1.3: MHRCP - Requests for Police attendance at mental health
facilities
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Table of Contents
Table of Contents
2
New principles
4
The need for change
4
Police responsibilities
4
Scenarios
4
New process for managing requests for Police attendance at mental health
facilities
5
PST - Managing cal s from Health services that request Police attendance:
5
Upon arrival at MH facility:
5
Medication/sedation
5
District Command Centres (DCCs)
6
Matters that should be considered as part of the DCC decision-making process:
6
Disputes and escalation process
7
If available, District Mental Health Liaison Officers (DMHLOs) should:
7
Co-Response Teams (CRTs) or sometimes cal ed Multiagency Teams:
7
Disputes about the need for Police support in a clinical setting, useful phrases may include:
7
Handling reports about violent behaviour towards MH staff within MH in-patient units
7
Communication centre decision-making and escalation process
9
Communications staff receiving cal about attending a MH facility (Inpatient Unit)
9
Escalation process
9
An ECC shift team leader:
9
1.3: MHRCP - Requests for Police attendance at mental health facilities
Note:
- The processes and guidance in this chapter replace certain sections in the current “People with
mental distress and disorders” manual chapter.
- The Mental Health Response Change Programme (MHRCP) is set out over four phases. As Police
come across matters that relate to a phase, they should look to these chapters for guidance.
- It should be noted that Schedule one of the current MOU has been jointly withdrawn from by
Health New Zealand and Police as of 4 November 2024. Police’s primary source of operational
guidance is the “People with mental distress and disorders” and MHRCP manual chapters.
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1.3: MHRCP - Requests for Police attendance at mental health facilities
New principles
If a cal comes from a mental health (MH) inpatient unit, referred to as a MH facility, and there is an
immediate risk of death or serious injury, Police wil respond with the appropriate prioritisation.
Provided the matter is not an emergency, al other cal s from a MH facility wil have the new threshold
applied to them.
If the threshold is not met, Police:
- wil not attend the event, and
- must inform the cal er Police wil not attend.
The need for change
MH facilities sometimes cal Police for matters that do not require an emergency Police response. Many
of these cal s relate to:
- helping MH staff administer medication
- helping to restrain patients
- assistance with moving patients, or
- simply that MH staff feel unsafe and wish Police to provide a security presence.
Many requests from MH facilities draw Police into a space where legislative powers are unclear. Police is
then left to manage an incident that could be better resolved by better decision making.
Set up and design of MH facilities varies across the country, with some located within hospital grounds
and others on separate sites. People who are cared for within these facilities should have a rights and
recovery approach to their care, where restrictive and coercive practices are minimised.
Health staff should explore the many options available to them before requesting Police assistance,
including de-escalation techniques, support from other health staff, environmental changes, and
treatments. Although security support may differ across facilities, under the Health and Safety at Work
Act 2015, health agencies need to ensure they are protecting workers and other persons against harm to
their health, safety, and welfare, by eliminating or minimising risks arising from work.
Police responsibilities
Only under section 110A(5) of the MH (CAT) Act should Police potential y become involved with
restraining a person for MH staff to administer medication. Unless this section of the Act is invoked by a
medical practitioner, no request should be made for Police to restrain a patient for the purpose of
administering any medication.
Scenarios
For scenarios and related examples, please click here.
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1.3: MHRCP - Requests for Police attendance at mental health facilities
New process for managing requests for Police attendance at
mental health facilities
(ef ective from 4 November 2024)
PST - Managing calls from Health services that request Police attendance:
- Obtain basics of event/request and apply risk assessment to establish if it is an emergency or not.
- If the matter
is an emergency, prioritise as normal
- If the matter
is not prioritised as an emergency, direct the cal er to 105 to complete a Non-
Emergency Police Assistance Request. This wil be entered into CAD as a P3 event headlined
“MHS non-emergency request”, which wil be assigned to the local DCC for decision making,
as only the DCC can deploy staff to a non-emergency MH request.
- If Health has completed the Non-Emergency Police Assistance Request Process via 105, await
contact from DCC as to whether Police attendance is approved. If attendance is
NOT approved
ensure the DCC inform the health services cal er of Police’s non-attendance and the reason for this
and update the event details. Cancel the event to the DCC cal sign.
Upon arrival at MH facility:
- if Police attendance has been approved, ensure that attending Police have reviewed the I-Net
event
- advise Comms that you are 10/7 at the Hospital/Ward and ensure this is entered into CARD - this is
required for Police’s col ection of MH response data
- seek guidance and advice from on scene MH staff on the best way to manage the person in
distress. Make the final decision on this after applying your TENR process
- manual restraints can be used after TENR but must not be used routinely or arbitrarily.
Note: Police only has powers to restrain MH patients, proposed patients, and persons in distress where
there is a tangible safety risk to the patient/person, staff, or others.
- the senior nurse on scene is Police’s point of contact and is responsible for providing clear
direction about how Police can assist
- ultimately, Police wil decide if our attendance, involvement, and continued involvement is
appropriate when responding to any cal for MH assistance.
Medication/sedation
Important: Many medications prescribed for mental health purposes have a sedating effect. If Health
staff have medicated/sedated a patient beyond their normal prescribed dosage, then Police
CANNOT
and
MUST NOT agree to transport the patient.
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1.3: MHRCP - Requests for Police attendance at mental health facilities
- An ambulance
MUST be used for a patient medicated/sedated beyond any normal prescriptions -
there are wel -documented and known risks of sedated patients having compromised breathing
and airway risks.
- The DCC may approve an officer travel ing in the Ambulance with the patient and Mental Health
clinician if Police’s TENR assessment is that the sedated patient continues to present a serious
immediate risk to the life or safety of any person.
District Command Centres (DCCs)
- Only a DCC can approve a Police response to a MH facility outside of an emergency. PST must not
attend without prior DCC approval.
- Receive phone cal from ECC, advising of P3 event headlined “MHS non-emergency request”.
Review the event as only the DCC can deploy staff to a non-emergency MH request.
- Once the P3 event is received, the DCC should do the fol owing:
- review I-Net job and update
- complete their own NIA checks
- review any other relevant matters.
- The DCC’s decision should be based on Police’s functions and core business, any applicable
legislative requirements and aligned with Police Instructions. This decision should be
communicated to Health and Police staff.
- Update the I-Net event with DCC commentary.
- If PST attendance is approved, assign to unit as per usual process.
- If attendance is approved, but not PST, update the event with recommendations on further unit
assignment, and update the requestor.
- If the event requires reporting (e.g. an offence that we would not normal y attend, but they should
report), but no attendance, input comment “for reporting”, and update the requestor.
- If Police are not attending, and no reporting required, update I-Net with “cancel event” to the DCC
cal sign and update the requestor.
Matters that should be considered as part of the DCC decision-making process:
- Have Health staff utilised de-escalation techniques?
- Have Health staff used a cooling down period? This may be spread across many hours
- Have Health staff considered requesting assistance from a peer support team and/or whānau?
- Is the person being cared for in a low stimulation area?
- Has the person taken medications as directed by staff? Could further medications resolve the
situation?
- Have Health staff considered whether seclusion is necessary / beneficial? (e.g., Containment rather
than restraint)
- Have security staff at the health facility been ful y utilised?
- Have Health staff considered using paramedics?
- Have Health staff considered the wishes of the patient and their family, whānau or caregivers? The
wishes and views of the patient, their family, whānau or caregivers should be sought as standard
unless this is not reasonably practicable or in the best interest of the patient.
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1.3: MHRCP - Requests for Police attendance at mental health facilities
- What is the rush and need for Police attendance? If there is an urgent need, then ensure that
Police attendance is in the patient’s best interests and not to resolve an operational/logistical
problem for Health services.
Disputes and escalation process
- Avoid getting into arguments with Health staff.
- Remember, unless the request from Health is an emergency, ONLY a DCC can authorise deploying
Police staff to a MH facility.
- If the DCC has declined a Police response and it is clear Health staff insist on a Police response:
- The DCC should speak directly with the requestor and explain the Police decision.
- The DCC should enter a MH RIOD entry with details of the matter and the final decision.
If available, District Mental Health Liaison Officers (DMHLOs) should:
- provide advice to PST or DCCs
- compile recent issues and matters that have been escalated and advise the District MH
Governance Group.
Co-Response Teams (CRTs) or sometimes called Multiagency Teams:
- should comply with the process for normal frontline (PST) staff
- may help Health staff with their risk assessment process and, where required, help to escalate
unresolved disputes to the DCC
- may assist ECC or other PST staff with any response prioritisation - this assistance may be provided
by phone cal or direct entry into I-Net
- may assist the DCC with risk categorisation and decision making for an appropriate Police
response.
Disputes about the need for Police support in a clinical setting, useful phrases
may include:
- “We are focused on what is best for the patient.”
- “We want to ensure the patient gets the best care with minimal Police involvement.”
- “We want to help you provide patient-centred care and reduce risk of trauma and shame through
excessive Police involvement.”
Handling reports about violent behaviour towards MH staff within MH in-
patient units
- Police wil record and assess al reports al eging violent behaviour towards MH staff. Police may
attend where potential criminality is established. Police attendance wil be based on standard
TENR/triage processes, which includes assessing:
- the nature and seriousness of the incident
- the suspect’s relevant history of offending and/or MH concerns
- Police’s current operational priorities and available resources.
- Police wil not take action on the matter unless MH staff are wil ing to provide basic evidential
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1.3: MHRCP - Requests for Police attendance at mental health facilities
requirements, like formal statements to Police.
Note - MH staff wil sometimes ask Police to remove the person from the ward and can be reluctant to
provide statements or other evidence to support Police action. Nonetheless, if a serious assault has
occurred and the victim is reluctant to provide a formal statement, police should seek their cooperation.
- If Police decides to charge the person but the offence is not serious enough for Police to hold the
person in custody or detain them overnight, Police wil need to bail the person. MH services wil
need to advise Police if the person can be returned to the ward, or an alternative MH facility or
other suitable place.
- DCCs should create a RIOD event and report this matter through to the Health Partnerships Team
at PNHQ.
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