Introduction

Click on the questions below to read feedback from people who have attended NAAN's appropriate adult training.

Was the training pitched at the right level for its purpose?

·         A good amount of detail, well explained. As an OT amongst a group of social workers I was still able to follow and grasp the subject matter.

·         Absolutely the knowledge and experiences shared by Grev, was really appreciated and enhanced the learning.

·         Adequate and informative

·         Content was very beneficial

·         Covered all aspects needed

·         Delivery was very engaging

·         Detailed, informative and appropriate

·         Found it very useful.

·         Good clear narrative to support the slides

·         Good pace

·         Good recap on what we've been told before

·         Good training, a lot of information that was relevant and easy to understand.

·         Great, engaging and comprehensive training

·         Informative and effective training. Good use of gap exercises and discussion. Very knowledgeable.

·         Interesting, informative, challenging but at a good level. Learning without being overwhelmed.

·         It was engaging and presented in a manner I understood

·         It was helpful to learn about the role of the appropriate adult in a mental health setting

·         Proper breaks to assimilate information  Lots of discussion

·         Really enjoyed it and has further enhanced my knowledge about being appropriate adult

·         Really enjoyed the course and found it iuseful

·         Really good training, well presented and a great learning experience

·         The course was very interesting, there was a lot to learn, of course more time on each subject would have benefited, however, I feel that the course was the right balance of learning, questioning and group activities to obtain enough information to start the role.

·         The session was pitched at an appropriate level

·         The trainer was very helpful in the way that he pitched the training in making (sure - my edit) each subject was understood and retained. It was very appropriate for the role within a mental health setting.

·         The training was interesting and informative

·         This was an excellent day. Training was delivered in a very approachable way and hence I feel I have learned a lot, it has fuelled my interest and made me even more determined and enthusiastic to be part of Headways future AA plans.

·         Training gave me confidence and a good insight to what an AA involves.

·         Training was extremely informative and accessible and answered questions that was not sure about.   Well presented and information

·         Very clear and concise  Informative in all aspects

·         Very enjoyable

·         Very enjoyable

·         Very good training, interactive, good knowledge and confidence in being an AA

·         Very informative  A lot of discussion was had

·         Very well covered in a short time

·         Well informed refresher course

·         Well paced and explained

·         Yes key points covered numerous times throughout the day to make sure that we understood the role of the appropriate adult

Was the right balance struck between breath and depth?

·         Liked re-capping and checking understanding  - Key points reiterated

·         A bit rushed at the end - but running out of time!

·         As above

·         Enough time was spent on each topic. Good refresher.

·         Felt right, good to cover theory then go into the custody suite to see 'reality'

·         Good balance

·         Good balance of information in one day.

·         I feel that everything was covered in the right amount of time

·         I think just a bit more on confidentiality

·         I thought that the training would be how to become an AA and the process involved becoming one.

·         Information was delivered at a steady pace and very current

·         Modules broken down and relayed well.

·         Mostly about right but some subjects were a bit rushed die to time constraints

·         N/A - What was delivered was great!

·         Perhaps a few more examples/anecdotes

·         Steady pace, allowed for interaction within the group. Topic of interest. Would be useful to some of my outreach team.

·         Subjects were appropriate to client based service, and correct times spent on each subject.

·         Very informative and explained in depth

·         Would liked more time on the final slide show from the psychologist

How much have your knowledge/skills improved?

·         A role play would have helped.

·         As I am new, I got to learn a lot of stuff i'd never encountered or even heard about

·         At start of training had some idea about procedures/process but clearly have a much better understanding

·         Course delivered very well by Grev

·         Excellent training. I feel really informed.

·         Excellent training. Knowledge gained and skills will be improved

·         Eye open and informative

·         Feel empowered and more confident

·         Feel more confident/prepared for when requested to act as an appropriate adult

·         Feel suitably prepared and reasonable confident with the role

·         Good feedback from people attending

·         Have never been an AA before. However, would feel confident enough to be one.

·         Having been an AA for patients from PHC Linder psychiatric hospital to care and look out for clients, it was good to learn the legal aspect.

·         I feel th abd at i know much more and it has made me feel far more confident.

·         I had no idea what the role involved and now have a clearer knowledge of what it entails

·         I have not had this training in many years, so I found it very helpful.

·         I learn't more in this one day course than the two day course that I attended.

·         I learnt the role of the AA and the rationale behind the role

·         I now feel ecquiped to undertake the role.

·         I realised how important this role is and how important it is to speak up.

·         I was happy with the training

·         I was totally blind of what was concerned about. Learn a lot.

·         Improved and updated skills and knowledge. Gave me more confidence etc

·         In-depth discussions after slides and handouts to be able to let the info sink in

·         It has also given me a lot of confidence because I understand the role better.

·         It has give me more insight into the role outside of the hospital setting

·         My skill set was challenged because of the course material. This will help my professional growth.

·         My skills/knowledge have enhanced making me understand my role as an AA in Feltham better

·         Need to do more background reading the material. Codes of practice.

·         Position in relation to legal rep.

·         The info was given over the whole session not just in each module so actually the cover was better.

·         The training was very informative, gave me a true understanding and a lot of knowledge about being an appropriate adult.

·         Very empowering

·         Very engaging and trainer clearly an expert. Very informative.

·         Very useful and well presented.   I have gained much more confidence at the thought of attending the police station with service users

·         Would have liked more videos on examples of an AA interview situ at police station

·         Would still need a lot more knowledge/skills development to become more confident

Will you be doing anything differently as a result?

·         More confident in the event I need to be an AA and know a lot more in terms of what to expect

·         Added into work rota for being an AA

·         All new learning so will take it all forward

·         As team, we will request a police document to be put together for our establishment

·         Be a clearer advocate on behalf of young people and more confident to challenge procedure or what might be inappropriate

·         Be confident to challenge the police.  Very interesting course! Thank you!

·         Before the training I was not aware that I could see the custody record

·         Better understanding of the role of AA/legal. Asking more questions at the police station. Scrutinising a copy of the custody record.

·         Clarification on shaking hands

·         Definitely consider taking up an AA position outside of Headway

·         Feel completely equipped to commence in the AA role

·         Feel confident if asked to be an AA.

·         Feel more confident to be called upon as an AA in future. The course has increased my knowledge of the process and procedure of being an AA and what it entails.

·         Feel more confident to voice concerns. Much better equipped to be an AA.

·         Feel very confident being an appropriate adult when/if called on

·         Feeling more confident in the role of the AA

·         Feeling more confident in the role of the AA.

·         Get more involved in the interview process if there is something wrong and be able to offer more help to the detained person

·         Have never been an AA before - however, would now feel condfident enough to be one.

·         Haven't been an AA yet, therefore more confident that I know what my role would be and that i'd be able to support a service user in that situation.

·         Having never acted as an AA previously I found the course gave me a good foundation for the role.

·         Hopefully gaining experience

·         Hopefully I will become an active AA for Headway in the north east

·         I am aware that I can challenge the police and staff if required, request legal representation if declined by detainee

·         I am more aware of the AA's powers and will be more confident in the role.

·         I am now fully aware of the do's and dont's expected from an AA and feel confident if I choose to move forward with it.

·         I feel after today more confident in my role as an appropriate adult

·         I had no expectations of the AA role, that said it is a lot more involved than I first believed so the training was very useful for required knowledge and expectations.

·         I have a better understanding of my powers as an AA, and feeling confident in that role.

·         I have been made more aware of this role and feel it would be something I want to pursue

·         I have gained a better understanding of the role of an AA. I will put this into practice when needed.

·         I have never been an AA so hopefully I will be able to do things in a reasonable positive way.

·         I have never done it before but would be confident going forward

·         I haven't acted as an AA in this setting yet

·         I haven't done any work as an appropriate adult yet so really I am unable to comment.

·         I know a lot more about the persons rights and my role as an AA. I will be more confident and will question the process more to ensure that the person is treated fairly.

·         I now feel more comfortable in being able to stop an interview and know when to.

·         I now have knowledge and understanding of the role

·         I now know what to do.

·         I understand more the importance of an AA now.

·         I wasn't an AA before

·         I will be able to apply this knowledge

·         I will be challenging police officers when I feel things are not right, like when my YP's need a break etc.

·         I will be looking into becoming an AA

·         I will look at the case studies included in the slides.

·         I would know what rights I have as an appropriate adult, what to do when acting as an appropriate adult, and when to interject in an interview and to ensure that it is conducted fairly.

·         I wouldn't have felt comfortable doing this role without the training - although I am still apprehensive, I feel much better prepared.

·         If called, on the empowering nature of this talk would change my approach

·         It will give me greater appreciation of the role of the AA and what to expect if my clients are detained.

·         Liaise with local police re ID card and AA role locally.

·         More callouts - builds on confidence  Talking to colleagues about their experiences

·         More confident when dealing with the police

·         N/A

·         N/A - No previous experience of the role

·         No previous experience of being an AA. Therefore everything I know is from today't training  I won't be frightened to speak out in the police station. If I have a concern for the client, I will say so.

·         Not be afraid to speak up. Not be intimidated.

·         Not been an appropriate adult before but will definitely know what I will be doing if I ever did.

·         Not undertaken role as yet so no changes to make. But I will feel more informed.

·         Now well informed of the role, the rights of the person and the rights of the AA.

·         Put appropriate adult skills into practice

·         Supporting survivors of a brain injury as an appropriate adult.

·         This was our first training

·         Will ask more questions. I feel more confident in my role as an AA.

·         Will use new confidence and knowledge to support survivors of acquired brain injury

·         With a lot of confidence and knowledge

Please ensure you have read the Membership/Discover section before completing this form. All data is subject to the Data Protection Act 1998. The National Appropriate Adult Network Limited will use the information recorded on this form to process your application for membership. We may use it to produce a register of members and to send you relevant information. We will not pass this information on to any other person(s) without your express consent. By completing this form you give consent to your contact details being made available to other NAAN members, subject to a sucessful application. By clicking submit below you agree to your data being used for this purpose.

PACE Code C requires police to secure an appropriate adult whenever they have suspicion, or are told in good faith, that a person may have a mental disorder or other mental vulnerability.

Across the country, police forces are increasingly developing and supporting card-based identification schemes. These cards can be helpful in assisting police to identify mental vulnerabilities. They are all voluntary.

Click on a card name below for more information. If you know of a scheme that's not listed, please tell us about it

Card name Police forces area
Pegasus Nottinghamshire, City of London, Dyfed Powys, Lincolnshire, Surrey, Sussex
E-Card Lancashire, Greater Manchester
Keep Safe Cymru   South Wales
Autism Alert Devon & Cornwall, Thames Valley (Oxfordshire), Kent, Hampshire, Essex, Suffolk, Norfolk, Cambridgeshire, Hertfordshire, Befordshire
Autism Attention West Midlands, West Mercia, Warwickshire, Staffordshire, British Transport
Brain Injury ID Pilot project - see list of areas

Pegasus

pegasus card


Police Forces: Nottinghamshire, City of London. Dyfed Powys, Lincolnshire, Surrey, Sussex

The Pegasus system was developed by Chris Channon MBE, a former paralympian who has cerebral palsy. It is aimed at those whose disability or illness makes it difficult for them to communicate when calling or speaking face to face. It’s designed to make it easier to contact the police quickly and easily. It’s a secure database which contains details registered by an individual. They only have to say ‘Pegasus’ and give their pin number or show their Pegasus card to an officer. The Pegasus scheme is currently arranged at a local level. the card image above is from Sussex police and may look different in other areas.

How to get the card: Click on your police force to find out how to apply; Nottinghamshire, City of London. Dyfed Powys, Lincolnshire, Surrey, Sussex.


E-Card

ecard GMP

Police Forces: Lancashire, Greater Manchester

Lancashire Constabulary have developed an emergency information card, which aims to assist people with disabilities to communicate with police or other emergency services. It is credit card sized and has space for the person’s name and photo, medical condition, details of an emergency contact person, and other useful information such as communication needs or requirements in an emergency. The E Card is free of charge and distributed via various channels including NHS mental health teams. It was funded in partnership with Lancashire County Council, Physical Disabilty and Sensory Impairment (PDSI) and Lancashire Partnership Against Crime. the card was launched in 2007, has been identified as best practice by MIND and received recognition from in the media.

How to get the E-card



Keep Safe Cymru Card

safe cymru

Police Forces: South Wales 

Mencap Cymru, Learning Disability Services and South Wales Police have jointly developed the scheme for anyone in the South Wales force area with a Learning disability or mental health and communication need.

How to get the Keep Safe Cymru card



A
utism Alert Card

There are a wide variety of Autism Alert Cards in use. As initiatves are local, designs vary widely between areas.

autism alert


Police Forces: Devon & Cornwall

The Autism Alert Card is free, plastic and credit card sized It can be issued to individuals aged 10 or over who live anywhere in Devon, although similar schemes are in place in other areas of the country and so the card may be recognised elsewhere.

How to get the Devon and Cornwall Autism Alert card

alert card

Police Forces: Thames Valley (Oxfordshire only)

How to get the Oxfordshire Autism Alert card

kentautismalert

Police Forces: Kent

How to get the Kent Autistic Trust Autism Alert card

Hampshirealert

Police Forces: Hampshire

How to get the Hampshire Autism Alert card (a smartphone app is also available)

alertanglia
Police Forces: (Anglia) Essex, Suffolk, Norfolk, Cambridgeshire, Hertfordshire, Befordshire

How to get the Autism Anglia Autism Alert card



Autism Attention Card

autism attention

Police Forces: West Midlands, West Mercia, Warwickshire, Staffordshire, British Transport

Autism West Midlands have developed the Attention Card in partnership with police services across the West Midlands. It has space on the reverse to include the contact details of a trusted person. In stressful situations professionals are able to contact this person.

How to get the Autism Attention card 


Brain Injury Identity Card

braininjurycard

The Brain Injury Identity Card is currently being developed by leading brain injury charity Headway. It is designed to help identify a brain injury and ensure that the survivor receives an appropriate response. The card also displays a 24 hour criminal legal assistance helpline number, should a brain injury survivor require legal advice. 

For more information about the Brain Injury Identity Card, email This email address is being protected from spambots. You need JavaScript enabled to view it.

Who's looking out for the adults?

by Chris Bath 

 

Summary

Appropriate Adults (AAs) are a critical safeguard for children and mentally vulnerable adults detained or interviewed by the police. However, there is no statutory provision of AAs for mentally vulnerable adults. Identification rates of mental vulnerabilities are historically very low but look set to increase with the Government's investment in Liaison & Diversion in custody suites. This will increase demand for AAs. At the same time, pressure on local authority budgets mean non-statutory services are under intense threat.  If false confessions and other miscarriages of justice are to be avoided, cooperation around pooled budgets and regional co-commissioning is urgently needed, involving all parties with an interest in the welfare and rights of mentally vulnerable adults.

Download a short briefing on this issue. 

Appropriate Adults

Under the Police and Criminal Evidence Act 1984 (PACE) Codes of Practice, police custody sergeants must secure an Appropriate Adult (AA) to safeguard the rights and welfare of vulnerable people detained or questioned by the police. This is a critical safeguard in our justice system that arose in part due to vulnerable people confessing to crimes they did not commit. 

Originally covering juveniles (10 to 16 year olds) and mentally vulnerable adults, the anomaly of 17 year olds being treated as adults in police stations enjoyed a high profile in 2013. Long a concern for NAAN, and many others, the issue was highlighted in the Criminal Justice Joint Inspection report Who’s looking out for the children (2011). Then, following a judicial review, PACE Code C was amended to ensure 17 year olds, and therefore all children, have the support of an Appropriate Adult.  

Demand: the prevalence of mental vulnerability

Arguably a bigger concern (if only by sheer volume) is whether anyone is ‘looking out for the adults’. At any one time, one in six British adults (around 8 million) is experiencing at least one diagnosable mental health problem.[i] An estimated 1.2 million people in England have learning disabilities (2.3%), of which 75% are adults[ii].  Four per cent of the population have severe dyslexia.[iii] Some 39% of people in contact with probation have a current mental health condition, while in prison rates are much higher. Between 20 and 30% of offenders have learning difficulties or learning disabilities that interfere with their ability to cope within the criminal justice system. For example, a person may find it be difficult to understand and participate effectively during a police interview.[iv]

Supply: the lack of statutory provision

However, despite the requirement in PACE Code C, no agency has a statutory duty to provide AAs for vulnerable adults. Consequently, the existence of formal services, using trained, vetted individuals who attend when family or carers are unavailable, is limited. Some areas have ad-hoc arrangements.  Social services emergency duty teams may respond if they have no higher priorities. In other areas services are entirely non-existent. In contrast, statutory provision, under the Crime and Disorder Act 1998, means Youth Offending Teams provide or commission a service for children in every local authority in England & Wales.

Historically, where provision for adults has existed it has typically stemmed from local authority adult social services and NHS mental health trusts. Some police forces, and more recently some Police & Crime Commissioners, have also provided financial support, though police employees are prohibited from acting as AAs for obvious reasons of independence. However, continued budget cuts mean any non-statutory service is under severe threat. NAAN has been contacted by several police forces and AA schemes that have been advised that local authority funding for AA services will end in April 2014.

Such cuts clearly affect the police’s ability to deal effectively with adults that are mentally vulnerable or experiencing mental illness. If AA schemes are lost, police will need to constantly source untrained individuals ‘off the street’ or try to create and manage their own schemes – raising issues of skills, resources, efficiency and most importantly, of independence.

The problem of identifying mental vulnerability

One possible reason why commissioners may not have may not have AAs for mentally vulnerable adults on their on their radar is an apparent lack of demand.

Rates at which mental vulnerabilities are identified in police detention are extremely low. Given the prevalence of mental vulnerability in society, and the justice system, in particular, annual demand for AA call outs ought to be much higher than it is. One study, which analysed over 21,000 police custody records, found an AA was used in only 38 (0.016%) cases.[v] 

There are around 1.2 million arrests in England & Wales for recorded crimes annually. A NAAN survey of police forces in 2009/10 found that only 12 regional forces (of 34 respondents) reported any call outs of AA services for vulnerable adults. Of these, the Metropolitan police accounted for 54% of the reported 14,436 call outs annually. Excluding the Met, the South West (Dorset, Devon & Cornwall and Avon & Somerset) accounted for 50% of the remaining 6,636, with call out rates ranging between police forces from 4 to 120 per month.

Academic studies have suggested multiple factors affecting whether AAs are called out for vulnerable adults. These include: the skills, training, experience and attitudes of the arresting officers and the custody sergeant; the offence type; the arrest circumstances; the presentation of the individual, and pressures in the custody suite. This is supported by the findings of the joint thematic inspection on learning disability published in January 2014. Inspectors found that Appropriate Adults were not always called, even when it was recorded that the detainee had a learning disability. They concluded that, "The identification, assessment, referral and diversion of offenders with learning disabilities, and the provision of Appropriate Adults, depend on the ability of police officers and other custody staff to recognise learning disability. This is, in part, dependent on the level of training provided to officers and other staff."[vi]

It is not that the police don’t have strong incentives to call an AA. Breaches of PACE risk rendering evidence gained during interview inadmissible in court, not to mention disciplinary action. PACE Code C is clear that anyone “mentally disordered or otherwise mentally vulnerable” has the right to an AA. The threshold is intentionally set very low to reflect the fact that police personnel are not, and cannot be expected to be, experts in mental vulnerability. Custody sergeants are directed to call an AA whenever they have any doubt about the mental state or capacity of a detainee. PACE is clear that, once someone is identified as being mentally vulnerable, the police cannot proceed without an AA present.

This is a critical point. Once a custody sergeant recognises that an individual might be mentally vulnerable, the whole process stops until an AA can be found. Where there is a high-quality, reliable, quick-response AA scheme to call on, this does not cause a problem. However, without such provision, and in a busy custody block with over-stretched officers, there is a powerful disincentive to identify.

A vicious circle therefore exists in which the lack of supply creates an apparent lack of demand, which in turn fails to generate pressure to increase in supply.

Liaison & Diversion: an opportunity for change

In England, the Department of Health has announced a welcome £25 million to further develop liaison and diversion services for children and vulnerable adults in police custody. Their purpose is to identify and assess individuals suspected of having, amongst other conditions, mental ill health or learning disabilities, to ensure support, and to help inform criminal justice decision making. The Government’s commitment is that liaison and diversion services will be in every police custody suite by 2017, run under the auspices of NHS England.

The good news is that this investment will do much to solve the issue of chronic under-identification of mentally vulnerable individuals. The bad news is that, just as the vicious circle is broken, AA provision for vulnerable adults may be almost non-existent. This presents a risk to the liaison and diversion programme, and to efficient police custody processes.

Impact

With the exception of the vulnerable people themselves, it is frontline police who will feel the lack of AAs most keenly. Set neatly between a rock and a hard place, local stations are already in debates about setting up their own schemes.  This is both entirely understandable and deeply concerning.  Appropriate adults are a critical part of the checks and balances of our justice system, protecting the most vulnerable from potential abuses of police power. Even well intentioned police run schemes are at risk of breeding compliant AAs, creating distrust in the mind of the person being detained, and damaging public perceptions of independence.

Solutions

Due to their historical support in some areas, one option is to look to adult social services or mental health trusts to avoid retrenchment and increase spending to meet the demand. Another possibility is that, since it impacts significantly on an NHS England project, they should find the money. Alternatively, it might be argued that, because the duty arises out of PACE, the police, Police & Crime Commissioners or the Home Office are solely responsible.

Ultimately, the answer is to place appropriate adult provision for mentally vulnerable adults on a statutory footing, as envisaged by Lord Bradley in his 2009 report. This approach would ensure parity with children’s AA services, provide clarity and accountability, and prevent mentally vulnerable adults from ‘slipping through the cracks’ between agency responsibilities.  It would also ensure independence from the police, allowing them to focus on their core role, avoiding conflicts of interest, reinforcing the need for challenge and encouraging public confidence.

In the meantime, it is critical to act now to save existing provision. The cost of an appropriate adult scheme is small, with the role often fulfilled by parents, carers or volunteers, and opportunities to expand existing schemes. To replace such experience and knowledge will be far more expensive.

However, to place responsibility with a single agency would be to ignore the complexity of mental vulnerability and the harsh reality of the current economic climate. The range of needs (and therefore agency budgets) is broad including: mental health, learning disabilities, ADHD, autistic spectrum disorders and Asperger’s syndrome. If any one agency were given the choice between funding it all, and not funding it at all, they would likely find it impossible to do the former. Even a small cost is currently burdensome for any single commissioner.

So, if false confessions and other miscarriages of justice are to be avoided, and if the massive investment in liaison and diversion is to be successfull, cooperation is required. Discussions about pooled budgets and regional co-commissioning are urgently needed and should involve: adult social services, mental health trusts, NHS area teams, Clinical Commissioning Groups, Health and Wellbeing Boards, police forces, Police & Crime Commissioners and any other party with an interest in the welfare and rights of mentally vulnerable adults.

The National Appropriate Adult Network (NAAN) is a charity working to ensure that the rights and welfare of every child and vulnerable adult detained or interviewed by police are safeguarded effectively by an appropriate adult. Our mission is to inform, inspire and support effective policy and practice. As the national hub, we collect, develop and share knowledge and skills, as well as setting national standards for appropriate adults.

Download a short briefing on this issue. 



Guidance

Guidance for children and vulnerable adults

Guidance for appropriate adults

  • Guidance for parents, carers and other untrained AAs (Home Office)

Guidance for other professionals

  • For health care professionals (NAAN & Royal College of Nursing) - Download
  • For Liaison and Diversion Services (NAAN) - Download

  • For solicitors and legal representatives (NAAN)- Download

  • For Professionals in the Criminal Justice System working with Offenders with Learning Disabilities (Department of Health) p.37 - Download

  • For police:  Guidance on responding to people with mental ill health or learning disabilities (National Policing Improvement Agency and Department of Health) - Download

  • For police: Schemes to help police identify people who have vulnerabilities - Link

Guidance for AA scheme co-ordinators 

  • Members Briefings (members only) - View 

  • Development Templates (members only) - View

  • Self Assessment Tool (members only) - View

  • Training Pack (members only) - View

Guidance for volunteer co-ordinators 

  • Compact Code of Good Practice on Volunteering - View
  • Guide to increasing the level of management support for volunteering in your organisation - Influencing Up
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