incident?
Head of Crime Services:
There is not a policy per se but I think as we have articulated, if we get a call from a member of the public or parents, whoever, to an incident involving a young person that is presenting some form of abnormality, whether it is mental health, drink, drugs, whatever that might be, then officers would respond in the manner that we have described.
The Deputy of St. Ouen :
Would your officers have the confidence that they would be able to contact and appropriate individual to aid them in a particular incident, if required, like children's services?
Head of Crime Services:
What we recognise is that ... and this is an issue for the Island and something I have been asked to address through the safeguarding partnership board, I am the deputy chair to Glenys Johnston the independent safeguarding board chair for children, and I have been asked form a subgroup this year to specifically look at accommodation, not exclusively for children but more appropriate accommodation for individuals who have mental health problems. But in particular with children because we recognise that a police station, a custody block is the last place you want to be taking a vulnerable ... a young person. But in the absence of alternative accommodation outside core hours sometimes we are left with little or no choice. In particular where a family are in crisis and they are unable to deal with their youngster sometimes. As a place of safety - that is the term we use - then a police station the custody block is the last point of resort. At that point we would then seek to engage colleagues from health and social services, our force medical examiner in order to undertake a proper diagnosis and help to manage the needs of the vulnerable young person.
[10:45]
The Deputy of St. Ouen :
I would just like to explore the alternatives to prosecution that are available to you or to your officers, I should say, when they are present at or been called to an incident. Can you just talk us through what those alternatives might be?
Head of Crime Services:
Our police officers are empowered to use their discretion and certainly working with parents we would look ... as I said earlier, they are trained to de-escalate and try to bring some calmness back to the setting that presents itself and perhaps ... unless it is a really serious incident, unless somebody has been seriously harmed, as I indicated the last place we want to bring that young person is probably into custody and that would only be a last resort, you know, working with the parents. That is what they are trained to do.
Public Protection Unit:
The way I look on it there are 2 matters: the incident at hand and then there is what we do after that incident has occurred. There are various measures that can be taken as far as the incident is concerned. If it is something that the officers cannot resolve by either relocating the child to a family member or a friend or de-escalating it in another way, if during the core hours we can contact our social services colleagues and we can look at alternatives outside of our core hours we would contact our out of hours colleagues and we would seek guidance from them as to whether or not there are alternative arrangements for accommodation. So we can deal with the incident as it has happened. Obviously if there is a crime that needs to be investigated, well then the officers will have to instigate a criminal investigation. But when you are looking at sanctions ... I would suggest that the police would be reluctant to criminalise a child under these circumstances as would the parents. However, in some cases for minor offences we seek to despatch, if you like, the case through our honorary colleagues, through the parish hall system, which is a very beneficial system to put a sanction in place whilst the child does not get a criminal conviction, as you will obviously be aware of yourself. It is a fair decision process. It is a case of getting the
sanction in place without a child incurring a criminal conviction. But then, as Mr. Gull has said, we have discretion, we can issue words of advice to parties, we can refer on to other agencies because we can make a decision in consultation with social services that yes there might be a crime here but it is not necessarily the right course of action to take that child down that route. A better route would be to put other interventions in place in order to help the child and the family come through that crisis as Mr. Gull has already said. So there are other sanctions outside of criminal justice.
The Deputy of St. Ouen :
Within the force are there specialised officers who are specifically trained to support families, youngsters that find themselves in those sort of difficult situations following a call out?
Head of Crime Services:
We have a public protection unit. David is one of the detective sergeants in our public protection unit. Relatively small team but they have responsibility for investigating child abuse, adult abuse, domestic abuse and they also have responsibility for managing sex and violent offenders. So a really broad remit. I think it would be fair to say, David, that that team would be recognised as having additional skills in terms of dealing with issues of that nature but what the police do not have ... as you quite rightly identified, our primary role is one of law enforcement, but over the years it is ... the police service not just here but in other jurisdictions have had to learn and develop and acquire new skills, softer skills. I think that is quite right and proper. Certainly within the safeguarding arena for children and adults the only way forward is in partnership. No one agency has the complete ... sees the complete picture and that is why we advocate and will continue to advocate the strength in the partnership approach. To give you some idea of ... I am not sure whether this is a good indicator or not, during the last 3 years ... we did have a look at this data recently because a couple of my colleagues went to speak to a family support group, SPOTT (Support for Parents Of Troubled Teenagers). You may or may not be familiar with it.
Deputy J.A. Hilton: Yes.
Head of Crime Services:
We discussed openly and I think the group found this quite helpful. We explained some of the issues that we are talking about here today and what the police can and cannot do. But in preparing to talk to that group we had a look at some data and during the last 3 years, just to give you an indication of the scale of the problem ... this was recorded assaults on parents by teenage children, there were 24 in 2011, 16 in 2012 and 19 last year. So I do not know whether you would regard that as a significant amount or not. Relatively low figures, I think. Perhaps on average, you know, a couple a month. I think that perhaps demonstrates (a) the reluctance sometimes of parents to call us but (b) the broader discretion and the softer skills that police officers have and use when looking to support parents.
The Deputy of St. Ouen :
Would those figures include self-harming?
Head of Crime Services: No, they would not.
The Deputy of St. Ouen :
So would you have separate data for that?
Head of Crime Services:
Yes, we may well have some data on self-harm, yes.
The Deputy of St. Ouen :
Obviously that is another particular situation which presumably is difficult for any police officer to face and deal with. How confident are you, when your officers are presented with those situations, that they can call in the appropriate professional assistance to help them deal with a particular matter?
Head of Crime Services:
Inevitably we are one of the 3 primary emergency services, together with our honorary colleagues, we are often the last but first port of call when things have just totally broken down or just got out of control. Sorry, your question was?
The Deputy of St. Ouen :
Yes, it was: how confident are you, when your officers attend a particular incident which involves a young person presenting particular difficulties that are able to contact an appropriate professional, whether it be a social worker, children's service officer, whatever, to come and provide and work with them to deal with the particular situation that they find when they arrive?
Head of Crime Services:
Yes, we are confident we can and we know those routes, they are well established right across the public sector. Inevitably in public service there is pretty good join up. It might not always be immediate for whatever reason and our officers understand that. As I said, over the years - and it applies equally here in Jersey - officers have had to develop softer policing skills but we know who to contact and how to access other support services.
The Deputy of St. Ouen :
Would there be a benefit in having a better relationship with a service or services that you would be able to call upon a professional individual to attend at the scene once your officers have assessed the situation?
Head of Crime Services:
Potentially, yes. But we recognise that there is not a bottomless pit with public services, is there, and sometimes with increased demand you have to prioritise and risk assess accordingly and that sometimes can be quite challenging. I think on the whole partners work pretty well together.
Deputy J.A. Hilton:
Going back to the recorded assault figures, 59 over a period of 3 years, were any of those repeat offenders, do you know?
Head of Crime Services: I do not know, I am sorry.
Deputy J.A. Hilton:
So potentially that is involving 59 families whose parents have suffered some degree of physical assault, harm. Have you any idea of how many of those 59 were charged with an offence or were ...?
Head of Crime Services:
Sorry, again, I do not know. It was just sort of core data. Our recording is not necessarily that sophisticated but I just thought you might find it interesting this morning as an indicator.
Deputy J.A. Hilton:
Yes, that is interesting, it is quite alarming because we know generally speaking when one talks about domestic assaults it is usually ... most people imagine a male on female, some female on male, but you do not often think of children assaulting their parents. So it is quite alarming. Would you have any evidence to suggest that some of those families that were involved in those incidents were in the care of social services or C.A.M.H.S.?
Head of Crime Services:
I do not know. I think it would be fair to say that probably some were to a greater or lesser extent and I would not be at all surprised if some of them were repeats. That is probably the case. I think like domestic abuse, it is well documented now that a victim would probably be subject to domestic abuse - I think the figure is - 35 occasions before they actually report it. I suspect we are not talking about a dissimilar figure for families because probably like most families you want to try and work out the problem yourself. But it perhaps gets to a point where you decide you need to engage partners.
Deputy J.A. Hilton:
Just going back to out of hours services again, we touched briefly on place of safety, you are setting up a subgroup to look accommodation, is that like emergency accommodation for young people who find themselves at police headquarters?
Head of Crime Services:
It is for vulnerable people, including children and young people, recognising ... and again there has been a lot of research nationally that a police station, a cell block, is probably the last place that you want to put a vulnerable person. When you often add in other complex issues including drugs or alcohol, it does present a set of complex challenges. So there is not going to be a quick win here but we are starting to have a look at it.
Deputy J.A. Hilton:
So do the States of Jersey Police find themselves in a situation where they find that they have young people in custody at police headquarters with absolutely nowhere else to go, so you are the last port of call? How often does that happen?
Head of Crime Services:
Yes, sadly. It is the exception rather than the rule and it is the absolute last resort. I think in any given year we have been talking about single figures but sometimes ... and perhaps principally for the safety ... in order to safeguard that child so that they do not cause any further harm to themselves, we need to bring them into the police station.
Deputy J.A. Hilton:
How do other jurisdictions deal with that issue of 18s being brought into custody with mental health issues? How do they deal with it in the U.K. (United Kingdom)?
Head of Crime Services:
Pretty much the same. Some local authorities are able to provide better alternatives, better provision than others, but it is a challenge, certainly up and down the U.K. Again, I forget the specific piece of research but without wishing to labour the point it has been made that custody blocks are not the best place for vulnerable people.
Deputy J.A. Hilton:
So would it be fair to say that we could go a long way to improve the services or the help we provide to young people with regards to a place of safety and out of hours psychiatric care? Because I think from what you said in your previous answer was that C.A.M.H.S. is not available to you out of hours, you are relying on somebody else.
[11:00]
Head of Crime Services:
Well, the route into C.A.M.H.S. would never be direct unless we were aware in core hours that it was an open case so ...
Deputy J.A. Hilton:
I think what I am getting at is that if you have a young person who comes into custody who you are aware are already under the care of C.A.M.H.S., would it be ... I would have thought it would have been better for the young person concerned if you had access to C.A.M.H.S. or somebody from C.A.M.H.S. who could assist you in dealing with the person that has been brought into custody.
Head of Crime Services:
That would not be an unreasonable expectation, I guess. But, as I said, I would not want you to think that we cannot access appropriate ... and we do, either through the on call social worker or direct to the hospital who would arrange for appropriate mental health assistance.
Deputy J.A. Hilton:
So that would be an on call psychiatrist, basically an adult psychiatrist.
Head of Crime Services: Yes, it would.
Public Protection Unit:
Just to expand on that slightly. Most children that would be under C.A.M.H.S. would have a social worker, so they would be open to social services. That is our first line of call. That is why we predominantly go to social services first in those circumstances and then through them we would have the engagement through C.A.M.H.S.
Deputy J.A. Hilton:
This is specifically about out of hours, when you are dealing with the out of hours social worker or psychiatrist, how often do you find that they know nothing about the person you have in custody?
Public Protection Unit:
Very often, because the social worker can be from any area within social services and not necessarily in the team that that person is open to.
Deputy J.A. Hilton:
I do not know what access they have to records but obviously, I would have thought, it would be far more helpful, if was somebody that was known to C.A.M.H.S., that they had access to somebody at C.A.M.H.S. who could access records to assist?
Public Protection Unit:
It is a problem when we have to contact out of hours and the child is open to social services, because it is not always the case that the child would be open to social services. But the child is open to social services and that social worker is not able to access that information. I think ... I cannot talk for social services but my understanding is that the out of hours are there to deal with the incident, whatever is happening at the time. If a child needs to be relocated to an alternative accommodation and ensuring wherever they go that that place is going to be safe. But not necessarily to be able to look into the record of that child at that time. Because obviously they will do a referral then on to the relevant social worker for them to pick up the following day when they are next on duty.
Deputy J.A. Hilton:
Could you tell us how you believe the service could be improved for young people who find themselves in this predicament? What do you think is the best thing we could do or provide?
Head of Crime Services:
I think we have identified one area and I think that is about appropriate accommodation which is now being actively considered and looking at alternative options. We want to provide, as with any other community, the best possible service ...
Deputy J.A. Hilton:
Is there anything that is glaringly obvious to you, being at the sharp end, that we should be addressing? That the States of Jersey should be addressing.
Head of Crime Services:
I know some of my uniformed colleagues, and certainly in custody, sometimes get frustrated about the timeliness of a response from partners but it is about recognising other demands, other challenges, appropriate risk assessment and prioritising. Certainly out of hours there is not a limitless pot of mental health specialists.
Deputy J.A. Hilton:
Do bank holidays cause you challenges?
Head of Crime Services:
Yes, they do but probably no more so than weekends or out of hours.
The Deputy of St. Ouen :
Is there a set procedure that you follow when officers decide to remove a young person from their home and take them into custody?
Head of Crime Services:
Is there a set procedure? Yes, but it is core business for us I suppose in terms of detaining anybody, whether it is formally by way of arrest or even by way of a place of safety, for their own protection. We would seek to do that in the most sensitive and most supportive way that we can. Particularly with a vulnerable person.
The Deputy of St. Ouen :
I understand obviously you are required to and you would naturally detain individuals and provide for them but I just wondered whether or not there was a specific set of procedures for focusing on young people under 18, under 16, whatever it is, and whether those procedures were different to that adopted and used for detaining adults?
Public Protection Unit:
In respect of obviously any child that is brought into the police station would have to have an appropriate adult, so whatever the police were going to, for instance if the child had to be arrested, we would not be able to give that child their rights and all entitlements without an appropriate adult being in place so they know that that child understands exactly what their rights are while they are at the police station.
The Deputy of St. Ouen :
So the appropriate adult attends with the child ...
Head of Crime Services:
Not always immediately, depending upon the circumstances and on those occasions it might not be appropriate for mum or dad or guardian to come in if they are involved as a victim or a witness, so we would need to go to ...
Public Protection Unit:
... There is a vulnerable adult service
The Deputy of St. Ouen :
Is it standard procedure to notify social services or children's services that you are about to or have detained a child at the police station?
Public Protection Unit:
Any dealings that we have with a child ... if a child gets arrested or if there is any concerns for the child, we will create a referral which will go into the M.A.S.H. so that social services are aware that the child has been or is in custody. It is usually really after the event unless we need specifically for a social worker to come to the police station to assist with that process.
Deputy J.A. Hilton:
Sorry, is that any child under 18 who is involved in an incident that is arrested?
Public Protection Unit:
The officers dealing with the incident will be required to create a referral on our system and then the sergeant with responsibility for that area will assess that and will forward on to M.A.S.H. for their information and any other interventions that need to take place.
The Deputy of St. Ouen :
If it is after the event, just thinking about what you were saying earlier that your custody sergeant, who is obviously trained to determine and carry out risk assessments, there is a greater responsibility placed on the custody sergeant's shoulders if the involvement of the other services happens after rather than at the moment or at the time when the individual is in your custody. Is that not the case, is that a true statement, or is that something ...
Public Protection Unit:
Sorry, could you repeat the question, I am just a bit unsure as to ...
The Deputy of St. Ouen :
Well, if a young person is in custody and you are saying that then after the event, at a later date, you then make a referral to children's services or another agency, what position does it place the custody sergeant because if he is making a decision about releasing the individual and undertaking risk assessment when you are not certain that the professionals believe that that individual either needs more care, direct assistance and so on and so forth, what situation does that place the custody sergeant in?
Head of Crime Services:
Well, the custody sergeant would not release in those circumstances. He or she would only release any vulnerable person but in particular a child or young person where he or she was convinced that to the best of their assessment they were not going to come to any further harm.
The Deputy of St. Ouen :
Right, so just to recap there, they have access to the police doctor, they have access social workers if necessary and presumably some discussion takes place with parents, guardians or others that would be responsible for the young person?
Head of Crime Services:
Yes, and as David indicated sometimes helpfully you can identify ... other family members are able perhaps in the short term to accommodate the child.
Public Protection Unit:
I think it is fair to say decisions are not made in isolation by the police when you are looking at safeguarding a young child. I think predominantly it would be fair to say that ... and I do not know if that is the road you want to go down, but if we are talking about children that are brought into custody for instance for criminal offences, the majority of children will be released back to their parents because that is where the best place is for them. We know that they are safe. Obviously the responsibility is on the custody sergeant to ensure that. Then the officer who is dealing with the case will create that referral process so that social services are aware of that incident. So it is again going back to that thing of dealing with the incident as it has happened and then you have the after interventions that take place once that has been dealt with in whatever way it needs to be dealt with.
The Deputy of St. Ouen :
Do you feel sometimes that the police find themselves in a difficult situation where ultimately they are having to deal with matters that are perhaps outside of your general standard remit, which is managing law and order?
Head of Crime Services: Yes.
The Deputy of St. Ouen :
If that is the case, what practical thing could be done to help address that issue?
Head of Crime Services:
Potentially a suitably qualified health professional embedded in custody. That might be an option but, of course, that comes at a cost. That funding is not currently available to us. I know one or 2 other authorities, because of the throughput, they can perhaps justify that and there are embedded health professionals within custody settings now, certainly in some U.K. larger metropolitan forces. But that clearly assists because it would quick and immediate and you would get a very timely response and assessment in respect of the vulnerable person as they presented.
The Deputy of St. Ouen :
During the training of your new recruits are they made aware of ... and consider how to deal with young people that present themselves with mental health issues or serious behavioural problems?
Head of Crime Services:
I am not sure that we specifically focus on children and young people who may have mental health problems but as part of an officer's core training and ongoing training and development we would focus on vulnerable people more broadly and officers would then utilise those skills in dealing with those people, yes.
The Deputy of St. Ouen :
You have community police officers, do you not?
Head of Crime Services:
Yes.
The Deputy of St. Ouen :
Would they be more skilled and have the appropriate qualifications to be able to deal with these individuals?
Head of Crime Services:
I think perhaps maybe with an ongoing family within a particular parish that might be appropriate. As we know where you can develop a longer term relationship and understanding with a particular family then a familiar face sometimes helps, does it not? But I think more broadly in terms of the sort of work that we are talking about here, it is our response officers that are having to deal with these incidents and it is often 999 call: "Come, help. My son, or daughter, are out of control, we need some help" and it is that sort of response.
The Deputy of St. Ouen :
Obviously your primary focus is on dealing with the incident and managing it?
[11:15]
Head of Crime Services:
Supporting parents, protecting the child.
The Deputy of St. Ouen :
So once ... you often find that they have to remove the child, what support is offered, if any, to parents or other family members that may have been involved in that incident?
Head of Crime Services:
We would certainly maintain contact and follow up, we would remain engaged with the family. It is not uncommon for mum or dad to be on the phone to us before we have even arrived back at the police station. They are crucial, are they not, mum, dad, parents are crucial to the ongoing needs of the child and we maintain an ongoing dialogue.
Public Protection Unit:
Just again to give an example, often on referrals that officers will complete as a result of attending such an incident, they will document the conversations they have had with the parents and the parents saying that they need assistance. It is obviously not always the police that can provide that assistance but they are highlighting with the officers they are having those conversations in those emotive times and that information gets forwarded on to social services so they are aware of what the parents are seeking ... the support that they are seeking to get.
Head of Crime Services:
But the case that David alluded to earlier, you met with the father this week with a senior colleague from Health and Social Services, so it is quite rightly every case is approached on its own merits because either the family or the child have different needs and we try and meet those as best we can.
The Deputy of St. Ouen :
I must add that in the conversations we have had to date with parents around C.A.M.H.S. and issues to do with their children, they do and have responded positively about the service that you provide, albeit that they acknowledge that it might be preferable to have other agencies getting involved perhaps before they are required to call you. Please do not leave thinking there is a poor view of the services you provide. It is our aim to look at what can be improved and how best to provide for these vulnerable young people.
Deputy J.A. Hilton:
Every single family who made a comment about the States of Jersey Police spoke about you in very glowing terms and the assistance and help you provided to families when you had been called to help with incidents.
Head of Crime Services: That is reassuring, thank you.
Deputy J.A. Hilton:
We have been told by the head of C.A.M.H.S. that figures last year increased by a third. In the first quarter of 2013 they just thought it was a blip because she said they get blips but it remained constant right through the first 3 quarters of 2013 that there was a massive increase. Has that been reflected in incidents that you have been called to involving young people, either through self-harming, anti-social behaviour, you know, incidents in the home? Have you seen an upturn in your figures? Have they remained constant, do you think?
Head of Crime Services:
Neither of us have researched data in advance today. We know ... to take some sort of global figures, we know overall that crime was down again last year, 18 per cent reduction, 670 fewer victims of crime. You will perhaps recall the Home Affairs report that was published last summer about youth crime and I think it is at its lowest point for 10 years. I think that is indicative of long- term investment here for which Jersey should be congratulated. But I think it is a very complex world that we live in now, is it not, and certainly for young people ... I am just about to commence some work again with partners from social services, education in respect of so-called N.E.E.T. (Not in education, employment or training) children and young people. Because we recognise that a large number of our vulnerable people fall into that bracket. So we want to do some further work there to see if strategically across the public service, as you know, we can do more for these vulnerable young people.
Deputy J.A. Hilton:
You mentioned M.A.S.H. before and did you say that you were chairing that? No, you are vice chair of the safeguarding forum.
Head of Crime Services: Yes, that is correct.
Deputy J.A. Hilton:
Okay, so the States of Jersey Police sit on M.A.S.H.?
Head of Crime Services: We do, yes.
Deputy J.A. Hilton:
Is C.A.M.H.S. on M.A.S.H. as well?
Head of Crime Services:
Not directly, no, but they are represented through the managing director ...
Deputy J.A. Hilton:
So you generally ... Sergeant Hill has been part of the P.P.U. (Public Protection Unit), do you have much direct contact with C.A.M.H.S. yourself or the P.P.U.?
Public Protection Unit:
No, it would be very limited directly. We do attend multi-agency strategy meetings and if the child is open to C.A.M.H.S. you will have a representative from C.A.M.H.S. to provide the information about the ongoing treatment. Information can dictate how the police might proceed with an investigation because obviously we would be seeking their advice and guidance as to whether or not we would, say, for instance look to interview a child at a specific time about a certain allegation. If C.A.M.H.S. would be saying: "Well, it would not be appropriate at that time because of the development of the child" then we would not, so we do take advice from them. But that would be in a multi-agency forum as opposed to us contacting them directly.
Deputy J.A. Hilton:
You mentioned earlier when somebody comes in out of hours and you need an appropriate adult, which sometimes would not be parents for whatever reason, do you ever experience delays around getting an appropriate adult out of hours?
Head of Crime Services:
I do not think we do now, no.
Public Protection Unit: There is a new service.
Head of Crime Services:
We have a dedicated service, do we not, David?
Deputy J.A. Hilton:
Okay, can you just explain that?
Public Protection Unit:
Previously we have had ... there had been problems but there is a service now that we can use, that we can contact, it is like a bank, if you like, of people that we can contact and they will come in as and when they are required.
Deputy J.A. Hilton: Okay, thank you.
Head of Crime Services:
It is perhaps also worthy of pointing out just briefly that C.A.M.H.S. do sit in their own right as part of the safeguarding partnership board and at a strategic level I am obviously involved with a lot of work with C.A.M.H.S.
The Deputy of St. Ouen :
Just for my own information, how does your custody sergeant or whoever decide who is an appropriate adult?
Head of Crime Services:
We use somebody that is trained and qualified from a bank that we would call on.
The Deputy of St. Ouen :
Yes, I know but I am just thinking if a friend of the young person arrives on the scene and says: "I am happy to take responsibility for this person" how do you ...
Head of Crime Services:
First of all the individual would have to be over 18 and the custody sergeant would assess as to the ... he or she would use their professional judgment as to the appropriateness of somebody presenting ...
The Deputy of St. Ouen :
Right, so they would confirm that they had a home to go to and ...
Head of Crime Services:
Correct. On occasions it might be an adult brother or sister, David, I guess, or an aunt or uncle, occasionally grandparents.
The Deputy of St. Ouen :
Right, but there are checks that are undertaken before releasing a young person into the custody of another?
Head of Crime Services: Yes, absolutely.
Deputy J.A. Hilton:
That person would have to be over 18?
Head of Crime Services: Yes.
Deputy J.A. Hilton: Okay, thank you.
The Deputy of St. Ouen :
I just want to explore a little bit further about what happens when the child is in custody. You said that they need to be accompanied by an appropriate adult. Is that appropriate adult required to remain with the young person while they are in custody or is the young person left on their own?
Head of Crime Services:
If there is a requirement for the child or young person to be placed in a cell then the appropriate adult would not be in the cell with them. They are primarily there to ensure that the child or young person understands their rights and they would certainly be present during an interview throughout. But outside those occurrences it is not necessary for the appropriate adult to physically be at the ... they might wait but similarly they might go away and come back again. I think that is the way it works, David, is it not?
Public Protection Unit: Yes.
The Deputy of St. Ouen :
I am just thinking of different incidents where a young person for various reasons could have significant problems, be in a state of anxiety, to the point of self-harming and I just ... maybe you could explain how that is addressed while the child is in custody.
Head of Crime Services:
This applies to anybody who is entering custody, there is an incredibly thorough and rigorous risk assessment that takes place by the custody sergeant. Depending upon the level of risk that is assessed would determine the level of support that that individual got while they were in custody. So, for example, if we risk assessed somebody as very high and certainly in respect of self-harm, then that individual would be on what we call constants, so they would be constantly assessed, probably with an open door and an officer physically, or sometimes 2 officers, sitting there and monitoring the individual. Less risk, the less the level of supervision. So it might be every quarter of an hour, every half of hour or might be hourly, but for somebody who is assessed as very vulnerable and at a risk of self-harm they would probably be on constants. But that, of course, is incredibly resource intensive.
The Deputy of St. Ouen :
On occasion are there other places that the young people might be transferred to while in custody?
Public Protection Unit:
While they are in custody pending an investigation of a criminal offence?
The Deputy of St. Ouen :
Yes, or while you seek to deal with the particular incident that you have attended? For argument's sake, Robin ward we hear is used on occasion to accommodate young people. We have heard obviously, dependent on the age of the person, 17, 18, Orchard House may be considered. I just wondered is that something that you as officers can determine or would it need a professional to say: "No, the cell is not the place for this young person, they should be better held, contained or looked after within another facility."
Head of Crime Services:
It is not for us to determine. We would use our force medical examiner, we would use a psychiatrist where appropriate and they would determine where a child or young person is best kept. Occasionally, where we are dealing with a young person at risk sometimes we take them direct to the hospital, they are assessed in the emergency department and, you are right, on occasions ... I know where a young person has reported as missing and we locate them and think there is still some vulnerability there then we would take them to the emergency department, they would be assessed and on occasions I think they find themselves on Robin ward.
The Deputy of St. Ouen :
The point is, it is not an automatic decision, is it, right, we are removing the young person from the home and automatically they all go to the police headquarters and end up in a ...
Head of Crime Services:
No, not unless there was a criminal offence involved. But where there was no criminality, where there was no complaint, there was just concerns of vulnerability and risk then police officers would take them in the first instance to the emergency department.
The Deputy of St. Ouen :
If they have committed a criminal offence, in other words they have sought to do harm or have harmed a sibling or parent then are you saying that there is no choice, they will be detailed at police headquarters?
Public Protection Unit:
No, the welfare of the child is always going to be the most important thing from our point of view. If a child is detained for a criminal offence but there is a concern for their mental wellbeing, we will seek to address that. Whether that is taking the child to A. and E. (Accident and Emergency) or getting a professional to come into the police station we will seek to assess that.
[11:30]
Head of Crime Services:
But you can see some of the challenges now that frontline, sometimes inexperienced, officers face because we also have the interests of the victim as well and that might be mum, dad, it might be an aunt, so it is real tough issues here to wrestle with.
The Deputy of St. Ouen : Thank you for clarifying that.
Deputy J.A. Hilton:
I just have a couple of questions that fall out of that. Have you ever been called to an incident at Robin ward involving a young person with mental health issues?
Public Protection Unit:
That is causing problems on the ward?
Deputy J.A. Hilton:
Yes, that you have had to go in and assist?
Head of Crime Services:
I am not sure we can be specific about Robin ward but I know occasionally, certainly in A. and E. we will be called sometimes with a child, sometimes with an adult. Where medical staff are really struggling and they will call on us, yes.
Deputy J.A. Hilton:
All right, but you cannot answer specifically about Robin ward?
Head of Crime Services: No.
Deputy J.A. Hilton:
Also, just going back to being held in police custody, in what circumstances would a young person with mental health issues be held in a police cell rather than an interview room?
Head of Crime Services:
The simple answer is a cell is secure and an interview room is not. So if the young person had been arrested, detained for the purpose of an investigation and interview then ...
Deputy J.A. Hilton:
I ask that question because I am aware of the layout at police headquarters and that the interview rooms are a less hostile environment compared to the police cells. So I was just wondering, when you are dealing with young people with mental health issues whether you would choose to use the interview rooms, which I believe can be locked, rather than ... there is a lot more activity I would assume in that corridor than being detained in a police cell.
Head of Crime Services:
It is difficult to be general. As I say, I draw the distinction and you will be very familiar with the difference, I guess a custody officer on occasions, maybe because of the real vulnerability, he or she may say: "Right, I am not going to put you in the cell, I will tie up a couple of police officers and we will go and sit in an interview room." But you will understand, it can sometimes be an elongated period and it is ... every case is judged on its own merits. But a young person would not be locked in an interview room and left as an alternative to a cell. That would not happen because an interview room is not appropriate.
Deputy J.A. Hilton:
You mentioned previously about how ... when you have a vulnerable person in a police cell and they are on constant watch because there are concerns around their safety, that is very resource intensive. So presumably getting back to our previous conversation about the group that you have set up recently to look at alternative accommodation, that would help enormously I would think.
Head of Crime Services: It would, yes, absolutely.
Deputy J.A. Hilton:
You have said you are chairing this group to look at this, when you think you will be coming back with some firm proposals, and to whom are you going back to with those proposals?
Head of Crime Services:
The independent safeguarding chair has commissioned this piece of work, she has asked me to lead it, it has only started this year. I would hope to be able to report at some stage this year and I guess ultimately any proposals would go to the States Children's Policy Group. I assume that is where we would go.
The Deputy of St. Ouen :
One last question based around facilities. Will our new police headquarters have better facilities and provision to hold young people while in custody?
Head of Crime Services:
Yes, much. Yes, our current custody block is not really fit for purpose and thankfully with States support we cannot wait to get into our new build. The whole of the new custody block will be far more appropriate, not just for children but for everybody.
The Deputy of St. Ouen :
Will there be a dedicated area within that for ...
Head of Crime Services:
Certainly from my experience ... I am not familiar with the detail of the new build but I am pretty sure there will be. There certainly is within the U.K. new custody blocks, yes, there would be specific provision for children and young people.
The Deputy of St. Ouen : Thank you.
Deputy J.A. Hilton:
Thank you. I am going to call the meeting to a close. We have run over by 5 minutes but there were lots of questions to ask so thank you very much for coming this morning. I close the meeting.
[11:35]