In the general debates about policing, we hear a lot about the importance of policing by consent and those who have read into the history of policing will know that the service was founded by Sir Robert Peel who set down nine principles of policing. These principles, in the opinion of many officers including me who have them postered or framed on their office walls, have stood the test of two hundred years of policing as we’ve moved from industrial, nineteenth century Britain to the current time.
I would like you to read these principles and think about what you want your police service to be – it won’t take long:
PEEL’S PRINCIPLES OF POLICING
2. To recognise always that the power of the police to fulfil their functions and duties is dependent on public approval of their existence, actions and behaviour and on their ability to secure and maintain public respect.
3. To recognise always that to secure and maintain the respect and approval of the public means also the securing of the willing co-operation of the public in the task of securing observance of laws.
4. To recognise always that the extent to which the co-operation of the public can be secured diminishes proportionately the necessity of the use of physical force and compulsion for achieving police objectives.
5. To seek and preserve public favour, not by pandering to public opinion; but by constantly demonstrating absolutely impartial service to law, in complete independence of policy, and without regard to the justice or injustice of the substance of individual laws, by ready offering of individual service and friendship to all members of the public without regard to their wealth or social standing, by ready exercise of courtesy and friendly good humour; and by ready offering of individual sacrifice in protecting and preserving life.
6. To use physical force only when the exercise of persuasion, advice and warning is found to be insufficient to obtain public co-operation to an extent necessary to secure observance of law or to restore order, and to use only the minimum degree of physical force which is necessary on any particular occasion for achieving a police objective.
7. To maintain at all times a relationship with the public that gives reality to the historic tradition that the police are the public and that the public are the police, the police being only members of the public who are paid to give full-time attention to duties which are incumbent on every citizen in the interests of community welfare and existence.
8. To recognise always the need for strict adherence to police-executive functions, and to refrain from even seeming to usurp the powers of the judiciary of avenging individuals or the State, and of authoritatively judging guilt and punishing the guilty.
9. To recognise always that the test of police efficiency is the absence of crime and disorder, and not the visible evidence of police action in dealing with them.
THE BROADER MENTAL HEALTH SYSTEM
I have had concerns about the emerging role of our police service in the broader mental health system for some years, precisely because we implicitly attempt to undermine these general principles. Other posts I have written highlight in particular how we expect more and more that the police will be the agents of the use of force in administering the Mental Health Act, despite the fact that Parliament intended this to be far from a frequent occurrence. Perhaps in community setting where there is limited circumstances where there is an urgency and broader risks to the public we can understand that it has legitimacy and utility, but I never forget the incidents where the police are calmly requested to attend mental health wards to restrain patients for medication, almost on a pre-planned basis. “You’ve got to be kidding? You knew this patient would need medication at 8pm and yet you haven’t planned to have sufficient staff or sufficient trained staff for that time?! Are you aware that some barristers argue that this is not legal on a few different grounds?”
The above picture is of officers detaining someone in a non-mental health context: it was during public order disturbances around St Paul’s Cathedral, London in 2008. One of the main objections of the public when they see this, is the number of officers involved. And yet guidelines for the NHS in undertaking restraint is to have one professional per limb, one ensuring safety of the head and airway and one taking an overall view. Just count the number of officers, above bearing in mind they are also applying handcuffs to a resistant adult man … now imagine again that this was on a mental health ward somewhere near your house.
And this is not just a debate about resources, either:
- We know that NHS organisations have difficulties in staffing health based places of safety, in accordance with Royal College of Psychiatry Standards – in other words, being able to receive patients without the need for ongoing police support “even where patients are disturbed” (p8).
- We also know that many AWOL protocols fail to acknowledge in reality para 22.13 of the Code of Practice to the MHA, despite it being fairly unequivocal.
- We know that where force is deemed necessary after a patient is subject to compulsory admission under the Act from a community location, AMHPs do not believe it is their role to use force (training, lone working, etc.) and they are not at liberty to call upon other, trained mental health professionals in order to coerce those patients whose resistance or aggression is consistent with non-police professional management.
It may be that some people would read the above and think that there are good reasons to prefer the police service to undertake these functions. Perhaps it’s an argument about their training and availability; perhaps it is about something else and you are entitled to your view. I’ve got two things to say on this -
- It’s not what Parliament intended – our laws, our codes of practice were put together after exhaustive democratic processes. Even where we are referring to non-statutory guidance like Royal College standards: they are documents agreed between organisations like ACPO, BASW, etc., but to what point if they’re ignored?
- Is anyone asking service users about this? I know from what little mental health training I have received and from some experience picked up along the way, that cognitive issues around policing can be serious problems for patients. Whether manifested in delusions or paranoia or some kind of less-acute anxiety about whether it will be a humane, sensitive and patient police officer who arrives – such feelings can be aggravating factors for people in crisis.
Of course, if the police also subsequently struggle to access other services quickly and efficiently: all of this can aggravate the impact upon someone’s clinical condition. Only last week a police surgeon, section 12 qualified, stood in my area’s custody office and said, “Being here is making it worse – we need to get her to a hospital.” But the clinical features in play were not ‘RED FLAGS‘ – no-one wanted to deal and this was making the patient worse. So which hospital?!
Are we not at risk of developing a paramilitary style of something well-short of nursing and creating a situation where the only role that policing plays in the broader mental health system is coercion? Is that not precisely what Peel said policing should NOT be about; and precisely what our mental health system should NOT be about?
If the last resort – policing, police stations and “paramilitary nursing” – is often also the first thought, where does this leave our principle of ‘least restriction’ in social care? And if I’m wrong that it all too often is the first thought, why do we still have areas of the UK with no NHS place of safety where the expectation still remains that police officers will potentially breach laws because we can’t get our commissioning together? Where are the community deployable nurses or nursing assistants who can use low levels of proportionate and therapeutically appropriate force on nervous, frightened and / or confused patients without the need for uniformed stab-vests and tasers implying “or else” somewhere in the background?
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.”