Sometimes, I listen to protracted debates at work around divisions of responsibilities. Is a particular type of burglary or robbery a local CID job or a force CID job? Is a neighbour dispute neighbourhood policing or 24/7 response job? How do we determine whether a fraud is for Economic Crime – value or complexity? – and who investigates it if it is not serious enough? Does any of this matter?! Well, only up to a point – I don’t like to play the ‘remit game’, as it often misses the victim.
So I was interested a few weeks ago in a squaring-off between two sergeants over some routine business which, when I was a sergeant, I’d have been humilitated to think reached my inspector. I wouldn’t have wanted him to know I couldn’t sort it out, being so utterly straight-forward. But notwithstanding how simplistic it was to us, it was extremely important to the victim.
I made it known that these ‘stripes’ should talk to each other and reach some professional compromise because “if two people paid £40,000 a year each want to bore me again with the fact that they are unable to sort out a shoplifting, they’ll both get a decision they don’t like.” Both sergeants had good reason to say ‘no’ but that wasn’t getting the victim a police service. I didn’t actually care who took it on because the victim was more important than either them. I didn’t hear anything further and the victim got what he needed.
This brings to me to mental health: there is always scope to argue that the police or mental health professionals should do this or that and I work in an urban area where resources are (comparatively) plentiful. But I’ve been reminded by colleagues who work in very rural areas, that agencies often do favours ‘above and beyond the textbook’ because they have to, to get things done. Police officers cover school crossing patrol for the council – unheard of in cities – and GPs let their surgeries get used as a ‘place of safety’ when a PC is struggling to get someone removed 45 miles to a psychiatric unit. (I mentioned this in my area once and was patronised out of the building.)
In many examples we could debate, laws and guidance don’t actually prescribe work to be the responsibility of one agency or another. Managers are required to acknowledge that they have no stick with which to beat the other party; they must, for practical purposes work out how to support each other and compromise. So whilst I have a rough rule of thumb as to the basis upon which police support for MHA processes should be agreed – Resistance, Aggression, Violence or Escape (RAVE) – I’m not at all sure how this holds up in West Cornwall on a wet Tuesday evening. It may well be the case that the Penzance inspector is happy to assist whenever he can because he knows he’ll need a CMHT or AMHP colleague next week to act as an appropriate adult for an arrested offender when they have no legal obligation to do so. (It is a ‘he’ – I checked! What a job to have?!)
Working together, improvising together and compromising together is vital wherever you work: because the centre of it are real people who need assessment, help or support. That is more important than anything else, if we’re honest – as long as no-one is doing anything illegal.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All views expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2011
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11 thoughts on “People”
“People” is the apposite word – the whole process depends on real relationships (rather than prescriptive rules) between all the staff of the agencies involved in this at times invidious process.
Could not possibly agree both – on both the post and warriet’s comment.
I meant I couldn’t agree more.. brain faster than fingers!
I see “not my ballpark” syndrome applies to policing as well as health. I see it a lot when there’s nasogastric refeeding of patients with anorexia – medical wards don’t want to deal with the mental health issues, and say it should be done on a psychiatric ward; psychiatric wards don’t want to play around with NG tubes, and want the medical ward to do it. Personally I don’t care who does it as long as it’s done before the kid collapses from starvation.
I think there’s an extra element to consider here though. sometimes the staff on the psychiatric ward just aren’t trained to do some of the more ‘medical’ procedures and in that case it’s entirely appropriate to seek help. We are, after all, part of the same team.
I agree with the basic idea that we do what needs to be done for the individual without making artificial barriers and drawing ‘battle lines’ but we should also be careful bnot to lose skill mix and appropriate expertise along the way.
‘Babies and bathwater’ spring irresistably to mind.
I hear what you’re saying Stuart, and to be honest I’d agree that NG tube feeding is more appropriately done on a medical than a psychiatric ward. Though I’m aware our local paeds medical ward would beg to differ.
Just as I wouldn’t ask A&E staff to do a suicide assessment (that’s my job) I’d prefer if paeds nurses would recognise their own skills and the reason why we have different specialties.
I’ll gladly do what I’m competent to do but that doesn’t mean pretending to have skills I haven’t got.
It’s the same with nurses & police. Good practice clearly involves mutial support & helping out but not trying to over-reach our competencies.
A rathe noble and utopian outlook which is to be commended. I’d say that as a general rule the relationship between NHS staff and Police is very good. Unfortunately with resources being reduced all round things are only going to get worse. I like most other officers are always glad to help other services but there comes a point when we have to say “Sorry, but it’s your responsibility”. It’s one thing Lending a hand it’s another helping paper over the cracks.
Sadly true – the all round reduction of resource when demand is increasing is wrong for many reasons and the brunt will be borne by those at the sharp end. As the thin blue is stretched even thinner, the police will have less and less time to help the other services which themselves will be more and more challenged. Care in the community will become an even sicker joke than it was in the 80s 😦
Agreed. No reservation in doing so.
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