Once upon a time a long time ago on a division in a force I used to work for a team of senior officers came up with an idea.
In order to start investigating crime better right from the outset there was going to be a dedicated “Crime Car”. This car would operate on two shifts (7-3 and 3-11) from Monday to Friday. First of all this conveniently forgot that crime happens at night too!
A detective from the CID would be allocated to the car and would bring their considerable expertise and investigation skills to the project. The second officer would be a uniformed constable provided by the section relief on duty. In most cases this officer was a probationer who couldn’t drive. This was a tactical decision by section Inspectors to keep their drivers to cover the cars and van.
This team would be assigned a plain vehicle and would respond to important crimes on the sub-division. Officers from section would still attend if an emergency but when the dust had settled the crime car would pick up the lead.
The crime car was promoted as the panacea to all that was wrong with initial crime investigation. On paper it looked and sounded awesome. In reality it was flawed.
The crime car would attend burglaries. There were always several of those to deal with. The crime car would attend robberies or theft from the persons. They would investigate, take statements, organise SOCO (CSI as we are want to call it at present) and ultimately the detective would carry the crime.
Sadly, demand was high. The Crime Car never fulfilled its title because if tied up taking statements at a burglary they couldn’t attend the robbery in progress at the post office. If tied up at the robbery they couldn’t attend the three outstanding burglaries. The jobs backed up and the public got a poor service waiting even longer for officers to attend.
Then a situation began to develop whereby the crime car was asked to attend domestic assaults or shoplifters. The argument on the radio was “well it is crime and you’re the Crime Car” so get on with it. The Crime Car became utterly and completely swamped. It wasn’t thought out properly, it’s role was too broad and consequently it fell over…. every day.
The hot topic in policing at the moment is mental health. The topics and issues around mental health and the Adebowale Report have been widely discussed and blogged upon by my erudite colleagues @mentalhealthcop and @nathanconstable
The topic within the topic today is the Triage Car. 
This has been trialled in Leicestershire and Cleveland. The Leicestershire NHS Trust made a press release today praising its success. Meanwhile it has been announced that the scheme will be rolled out to five further forces.
On the face of it this all looks rosey and is redolent of that heady optimism when the Crime Car was launched. Yet I find myself wondering how effective it will be.
Mental health cases are not limited to Mon-Fri 9-5. They, like policing, are a 24/7 demand. In order to cover this fully you need two 
12hr shifts per day or the three 8hr shifts. The latter is the more likely. For the sake of the argument then we will say that 5 nurses will be needed to cover a full 24/7 shift pattern 7 days a week. Can the NHS fund such staffing? Will they have this role and their normal duties and paperwork that creates a competing demand scenario? The NHS will not want to pay a nurse to sit in a car doing nothing waiting for a job any more than the local commander his/her constable. It’s wasteful and as such they will both look to ways to obtain value from that resource. Inevitably this will lead to the nurse sitting at a desk completing paperwork and the Triage Car attending non mental health incidents as they are a resource and can lend a hand.
The area of responsibility then needs to be determined. Will they work on a BCU level, borough level (Met) or force wide? This clearly has to be established by population and demand. Inner city areas may be smaller in size but may have a population equivalent to a whole BCU of a shire force. Consequently a Triage Car could be covering a relatively small geographical area to one that is hundreds of square miles. If the Triage Car has no work and agrees to assist at an accident scene then it cannot respond immediately to its core function. If a crime occurs under their nose then the officer on the Triage Car has to act. Even if the arrest is handed over the officer will still need to complete statements. As many police officers will tell you; there is often nobody free to take that responsibility from you.
If the Triage Car is 2 miles away from the incident then it’s great. What happens when it’s 30 miles away? Officers at the scene cannot simply press the pause button and wait.
I am not convinced that Triage Cars are the golden solution they are being lauded as thus far. The demand is unpredictable. You can go days without a mental health case then get three at the same time. The demand can be spread far and wide and responding to that can be time consuming. When down time occurs, do they sit twiddling thumbs waiting to leap into action or will they be detailed to other tasks? Either way it is wasteful or creates a situation where they cannot respond because they are tied up elsewhere. Sound like the Crime Car?
There are two points in the press release that give me some concerns.
Since the pilot started, the Triage Car has seen a reduction in the number of people detained under Section 136 of the Mental Health Act by around 40 per cent, and is saving the partner organisations £9,700 a month.
This figure, considering the time the trial has been running, has to be questionable. Has it been running long enough to make such a bold claim? I think @simonjguilfoyle may have a view on that.
The second is this;
Staff either go to incidents in the Triage Car, or advice is provided to other officers over the phone.
We have a vision of a Triage Car zooming around force areas responding to and getting great outcomes at mental health cases. A real hands on approach. How long before it becomes little more than those last few words? A telephone advice service?
Police officers are not mental health specialists. However, having explored all options open to them and deciding that s136 fits and is their best outcome, they know what to do and what their powers are. What they need post arrest is a support network that positively accepts its area of responsibility, cares for those in need and doesn’t try to delegate its role to the police because they don’t have staff, a bed or the correct facilities.
The NHS need 
the infrastructure to care for acute demand as and when it arises so they can fulfil their obligations, ensure the best possible care for people who are ill and keep mental health cases out of police custody.
That won’t be solved by putting a nurse in a car.
The Custody Record 
A person with experience who thinks in a common sense way. Please go and run a mental health trust somewhere or indeed how about becoming Home Secretary!
The way you describe it there could be a similarity between that and the long waits for place of safety or indeed mental health act assessments. Yes ok they may be cutting down on m h act assessments but have they done triage trial statistics on what has happened after a decision not to section 136?
We had a sort of similar idea locally where the crisis team became centralised and ended up chasing across the county wasting much time on the roads. Achieving very little with waiting times for help getting longer. Other crisis calls were not attended quickly enough. I was in a situation where police and ambulance in attendance to my own m h crisis who were cursing and swearing while trying to get help for me at 9.30pm. The 2/3 staff on duty covering the county were unable to attend. Needless to say there has been a move back to local cover but not entirely as organisations are not so quick to admit they had got it wrong.
Here’s hoping that after the initial euphoria about street triage that the pros and cons are looked at long and hard.
Why is the ambulance service not running this? Or are they busy locking up crims?
This does sound an axel lent idea, but I think that is probably what it’s meant to do. Mental health is a much misunderstood, and often ignored, subject. It impacts into the lives of many. There would need to be far more than 1 mental health professional available. I wonder if this route might lead to a realisation that the 1 MH professional isn’t enough, we can’t afford any more so we’ll train certain Officers up. Therefore, after ‘going on and completing the appropriate course’ there will be MH cover of a kind. I worry that this may be the start of expecting Officers to be trained basically, in a vast array of specialisations, many of which they may never use; the figures/ targets can then reflect that fact. Sadly, although MH is a serious problem with widespread implications, the structure and funding has to be in place before the Triage Car ever sets wheels on the road, and even more sadly, neither the money or trained personnel probably exist. Great idea, but, like so many others, not thought through.