In an exclusive interview with Mental Health Wales, Matt Jukes, the recently appointed Chief Constable of South Wales Police, discusses mental health and policing, the Mental Health Concordat, prevention of mental illness in young people – and the contribution of physical activity to mental wellness.
How important is mental wellbeing to ensuring an effective police force, and how is the South Wales Police Force promoting mental wellbeing?
The nature of policing means we have a greater likelihood of seeing, experiencing and dealing with things that most members of society fortunately wouldn’t have to. It can have both short and longer term implications and if we don’t deal and support people with it, then we face seeing people no longer feel that they are fit enough to contribute to the workplace and taking sickness absence. If we are to be the best at protecting the vulnerable and understanding our communities, then we need to be at our best. For me, there are many opportunities to do this.
We introduced Wellbeing Wednesday, as a chance for staff to move away from the desk and do something with the team, a bit of lunchtime yoga, have a team walk – Twitter was full of examples of various teams across the organisation using their initiative and devising wellbeing events to take part. But these type of interventions will never be enough on their own and we are working with a range of organisations, such as Mind Cymru, to raise the skills of our managers to identify and support those in need of help. We have a comprehensive service and procedures to support those exposed to the most traumatic events but we also recognise the cumulative impact of our daily work. That means a career-long focus on wellbeing, which is not only about dealing with difficult issues in our work but also about making the organisation feel as fair and inclusive as possible.
You are Chair of Police Sports UK and have a personal reputation as a keen sportsman. How big a part do you think sport and physical activity play in mental wellness?
Undoubtedly, physical wellbeing can play a big part in mental wellness. For those with mental illness, their condition could see their likelihood of dying earlier increased. As organisations such as Mind have identified, this could see someone with schizophrenia or bi-polar dying 10 – 17 years earlier than their peers. Academic research shows the role that sport plays in the release of endorphins. We have our own experience of this after we introduced a programme to target walking 10,000 steps a day. From a baseline of 16% of people taking part achieving this at the outset, we saw nearly 68% meet the recommendation at the end of the challenge. Two thirds of those involved then reported a decrease in stress levels at home or work and an increase in their productivity and concentration. The results speak for themselves.
I am keen for Police Sport UK to play a bigger part in increasing physical wellbeing and its connection to mental health, but for me, it’s important that we look wider than traditional sports such as rugby and football. I’d like us to really value inclusion because the evidence shows that sport gives an increase benefit over and above other forms of physical activity, because of its social element. You can see that at a weekly ‘Parkrun’ as much as at the start line of a marathon. I’m also keen to promote active lifestyle choices and can’t claim to always get that right myself but I do know it helps. As Chief Constable it is not always easy to get to the gym as often as I like but cycling to meetings where I can, rather than using the car to travel a few miles, is certainly something that makes me feel better about achieving some balance.
During your career in the police force how have you seen attitudes to mental health change both inside the force and among the general public?
I have seen considerable change in the approach of the service to mental health. Within the service, there is a greater understanding of the impact of mental health to officer wellbeing and whereas after a traumatic incident, the answer would be to bite your lip or go straight to the pub, we are more cognisant of the longer term support needed. We now offer early intervention through trauma management practitioners and make available counselling to all staff with onward referral if necessary. Whilst mental illness would have precluded many from a career in the police, we now see people with conditions such as bipolar and depression being able to manage their condition and work. That’s not to say we’ve got it right, there is still a long way to go and as our work seems to get more complex and demanding, we need to keep up our progress.
That is also reflected within society as a whole. I am sure that over twenty years ago when I was first policing, we were dealing with people who had undiagnosed mental health needs. The individuals we did deal with were often isolated in institutions. We have come a considerable way to the point where we see Princes William and Harry, for example, being very vocal and candid in bringing mental health into the public eye and giving a voice to many who perhaps may have felt their condition left them in the shadows. In that sense, attitudes seem to have come a long way but issues that compound mental ill-health are all around us, including new pressures such as those from social media, so it is important that we keep talking.
Mental Health Concordat
What is the importance of Appropriate Adults to the criminal justice system and how does it support the police force work with people who experience mental illness?
Appropriate Adults are persons trained and experienced in mental health and learning disabilities who undertake a critical person centred role to provide support and safeguarding. Whilst not a substitute for legal advice, they are an important part of the criminal justice system, whose role is legislated under the Police and Criminal Evidence Act. Available 24/7 they act in lieu of family members, social services or carers when not available in providing support, advice and assistance to any person in police custody who requires their services and to facilitate communication between the detainee, the police and/or their legal representative. The importance is outlined in the increase of calls by just over a quarter in the period 2015 to 2017. Our service provider, Hafal, has personnel who are trained to understand how the Mental Health Act may impact upon their role within the custody environment and the roles of key staff in mental health matters.
Although fewer people are being held in police custody, how will delivery of Wales’ Mental Health Crisis Care Concordat reduce numbers in South Wales further?
Launched in 2015, the Concordat was focused on less people being detained under section 136 of the Mental Health Act and less within a police custody suite. As a force, we have committed to ‘zero tolerance’ for persons being detailed under section 136 and that they are conveyed to an appropriate designated health place of safety, which has seen numbers in custody reduced markedly. By focusing on parity of esteem, that is Physical Health vs Mental Illness, the Concordat highlights the need to treat people in a health appropriate environment without the need for police stations. With the introduction in December 2017 of a legislative requirement on police only taking section 136 patients to custody when authorised by an inspector or above, to give greater scrutiny and, only when protecting them from imminent risk of serious injury or death to themselves or another, South Wales Police have only seen three persons detained under section 136 held at police custody in the last three months.
How will the engagement between The Chief Police Officer Group – Cymru and the Mental Health Partnership Board with NHS Wales ensure the Concordat is supported by local operational plans?
We have seen that the way forward is through partnership working, which influences working practices at a strategic, tactical and operational level. This ensures a more focussed multi-disciplinary approach to deliver answers to matters which may not be within in the remit of just one organisation. Through the development of local plans, it will support the aims and objectives of the Concordat. By doing so it will see consistency of practice across Wales, so that there is an equitable services available for those in crisis and is agreed at an executive level. Leadership is important in making this work and it is only right that this is led by good partnership working at a senior level.
In your opinion, what more can mental health organisations (both statutory and voluntary) do to help police forces reduce custody due to mental illness?
I recognise that many organisations across Wales are already working hard with the Police and other partners to do just this. Statutory and voluntary organisation aim to provide the least restrictive means to look after individuals with mental illness with a view to keep them away from police custody suites and intervening early to prevent crisis situations from occurring in the first place. The key element is doing this together, rather than individually, so key services are not duplicated and by also ensuring that those in crisis receive the same care that they need at the right time by the right service. There is also a big part to play in building resilient communities, providing support and guidance to the most vulnerable but also allowing people to function in the wider community with the appropriate support and help, which reaps rewards in people being able to play their part in society, such as through work to make an economic and social contribution. The suggestions for practice in the Concordat give evidence based solutions that have been tried and tested elsewhere successfully, where individuals are supported.
For statutory organisations, an open access approach to mental health services, such as Cwm Taf University Health Board’s ‘First Access’ allowing anyone to contact crisis and community mental health teams, could be seen as best practice and rolled out to all local health boards. This provides qualified support and would reduce the risk of persons becoming unwell. Other examples could be open access to voluntary assessments for those who are not known to services.
At present, if you are suffering from a physical health issue or injury when you come into contact with the Police, it’s not necessarily the case that you will go into our custody or indeed, into hospital. For example, substance or alcohol misuse and minor injuries are dealt with by on-street paramedics and with the support of volunteers in our ‘help point’ services. For mental health, we seem to have very little between the street and hospital and we would like to continue to talk about options to provide safer sanctuary, short of requiring that people are detained.
An expansion of services provided by the third sector, such as Hafal, Mind Cymru and Gofal could be the way forward for voluntary services. South Wales Police are supportive of the principles in the Concordat and I feel it is essential to engage with mental health service user and carer groups to highlight feedback on changes to ensure they are embedded in practice.
Young people and mental health
You are a member of the Prince’s Trust Advisory Council in Wales. Has your involvement shaped your views on how society can help prevent young people from developing a mental illness?
Many of the young people working with the Prince’s Trust have had or are experiencing mental health issues. Low self-esteem is one of the things which the Trust’s programmes is particularly effective at addressing. Young people who have terrific potential but don’t believe it or haven’t had the start in life to realise it – they are getting huge support and three-quarters passing through the programmes go onto further training or into work. The sense of self-worth and coping skills that are developed in the programme are not a substitute for dealing with mental health directly but they can play a huge part. My work with the Prince’s Trust reminds me that despite everything I see in my career, a tough start in life does not write the future, however much it can shape it. We should do everything we can to instil hope and pride in young people.
It is well known that people who experience abuse, neglect and other childhood experiences are at greater risk of mental illness in later life. You have taken a leading role in work with Public Health Wales on tackling Adverse Childhood Experiences. What measures do you think might help prevent young people becoming unwell?
There is no single intervention that is going to help and above all, we need to take a child-centred approach – listening and responding to children and young people. The evidence around Adverse Childhood Experiences (ACE) gives us a lens to do that through: instead of asking ‘What’s wrong with you?’, it encourages use to ask ‘What’s happened to you?’. From that point, services need to be responsive to what they learn, working together. We are finding that although policing can help, early intervention and schools play as much a part, as do services in the NHS, of course. All those services do seem to be under real pressure but the one thing that really stands out from the ACEs work is the value of an ‘always available adult’ – a bit of a mouthful but essentially, someone to talk to and turn to. It may be a grandparent or a foster carer, a police community support officer or a teacher. Someone like that in a child’s life has the potential to reduce the requirement for those very expensive services later in life and all the harm that will have been caused along the way.