This blog is a difficult one: when my name was read out at the Mind Awards, one of the loudest ‘whoops’ in the room came from Paul Jenkins, Chief Executive of Rethink. He was kind enough to congratulate me afterwards and from the leader of one of our country’s major mental health charities, it is not without real significance for me. However, that he has been kind enough to signal he’s looking forward to this blog which I’ve indicated in advance will disagree with him, shows his willingness to debate and engage. << This is precisely how we will improve the debate about mental health and the role of the police, so it is in that spirit that I write this blog to Paul.
Most broadsheet newspapers have covered remarks from Paul Jenkins about the use of Taser on vulnerable people, suffering from mental ill-health. Paul is quoted as saying:
“It is completely inappropriate for police to use a Taser gun on someone who is threatening self-harm, and we are very concerned to hear that this is happening in some police forces. If someone is clearly in great mental distress, having a Taser gun used on them will seriously exacerbate their condition. People who take anti-psychotic medication may also be vulnerable to suffering a fatal injury if Tasered, as some medications greatly weaken the heart. If police are called out to a situation where someone has threatened to self-harm, there are other steps they can take without needing to resort to extreme force. Firstly, it is extremely important to try to talk to the person who is in distress, and police should consider bringing a properly trained crisis negotiator to help with this. They should also call an ambulance and speak to a mental health crisis team, who are better placed to act in a mental health crisis and who will be able to provide crucial advice and support in this situation.”
Vicki Nash, head of policy and campaigns at mental health charity Mind, also said: “Tasers are extreme and controversial weapons that we believe should only be used as a last resort by police. Tasers can cause extreme distress so to use them on people who are experiencing a mental health crisis, and already displaying signs of distress, can make things even more traumatic. We urge police to ensure they are equipped with the tools they need to make difficult decisions quickly. A better understanding of mental health problems would allow police to recognise those experiencing a mental health crisis, and de-escalate a situation before resorting to weapons such as tasers. There is no substitute for comprehensive mental health training.”
Firstly, in the continuum of force available to the police, Taser is never going to be the last resort, although usually close to it. Earlier this month, my team took a 999 call from the Ambulance Service regarding a mental health service user and the very first thing I did was instruct taser officers and a sergeant to the scene. Why? Because 999 services frequently deal with this particular man and he has a long and predictable history of getting drunk whilst ill, self-harming and then attacking paramedics and police officers with razor blades. Sending taser officers does not mean they will even use that equipement, but it gives them the option, if required. Officers who have known him for years will say that attending to him with a tazer drawn has reduced the instances of him attempting to hurt people, paramedics won’t go near him without police support anyway and here’s the key: he has never actually been tasered. Officers have fixed an aim on him – known as being ‘red-dotted’ – but they have never needed to discharge the equipment. This is an example of taser being ‘used’, despite not being fully utilized.
Secondly, hostage negotiators are fine ideas. I personally have never, ever known a situation last long enough for them to arrive although I know of plenty of incidents where they have been invaluable and have patiently negotiated difficult situations to a conclusion. In my experience, some front-line cop has always managed to “talk them down” or bring about a resolution first.
Thirdly, whilst calling ambulances and mental health crisis teams are noble notions, there is a practical reality that makes police officers read such ideas and – I’m afraid to put it so bluntly – laugh out loud at the thought of it. As a police officer put it recently “We can’t get the ambulance service to heart attacks and car crashes, never mind mental health jobs.” Mental health crisis teams are a step further, like throwing the meta-physical “seven”.
The ‘last resort’ in the continuum of force is shooting people with firearms. It was precisely such incidents like the shooting of Andrew KERNAN in Liverpool and Keith LARKINS in London that lead to the Home Secretary to consider the introduction of so-called “less-lethal” options in 2007. I have written previously about the use of force on vulnerable people and of the utility of force.
THE USE OF FORCE
NB: nothing you are about to read suggests that officers should not take all the opportunity that time and risk allows to de-escalte and communicate. Hours, if need be. This blog is about what happens after that.
As a police inspector on a 999 response team, I am responsible for certain decisions about the police use of force – I am consulted by the police control room countless times a shift to make decisions where force may be needed, because risks may be present. I have to take decisions about whether we send ‘normal’ cops, or we send taser officers, dog handlers, or any combinations of the above. If I believe that armed officers may be required, I have to fire that one further up the chain of command and sometimes, I’d prefer to take decisions for which time does not allow – sometimes things are just as good as they’re going to get and we’ve got to crack on to keep people safe.
A senior officer in another force shared with me a real story that perhaps highlights some of the dilemmas that officers face when deciding how best to deal with those who are experiencing acute mental ill-health:
Earlier in 2012, a man with a long history of mental health episodes and contact with police and health professionals, was found in a public place. Officers were concerned for his safety and detained him under section 136 of the Mental Health Act. He was taken to a health based place of safety where he was detained by medical staff. The following day he absconded from the unit and was reported as a high-risk missing person to the police. Officers were diverted from other duties to join the search. After some time the man was found when he made it back to his home address, in a town about a dozen miles away from the secure unit. Officers returned him to the unit.
Some time later police were called again to the secure unit as staff requested help as they had lost control of the man. He had been put in a relaxation room but had managed to gain access to a sharp implement and was slashing himself. The officers that attended estimated that the man had 70 to 80 self-inflicted slash wounds. He did not respond to verbal engagement by medical staff or attending officers.
At this point officers had the following options on a continuum of force;
- Do nothing – unconscionable.
- Let staff try to restart communications – that had already broken down.
- Communicate – tried to no avail.
- Restraint techniques – man is armed with a sharp implement.
- CS spray – not ideal in an enclosed space as it would ‘take out’ the cops, too.
- Baton strikes – risking serious injury to the man by striking him with a metal pole.
- Strikes by hand or legs (distraction strikes) – man is armed with a weapon.
- Shield tactics – delay in assembling trained staff and shields may be prohibitive.
- Taser – risk of reaction to discharge.
- Firearms – unlikely to be authorised in this situation and only possibly capable of leading to death / serious injury.
In front of their eyes the man was getting increasingly more out of control, and his level of self-injury was increasing by the second. Communication was having no effect. Medical staff couldn’t help. The man was still self harming. The man was tasered.
Officers immediately regained control of him and he was given rapid first aid for his multiple injuries. There was no long-lasting impact, beyond shortening the length of time that he could self harm. The following day the man was assessed and released. That evening he was found by police in the centre of his home town after reports from a member of the public of a man self harming….officers again detained him under section 136 MHA.
Tasering a patient in a secure unit sounds extreme. Given the circumstances officers took a decision that resulted in safe detention that enabled medical treatment to be given. All of the available options carried risks. Taser was assessed as being the least risky of all the risky options available, hence it was used to good effect. I have known taser be deployed in several situations like this senior officer’s story. I have also received emails from mental health professionals praising officers patience, courage and tact and reaching the ‘taser’ conclusion only after trying other things or being so pressured by the need to manage risks that there was no time. I have specifically followed up every taser incident I have known to ask mental health professionals their views on it being used and have never found any criticism or reservation being levelled.
Human beings using force on other human beings is never going to be perfect science. It will always be about selecting the least worst option and about attempting to minimise risks. The reason I find the debate on this subject fairly shallow is because it involves words like “never”. Whether or not we agree, the Home Office have licensed this equipment for use by the police and it is issued. If you want a political debate about whether this is correct, then that’s fine. Meanwhile, cops who are issued with this equipment and led by people like me have to make decisions respecting its use: do we use it in some situations or do we instead strike people with metal poles and spray them with CS?
Or do we ask people like PC Alex STUPYLKOWSKI to risk life threatening injuires from sharpened weapons whilst acting without such equipment? I’m wondering whether PCs Tom HARDING and Alastair HINCHCLIFF wish they had been equipped with taser when they were sent to Kingsbury armed with a metal pole and a small tin of pepper whilst being expected to detain Christopher HAUGHTON? The Metropolitan Police are reviewing the availability of Taser in light of Kingsbury because getting into the non-taser tactical options listed above meant Mr HAUGHTON had opportunity to attempt to murder two police officers and grievously injure several more.
No one thinks tasering ‘the vulnerable’ is inherently good, but just every now and then – very, very rarely – it may be the least worst thing to do with officers facing risks that could kill them or inflict life-altering injuries. I say this in knowledge that using taser may well exacerbate someone’s condition but repeat the point that by the time the police are crisis managing risk situations where people are self-harming, non-communicative and posing a risk to themselves or others, it might – just might – be the the least worst option available.
For a real example, we can see the Buckingham Palace incident in February 2013.
UPDATE 28/12 >> I am grateful to Paul JENKINS for reading and re-tweeting the blog to show an alternative point of view. Paul took on board operational realities for the police and rightly insisted that this should not prevent a broader ‘policy’ debate about how these situations come about. I totally agree with him about that! Would also encourage you to read Nathan Constable’s blog which shows a real example of the operational reality around police decision making, from first hand experience (trigger warning).
The Mental Health Cop blog won
– the Mind 2012 Digital Media Award, in memory and in honour of Mark Hanson.
The Awards celebrate the “best portrayals of and reporting on mental health in the media.”
– a World of Mentalists 2012 #TWIMAward for the best in mental health blogs.
It was described as “a unique mix of professional resource, help for people using services and polemic.”