Dyfed Powys police launched a street triage service in 2015 for responding to calls where potential mental health issues were identified. The street triage project is an ongoing initiative that sees police and mental health services work together to ensure people get appropriate care when police are called to a person in distress.

The aim was to ensure that the least intrusive options were used whenever possible. Section 136 detentions typically take up a considerable amount of police time. Use of police custody for these detainees has dropped by nearly 50 per cent in the first 12 months, which represents a considerable efficiency saving. Initially, significant effort and persuasion were needed to embed effective partnerships across police, health and social services.

The size and rural nature of the area have influenced the type of triage service developed. A hybrid model was adopted that combined an unmarked police vehicle with telephone support to front line officers. Mental health nurses are now based in the head-quarters and help assess information as it comes through.

A training programme, which started in December 2015, aims to deliver mental health awareness training to every officer in the force, up to chief constable level. Importantly Mental Health practitioners have been involved in designing and delivering this, including enhanced training for those in the triage team. There is now a much better understanding across the force that there are different types of mental health units and that people should be treated and not incarcerated. Currently the service runs from Thursday to Sunday from 4pm to midnight. There is however considerable demand after midnight and they are considering extending it to 4am. While challenging, they believe there is sufficient enthusiasm within the team to enable them to staff this.

Those delivering the service have been given the autonomy to continually reshape and develop it, as their understanding and analysis has developed. Regular reviews and re-evaluation, supported by the University of South Wales, have helped inform their thinking. In future this will include an 8-12 week follow up with detainees to identify best practice.

An unexpected finding has been that the client group is much older than anticipated, with considerable demand coming from over 65 single males. Another area of demand is at Aberystwyth University with a notable peak at the beginning of the academic year. The challenge for the team is the geographical remoteness of the university compounded by the lack of any locally based crisis care. Proactive engagement with student welfare officers has helped them manage this.

Strong support and buy-in at a senior level has helped the team embed a more sophisticated view of mental health across the force and develop the confidence to deal with most mental health situations.

Dealing with those under the influence of alcohol and drugs remain a challenge. The launch of the Welsh Mental Health Crisis Concordat in December 2015, should lead the development of a shared understanding and developing of best practice for tacking this and other issues.