Since starting this blog, I am very conscious that I have quoted a lot of law, hyperlinked to Codes of Practice and guidelines etc., etc.. All very technical stuff and often very dull; but aimed at equipping police officers to do the right thing in their operational reality as well as in strategic discussions about partnership arrangements. It was also intended to allow service-users and other professionals to see their worlds from a police officer’s point of view, to understand our obligations and limitations as well as our shortcomings.
As I look back upon my own time as a constable and sergeant, I can sometimes shake with fear at some of the things I was invited to do and which I entered into in good faith, doing my best. I didn’t know any better and I can also now see I was one of the lucky ones, for whom nothing went awry. It’s fair to say, I was party to processes I wouldn’t wish some of my enemies to be subject to, for a want of alternatives and knowledge of how to do it differently.
It’s right to say that police service has a moral as well as a legal obligation to police effectively and with compassion, within the law for the benefit of society. That is all important, noble stuff. However, it is not the main reason I want to raise my colleagues’ and others’ awareness of policing and mental health: I want to help them do the right thing and keep them out of trouble. I got interested in this work, because I wanted to know enough to keep myself out of trouble after seeing things go badly awry.
I want to try and help them do this whilst they police a society which stigmatises mental health problems and whilst working alongside a politicised mental health system that is chronically underfunded and structured wastefully (like the police). Of course, it’s not a “mental health system” at all; not in any real sense. Care is spread across multiple NHS organisations who often don’t talk to each other and whose commissioning is not properly integrated: ambulance services; local authorities; General Practitioners; Mental Health Trusts including community mental health and crisis services. And of course Accident & Emergency departments who “don’t do mental health” despite it being 15% of its demand.
Often, police officers and their 4-8hrs of mental health training get themselves into trouble in ways that they do not foresee: when they run to emergencies with all the right intentions to help, support and keep people safe. Where supposedly unpredictable events occur and wheels fall off it suddenly becomes apparent that for the want of better training and responsive NHS structures, problems where actually quite predictable, however unlikely.
This is an important distinction about risk: unlikely events are not inherently unpredictable.
I have talked at length with some police officers who have been involved in very difficult incidents involving the death of someone with mental health problems following police contact. Ironically enough, some of those officers have gone on to develop PTSD and other grave mental health problems, sometimes leaving the service completely, their lives affected forever through ill-health and divorce, amongst other issues.
I say this not to attempt to promote the impact upon some police officers of doing their job above the permanent, tragic impact to a family by losing a loved one in the custody of the state; but it is important to understand with some mental health incidents officers can legitimately say, “I actually did what my training and force or joint policies asked me to do” with a sense of bewilderment about how they’ve ended up facing allegations of neglect and human rights violations in a court.
There are some local authorities areas who do not actually have joint operating policies on the four areas of business where joint approaches should be outlined in such a way. Yet these documents are legal requirements?! I don’t understand.
It is the least that junior officers should expect in this complex area of business: that there are clear expectations of what should occur – PlanA or PlanB or PlanC, according to the partnership structures that exist at that time. If an area has not managed to set out expectations in a joint protocol, the law of the UK and Europe still apply anyway.
The point here is: some police tragedies involving mental health incidents are not entirely unpredictable for the fact that they were unlikely. I sometimes read of cases that went awry and think, “Why on earth did you do that?” There are various predictive factors which should raise our alertness to the possibility of tragedy – alcohol, drugs, violence – but because these are events are so rare, and because they usually do not end in horrific consequences, they can appear unpredictable. <<< This is a significant cognitive bias in operation.
Risks which ‘stack the deck’ towards a serious untoward incident should be mitigated every time, and to the ‘Nth’ degree where the impact could be disaster.