Improving safety and access to care through redesigned mental health pathways from police custody
| Outcomes at a glance |
|---|
| • For the first time, custody officers and mental health services across London have a shared, legally grounded pathway, replacing inconsistent local practice with a consistent system-wide approach |
| • Frontline custody officers now have a clear, agreed route to appropriate care for each individual, removing the ambiguity that had previously delayed access to urgent mental health support on a daily basis |
| • Time standards aligned to the Mental Health Act 1983 and the Police and Criminal Evidence Act 1984 are now in place across the system, reducing the risk of legally non-compliant decision-making in custody settings |
| • All partner agencies now operate with defined roles, escalation routes and governance arrangements, including, for the first time, a monitoring framework to track consistency of the pathway across London |
The challenge
Across London, people with acute mental health needs were spending extended periods in police custody because the pathways into appropriate mental health services were inconsistent, unclear and often ineffective
This created significant challenges, including:
- Increased risk to individuals due to delays in accessing urgent mental health care
- Additional pressure on police officers and custody staff who are not equipped to provide mental health support
- Operational strain across already stretched public services
- Difficulty meeting legal requirements under the Police and Criminal Evidence Act 1984 and the Mental Health Act 1983
NHS England London’s Health and Justice team identified the need for a revised, system‑wide approach, with clear standards and shared agreement across agencies that would work consistently in practice
Our approach
We were commissioned to lead the design of a new, coordinated mental health pathway, working across multiple agencies to develop a solution that would be practical and deliverable in the real conditions of custody settings.
The approach combined evidence review, stakeholder engagement and co‑design, including:
- Interviews with frontline professionals across police services, local authorities, mental health trusts, emergency departments and Liaison and Diversion services.
- Conducted an evidence review and analysis of Liaison and Diversion data (the services that identify and support people with mental health needs from when they first come into contact with the criminal justice system) to understand variation and system performance across London
- Established and facilitated a multi‑agency Task and Finish Group to develop and agree solutions collaboratively across agencies
- Led dedicated engagement with people with lived experience of mental health needs in custody settings, ensuring the pathway reflected real needs rather than just system convenience
- Development of clear supporting documentation, including protocols, guidance, a decision support tool and implementation materials
The impact
The programme delivered a clear, practical and system‑wide pathway to improve how people with mental health needs are supported in police custody.
Key outputs included:
- A decision support tool enabling custody officers to identify the most appropriate pathway for individuals
- The introduction of a decision support tool, agreed protocol, and clear time standards has strengthened coordination across agencies and improved consistency in how individuals are supported in custody.
- A multi‑agency protocol clearly defining roles and responsibilities across all partner agencies
- Time standards aligned to the Mental Health Act 1983 and the Police and Criminal Evidence Act 1984 to support timely, legally compliant decision-making
- A simple, accessible flowchart supporting consistent use in practice across custody settings
- A coordinated implementation plan covering governance, communication and monitoring
The output from this work gives custody officers, mental health services and system partners a shared, legally grounded framework for the first time, replacing inconsistent local practice with a consistent London-wide approach.
The model is designed to be replicable, and provides a practical template for other regions seeking to bring consistency to mental health pathways across complex, multi-agency custody environments
Ready to start a conversation? If you’re working to improve mental health pathways or bring consistency to complex, multi-agency systems, we’d be happy to talk through how we can help. Get in touch with one of our specialists to discuss your challenges.
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