Querulous Paranoia

Some years ago my chief inspector rang me up and told me he’d left an envelope on my desk.  He’d appointed me investigating officer for some complaints made against various police officers and the file of paperwork which had come via the Independent Police Complaints Commission and the force’s Professional Standards Department was bound together in the envelope.  When I saw the package the first thing I knew I’d need was a ring binder and some divider cards.  The paperwork over an inch thick with copies of police incident logs, custody records, letters already written.  There was a lot of material there.

I was given an advance clue: I’d been appointed as the investigator because of the links within the investigation to mental ill-health and was told the job would be ‘fairly challenging’ to resolve.  It seemed clear straight away, I would need to involve the complainant’s mental health team, if he’d agree to that.

Having given the file a skim read and it being the day before Christmas Eve, I decided to ring the complainant just to introduce myself and inform him that with the amount and detail of material involved I would read the whole thing over the Christmas holiday period and ring him in the New Year to meet and discuss.  By the end of that phone call almost 90 minutes later, I had started to wonder about ‘querulous paranoia‘.

This language dates back to the Victorian era, was written about by the seminal German psychiatrist Emile KRAEPELIN and has been written about in psychiatric journals.  Querulous, or querulent, paranoia is usually defined as the propensity to make persistent complaints about comparatively trivial issues, sometimes where there is no foundation to the complaint(s); and to pursue those grievances to the point where the damage done to oneself from the process and any dissatisfaction with the outcome is even greater than the original issue.  And possibly, to then further complain about the inaction to the original complaint or dissatisfaction with its outcome.

There is not a huge amount of material that I can find about this condition but it is one that complaints related organisations consider to be very important indeed and those of us who take and investigate complaints need to be aware.  And we can all see what a difficult issue this is – clearly, people regardless of their mental health are entitled to complain, whether that be about police officers, mental health professionals or anyone else.  Everyone is entitled to expect their complaint to be taken seriously and investigated professionally and impartially, with appropriate oversight and appeal mechanisms.  Some complaints are upheld against professionals every day in this country, whilst others aren’t.  Those complaints vary in seriousness and complaint processes seek to find the balance between reparation with ongoing learning for professionals, and punishment and sanction for serious or repeated failures where there is less mitigation.

But in some instances, no matter how minor or unfounded a complaint may be, any outcome below the most serious will be insufficient.

CONVICTION AND SENTENCE

And of course there are always two aspects to any investigation: the issues of conviction and sentence.  If a member of the public finds their complaint against a paramedic or an A&E nurse is upheld and vindicated, are they then satisfied by the organisational reaction to that complaint?  Maybe the A&E sister of senior paramedic believes informal advice or perhaps a written warning will suffice.  What if the complainant thinks that nothing other than sacking the staff member concerned will do?  How do we reconcile the differences?

One aspect of querulous paranoia, as it was once explained to me by a psychiatrist, is that such complainants often do feel further slighted by ‘sentence’.  If someone did their job improperly, they should not be doing that job: end of.  Anything less than sacking them often further compounds the problem amidst fears that those who have err’d have been inappropriately protected.  Hence further complaints about the complaint investigation.  At one point in the investigation mentioned above, I was being investigated for allegedly mishandling the investigation I was still doing before I’d had chance to reach my conclusion about the very very many complaints made against the different police officers.

The academic paper mentioned above suggests methods of early detection and alternative approaches, remarking that a “persistent complainants’ pursuit of vindication and retribution fits badly with complaints systems established to deliver reparation and compensation. These complainants damaged the financial and social fabric of their own lives and frightened those dealing with their claims.”  This rang true with me when I had to deliver news about my investigation that I knew would not be welcomed.  Thought was given, in advance of breaking the news, as to how I would respond to the reaction and particular supports around how I would arrange to have the news delivered.

DISTINGUISHING FROM INJUSTICE

The literature distinguishes this condition of querulous paranoia from the relentless pursuit of redress after serious injustice.  So for example, years or decades of campaigning after deaths in custody or miscarriages of justice would not qualify for consideration of this kind of label.  An example of something that would, may be a police officer saying something that they believed to be true at the time which then transpired not to be correct at all, and a relentless pursuit of that officer for “lying.”

Clearly, some investigations into public services establish that some employees have lied.  On other occasions it is quite provable that someone acting at a particular time was simply unaware of certain information that would have caused them to take a different decision and there was no dishonesty to their actions.  It is the perception that such matters are conspiratorially acting against aggrieved individuals, to the protection or cover up of corruption that attracts consideration of this concept.

Another challenging feature of all complaints processes is how the system reacts to factual doubt.  In my investigation, one officers was alleged to have said something to the complainant when they were at the original incident and there were no witnesses one way or the other.  I simply could not prove in the legal sense which one of the two men were telling me the truth, if either.  Because the complaint was a criminal one, where the standard of proof is beyond all reasonable doubt, there was no ability to prosecute the officer because there was considerable doubt as to what was said, if anything.  In the context of this complaint however, it immediately invites the question, “Why do you believe him not me?”  In reality, it wasn’t a question of believing the officer – it was a question of being unable to prove to a criminal court that he did do what the complainant alleged beyond all reasonable doubt.  But of course, I understand why the man walks away with a perception that the police inspector investigating his complaint has just appeared to dismiss his complaint by taking sides.

I was given advice as a young, ignorant sergeant by a wise old inspector when handling complaints: try to understand what people are trying to achieve, try to understand what they want from the complaint and what you might do to resolve it in those terms, if possible.  When the answer to those questions is along the lines of “I want my life back” we start to understand that it may be genuinely difficult through a complaint alone to deliver this.  And most incidents that lead to complaints are a point in someone’s lives where things have become difficult enough for the police to be called, so there is often a far broader personal context to complaints.  There was in this case.

I have found that mental health services are excellent at seeking to provide support to individuals who are complaining against the police.  I would advise any investigator to ask the complainant about whether they would like to see their mental health services involved in supporting them.  It was through doing this, that services were able to put in supports that addressed the problems which led to the incidents which led to the complaints.  Hence the original issues began to progress and whilst complaints never became irrelevant – and nor should they – the importance of them abated as life began to improve.

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Winner of the President’s Medal, the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award

 

All opinions expressed are my own – they do not represent the views of any organisation. (c) Michael Brown, 2014

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I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current.  Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.

Government legislation website – www.legislation.gov.uk