If you are reading this on a desktop computer, right click this YouTube clip and have it running in the background on another tab whilst you read this blog.
Imagine this scenario and the fiction in which you think it may appear —- you are the victim of a very serious crime. So serious that it has life altering consequences, not least in terms of your mental health, because you struggle to come to terms with what happened to you. OK, let’s be frank: you FAIL to come to terms with what happened to you. You know EXACTLY who hurt you, you can name them to the police and for a range of reasons that you fail to understand, that person was not prosecuted at all.
Meanwhile, back in your life, you continue to live or maybe, just exist, in a place where the person who hurt you can do as they will and you spend hours each day failing to grasp the enormity of it. Although you don’t have any previous history of mental ill-health, you find with time that you have started to self-harm. It becomes serious enough for your family to express their concerns and they support you in seeing your GP. After a few months in which you are not able to control the urge to hurt yourself and you start to neglect your welfare, you agree to admission to a psychiatric unit and are admitted voluntarily, unable to stop thinking about the trauma you experienced when you were hurt and unable to control voices in your head telling you that it was your fault and that you deserve punishment for what you did.
After period of time as an inpatient, you are discharged, although you are not quite certain that the time is right as you leave. Later that evening, you cut yourself so severely, that you have cut to the bone of your leg and you find both paramedics and police officers at your home who are keen to help and safeguard you. You are not sure about what to do when the paramedics offer to take you to A&E so that you can receive treatment to the serious leg injury
Now it doesn’t matter whether you are a man or a woman or what the offence is: this vignette is an amalgam of a few stories I’ve been told over the years. It could be a woman who was raped and publicly degraded; a man who was subject to GBH in a deliberate, disabling attack. There are versions of this story all over the place with many variations on the background, the reasons for it and the consequences. Some victims who physically self-harm, some who overdose on medication in life-threatening consequences. This may occur in the weeks or months following an attack or some years later where the someone had been the victim of childhood abuse of one kind or another where children are forced to grow up in contact with those who so badly abused them.
So imagine what it feels like when the police step into your life and for legitimate reasons to do with keeping you safe and hoping to get you some support, assessment and care, you find yourself incarcerated to the very cells that your attacker got nowhere near.
Imagine what that must be like – you are the VICTIM of a crime. You know this because you were there and no-one else except your assailant was. Yet you are the one that gets banged up; and RIGHT next to the kind of people that offended against you, when you’ve done nothing wrong. You’ve done nothing wrong.
I’ve made this point before: we are far too casual about thinking police stations are suitable places to detain someone who is mentally unwell. Do we fully grasp the implications of this kind of action? Putting victims of crime, who are struggling to cope with the trauma that was caused by the offence they lived through, in the very environment their attacker may never have reached, but knowing that the person next door to them will quite potentially have done to others what someone did to them?
So it’s not just about the environment — cells are cold, bleak places. Concrete walls, hard benches and stark furnishings. It’s about the symbolism and the semiology. We don’t put people in that part of a police station unless they are alleged to have done something wrong – rape, assault, theft; even immigration issues and matters connected to the administration of justice. All involve the suggestion that people had broken a law, of one kind or another. The provisions of the Mental Health Act seem the only exception to this principle, which is an interesting proposition when set against our commitment to international human rights law.
And think about what you see and hear in custody — they are noisy, disorienting places. I’ve heard prisoners singing songs all night, banging the hatch of the cell door all night and screaming obscenities all night. And I really do mean all night – for periods of 8 to 12hrs. I’ve heard men screaming threats of sexual violence: listing what they would like to do to the female custody officer or a male custody sergeant’s female relatives, in detail that could not be repeated here. Imagine if that had been heard by the hypothetical rape victim, above?
And what if this was done at the express wish of the NHS — what if the the police have decided to use s136 to stop someone from hurting themselves and after treatment for those injuries there is a request to remove the person from A&E because they are now “medically fit” – this usually means in terms of physical injury. Local place of safety provision being unavailable, the view is offered forward, “well it will have to be police custody for MHA assessment then.”
Against this known background? – seriously?! — and what if provision in the NHS was actually available, but the exclusion was against arbitary criteria or where PoS provision was available in the area immediately adjacent? A slightly longer journey across a bureacractic boundary or incarceration in the cells. Para 10.22 to the Code of Practice anyone?! << The last version of this story I was told, a PC who’d taken trouble to understand the background that A&E hadn’t asked about once, just simply refused to move the person and explained why. Antagnoistic, but understandable?
In one area where there was a sticky patch in progressing to NHS place of safety provision, I took a senior NHS manager on a tour of custody. The large central custody area of Birmingham central police station is a 19th century gaol. Having marched him round what looked like the set from Porridge and shouted at him to make sure my voice was audible over the shouting and screaming, I asked whether or not he had any children and whether putting them in this environment when they were disturbed and ill would be acceptable to him? It did the trick.
These are nasty, noisy places and dangerous places for anyone put there. People put there with particular backgrounds like in our stories above, have got particular reason to think such a decision, however it ends up occurring, is an outrage. And I admit that I agree.
50% of people detained under s136 MHA still get taken to police cells as a place of safety —– it doesn’t have to be this way. Just 3% of those in my force area are so treated – I still think that’s too many.
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.”