Predicting demand and pressures. Mark Smith Head of suicide prevention and mental health

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1 Predicting demand and pressures Mark Smith Head of suicide prevention and mental health

2 British Transport Police 2014/15 2,972 police officers 247 special officers 323 PCSOs 1,533 police staff 46,688 notifiable offences 406 rail fatalities

3 Impact of fatalities Fatal & Injury Events 2012/ / /2015 Total Fatal Suicide Total Fatal Suicide Total Fatal Suicide NR Lost Minutes 387, , , lives lost each year 60m cost to the rail industry each year 12,646 police deployment hours

4 Managing fatalities

5 Background BTP deal with some 400 fatalities on the railway each year High levels of resulting disruption Fatality incidents are complex and challenging for officers Large number of unexplained classifications Balance the need to investigate thoroughly with impact caused by police actions Need to change risk averse culture Research informed new strategy and operational guidance

6 Risk Averse A different approach Absence of information invariably led to immediate Unexplained Classification This launched a Think Murder type approach CSE and SIO attendance often from significant distance Body not touched so no early ID to progress enquiries Limited partial re-opening Significant delay Outside performance framework v Risk Managed Pre-classification stage Partial re-opening at earliest opportunity Early search of body Fast track actions Driver account, CCTV etc Intelligence on subject and info from NOK Classification takes longer but allows a much quicker return to normal Inside performance framework In first year reduced unexplained classifications from 101 to 30 and disruption by 21%

7 Suicide & mental health 2014/15 1,334 people tried to take their own lives on the railway 327 were killed 72 survived with serious injury 935 physically prevented from taking their own lives 289 calls to the Suicide Prevention Hot Line 1,156 people subject of joint police/health Suicide Prevention Plans 1,773 detentions under S136 Mental Health Act (includes 65 S297 detentions by BTP in Scotland) 3,570 Pre-Suicidal Incidents

8 Comparative data 2014/15 2,029 serious assaults 1,399 sexual offences 358 robberies 1,455 motor vehicle offences 12,039 thefts of passenger property

9 SPMH Teams Divisional Units in London Birmingham & Glasgow London & Birmingham units have NHS staff working in them (Industry/NHS funded ) They use joint risk management processes to concentrate activity against high risk cases RA tool devised by Oxford University and considers Aggravating and Protective factors FHQ Unit has policy and analysis role and strong links with Rail, NPCC, COP, Health, PHE, Government and 3 rd Sector

10 Key prevention themes Effective primary care for depression and anxiety Understand vulnerabilities- people and places Target harden the railway Public messaging - lethality of the railway Effective intervention, risk assessment & case management Multi agency safeguarding

11 Hot Spot identification Samaritans training Engineering solutions

12 Operation Avert tactics 64 National hotspot locations identified Key days and times Briefing slides of high risk individuals Local community engagement and Wellbeing surgeries High profile patrols involving police, rail staff, Samaritans, special constables and community volunteers Proactive approach to people who appear in distress or where behaviour causes concern

13 Life saving interventions 2014/ potential life saving interventions 725 to hospital, 103 to Custody (BTP 6) 526 by police (BTP 224) 236 by rail staff 129 by public, family or friends

14 SPMH - how does it work? Real time advice, intel & liaison with local health Review previous 24 hrs incidents Joint risk based decisions Suicide Prevention Plans for relevant cases GP letters, Referrals & sign-posting Post incident follow ups Support and enforcement - Acceptable Behaviour Contract (ABCs) Situational prevention visits and PSGs Awareness meetings, focus groups, joint training Referrals to MASH/MARAC/SAB CRISIS TO CARE

15 SPMH results 2014/ SPPS opened 1442 info/locate markers on PNC 10 subjects went on to take their own life (7 on the railway) Represents 0.86% fatality rate (0.6% on rail)

16 Costs 2014/15 Fatal & injury attempts cost Network Rail;- 60m Fatal and injury attempts will have cost London Underground:- 4m Total rail operating Costs:- 64m BTP fatality deployment 760k Total annual BTP SPMH staff 900k Total annual external SPMH 736k Total BTP operational 2.4m 327 suicides UK whole community cost(1) : m TOTAL COST RAIL SUICIDE 540.6m 1. Knapp M, McDaid M, Parsonage M (eds) (2011) Mental Health Promotion and Mental Illness Prevention: The economic case. PSSRU, LSE and Political Science

17 Potential savings 2014/ Life saving interventions on Network Rail represents a potential saving of;- 140m 87 Life saving interventions on LU represents a potential saving of :- 8.7m 935 suicide interventions UK whole community cost prevented:- 1.36b Total Costs GB Rail/BTP Total Saving to GB Rail TOTAL COST RAIL SUICIDE TOTAL SAVING RAIL SUICIDE 66.4m 148.7m ( 82.3m) 540.6m 1.5b ( 0.96b)

18 Crisis Care Concordat February 2014 BTP one of 22 national Signatories December BTP link in to local declarations March BTP input to local action plans: 1. Local Railway related data 2. BTP potential to refer at risk individuals 3. How we link into S136 protocols 4. BTP request for info from health around those at risk of suicide 5. Linking in with local joint training

19 Early warning system Distributed to: Network Rail Train Operators Mental Health Trusts NHS Confederation Voluntary Sector Change in Deployment Strategy 1 call a day to the Hotline since February 2014

20 Zero suicide ambition Depression and Suicide How do we treat depression in the UK? Why don t many suicidal people get detained in Hospital? Announced by previous Government Pursuing Perfect Depression care model Restricting Access to Means Pilot Schemes in our high demand areas East Anglia, Merseyside, South West A chance to intervene with those who have yet to attempt rather than those who have Our ambition Zero Suicides amongst our SPP subjects C. Ed Coffey MD CEO Behavioural Health Services Henry Ford Institute Detroit If Zero is not the right goal, then what is?