PARAMEDIC SERIES: Introduction

This is the first in the PARAMEDIC SERIES of blogs.  To see all of the others, refer to the index:

There was a recent suggestion by a Police and Crime Commissioner of physically situating police and fire services in the same buildings to facilitate greater inter-operability and overlap in the use of equipment / resources. My first reaction to this was, “why Fire? – surely there are greater overlaps between the police and the ambulance services?”

I can’t tell you how many jobs we go to with West Midlands Ambulance Service, it is far too numerous to count, but when we get there we are often working hand in glove. I have never, ever stood in a building with a fire officer making sure our joint decision-making stacks up to an effective intervention involving staff from each organisation – I’ve either been asking questions relevant to my criminal investigation of arson or taking direction about the extent of cordons or evacuations they need put in place when dealing with a fire which threatens public safety.

In contrast, my response team sees the ambulance service almost every day, sometimes several times a day; and the nature of the interaction is that someone needs an element of both healthcare and security and we have to work very closely together. 999 operators often despatch both services together.

It would be remiss of me not to mention the success West Midlands Ambulance Service have had in recent years.  They are currently Ambulance Service of the Year 2012 and when I talk to police officers who work outside my region, they are often surprised at the response WMAS provide to this area, in terms of mental health.  I know why and I’m proud to work alongside them all.

A “PARAMEDIC SERIES” OF BLOGS

I’ve taken some advice from paramedics I know about what would be of use and / or of interest about the role police when it comes to mental health related incidents. After their advice, I have written a number of blogs, to address several types of situation –

1.  The one where you are going to call the police into a situation you are already dealing with; and
2.  The one where the police are calling you into a situation they are already dealing with.
3.  The one where we’re both called to a Mental Health Act assessment being coordinated by an Approved Mental Health Professional; or to a situation where we start wondering about the application of the Mental Capacity Act 2005.

4.  The one where we cover the different kinds of assessments that can occur involving mental ill-health
5.  The one where we cover some legal issues about the use of force – both in terms of self-defence and the safe detention and conveyance of patients detained under the MHA.
6.  The one where we explain what an AMHP is?

I have been advised to do this whilst presuming no legal knowledge at all, and limited mental health training because it can then be read and used by trainees at all stages of their career.  If you think these posts are useful, I’d be grateful to you if you could raise awareness of them via social media or your professional networks.  It will be done over a few posts, to keep each of them short-ish and consumable – but they’re all listed below.

Treat this post as a general introduction or an index to them – I may add to it if you give feedback on the posts or we think of more ideas to cover in a “Paramedics’ series.”  The posts are, by necessity, summaries pitched at Paramedics – they contain links to the longer, substantive posts I have written which fully explain various issues and which are replete with legal technicality and links to specific stated cases, guidelines, etc..  At the bottom of each post are links to the full index of this blog and to the “Quick Guide” series I wrote for police officers which you may also find useful.

If after wading through these you want to think about the knowledge I’m aiming for police officers to achieve, please see this “Knowledge Check” post << everything you need to know about policing and mental health in 500 words.  I also once wrote a post about what the police would like the NHS to know and it has been widely read and circulated within the NHS.  Actually, it is in the top 5 of my ‘most read’ blogs ever.

Posts that may be of general interest on policing / mental health issues -

• “RAVE Risks” – this is a mnemonic meaning Resistance, Aggression, Violence or Escape.  It is my way of attempting to summarise how we judge a situation involving mental ill health where it may appropriate or very necessary to involve the police.
• Biology, Psychology or Sociology – a post which skims over the different approaches to mental illness.  I found this fascinating to learn and it goes some way to understanding from a 999 point of view why you sometimes feel you are banging your head on a wall.
• What If Richard Bentall Is Right? – some thoughts about our system of mental health care and the criticisms it often receives.
• Autonomy and Mental Capacity – some thoughts about respecting people’s right to make decisions.  Absolutely key to our 999 work is considering when it may be right to let someone take an unwise decision.
• Care in the Community – many people wonder whether community care is responsible for tragic events.  Some thoughts on this, as well as the the history and the alternatives.

NB: I’m using the word “paramedic” generically – I’m aware of the differences between technicians and paramedics and that we see third-sector ambulances which contain first-responders who are neither of the above.

LAWS AND ROLES

Firstly, you’ll see that there are different ranks and roles of police officer. I have previously written a detailed explanation of them all, but you’ll probably just need to know three on the frontline:

• POLICE
• Police constables – they wear numbers on their shoulder and actually do the work!
• The sergeants – they wear collar numbers and three stripes.  They supervise, oversee and direct where necessary.  You are quite entitled to ask to speak to one, if you think it’s needed.
• The duty inspector – my ‘proper’ day and night job – is the senior operational police officer and every area has one, 24/7 – they are the final decision-maker, they oversee the critical and serious incidents and they handle complaints issues.
• The duty inspector may also referee some of the politics which I regret creeps into our attempts to make this work – especially when resources are tight or many agencies are struggling to cohere.

• NON-POLICE
• Approved Mental Health Professionals, known as AMHPs (pronounced “amps”) – usually a social worker, occasionally a psychiatric nurse or another mental health professionals.
• AMHPs are legally warranted and at the centre of MH assessments which occur in a different few situations mentioned below. It is a criminal offence to obstruct an AMHP in the course of their duty, under s129 of the Mental Health Act 1983.

• LAWS
• I previously wrote a “Quick Guide” to the Mental Health Act – this lists all of the relevant section numbers from the MHA and gives a sentence’s worth of explanation for each.

If you want more detail on these subjects or any others, please email me on mentalhealthcop@live.co.uk and I’ll happily add more posts and link them within this page.  Some police officers have saved the blog itself, the Quick Guides or specific posts to their homepage on their iPhones as a reference – I add that just as a thought you may find useful. There should be an App available during 2013.

FURTHER READING

Don’t forget three methods of using this blog to find out more:

• There is a full index of almost 300 posts on all manner of topics.
• There is a series of “Quick Guides” originally intended for police officers, but some will be of interest to paramedics.
• There is a “search” facility in the top right hand corner: by entering any keywords on policing / mental health will bring up the relevant posts, including entering sections of the MHA like “s136″.

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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.”