Suicide

As a police duty inspector, you get informed of every sudden death – suspicious or otherwise.  You attend the suspicious ones and ensure detectives of varying seniority and forensic officers attend; but suicides are usually always intially presumed suspicious to be certain of a thorough examination of the circumstances.  Initial action is taken by the police to preserve the scene and any relevant information on behalf of the coroner. Of course if then thought suspicious, criminal investigations are initiated and this early judgement is crucial to how things are subsequently handled.

Here’s a recently published fact to get you thinking: suicide is the leading cause of death in under-35s, according to the Office for National Statistics (2009 figures, published October 2011).  This is also true in Australia and probably elsewhere.

Police officers are invariably called to all suicides and most of us have been to several.  My first was to a man on remand in prison for raping his step-daughter and who killed himself in the very cell at HMP Birmingham where Fred West had ended it all several years previously.  He’d been convicted and was awaiting sentence – he left a letter of admission and of apology having denied the offence throughout the trial – and he decided to hang himself.  It was an interesting, yet deeply harrowing and equally thought-provoking day at work.

Institutional suicide is especially interesting, not least because places like prisons and psychiatric facilities are most usually detaining people against their will.  They owe a legal duty of care which immediately raises questions in any police response around potential offences and other statutory or regulatory violations.  It turns the police from a partner organisation to the independent investigating authority, except that in deaths in psychaitric care it is not always the case that the police are called.  Perhaps another blog would be interesting on the subject of responding to sudden death, including suicide, in psychiatric care because various campaigners highlight inadequacies in the investigation and independence in the scrutiny of those matters … that’s for later.

This post is about the effect upon police officers of dealing with reports of sudden death, especially suicide.  It is a post which follows on from “Who Is Protecting the Protectors” – meaning the protection of police officers’ welfare and mental health; their protection from the impact those events can have upon officers, perhaps at a much later time.

I’m going to cover:

  • Police officers and ‘coping’
  • Police force responses and training
  • “Suicide by Cop” <<< in a seperate post.

Police Officers and ‘Coping’

Of course, officers have their idiosyncractic responses:  humour, alcohol, exercise or maybe something else entirely.  Some officers seem to have no issue in handling death and disaster at work – whether or not they do, is often not clear.  They just seem to switch it off at the end of the day … or perhaps they take it all home with them?

In addition to my first suicide, I recall my first death message: I had the job of telling a woman that her mother had died – on Mother’s Day. <<< I am NOT making this up.  It was therefore my duty to do this on the very day that was guaranteed to provoke the most emotive memories for every Mother’s Day in subsequent years.  As if missing your mother on Mother’s Day isn’t hard enough: to remember that was the day she died suddenly, you weren’t with her and were told by a fresh-faced young cop?

Some police officers “don’t do death”.  I know of several who will go out of their way to avoid sudden deaths, suicides, death messages and everything connected to it.  There are a range of tactics for the experienced constable or sergeant – inspectors can’t avoid it because there is only one of you at any given time in operational command.  But the experienced constable knows to ask, “Does your probationer need to do a [death message / sudden death]?”  Why not take opportunity to avoid something unpleasant and harrowing if another officer ‘needs’ to experience how to handle such incidents?

When I was a tutor constable and a shift sergeant, I used to ask the control room for our area to given my any sudden death report that came in, whether or not it was on our particular part of our area.  My probationary constables had to ‘do a sudden death’ in order to get their initial training competencies signed off.  It all sounds very macabre, but if it involved delivering a death message, so much the better for getting it done, dusted and out of the way.  Surely better to allow a newer officer to have to undertake the task under the closer supervision of trained tutors and / or supervisors to gauge their personal reaction as well as their professional handling and properly ‘debrief’ the event in way that may not be done for more experienced officers?

Police Officers and Training

So what of training and what of support when it needs to be more formal and professional?  All forces train officers on all aspects of sudden death.  Not just how to ‘police’ it in terms of scene preservation, referral to senior officers / detectives; but also how to manage death messages – the big “dos and don’ts”.  Training encourages officers to seek guidance and welfare support if required and not to presume that they are expected to ‘tough it out’.  It deliberately involves trying to ensure any cultural preconceptions about ‘being tough’ are dispelled and make people aware that they can seek after-care.  Having said this, there have been calls to improve police training on handling suicide, following the Bridgend suicides in South Wales.

Most forces have a variety of support mechanisms and there is much to be said for the very informal ones which exist through the natural support and camaraderie of working on a police team.  I actually find, when you’ve dealt with something really tough, cops have a got a fantastic propensity to support each other and I don’t mean through the sudden outburst of a “macho” nonsense.  I mean groups of officers who know each other well enough in a close-knit team to know when humour, sympathy or silence may be best – this is true across emergency and armed forces, from what I’ve learned.

The development over the last couple of decades of better training and support mechanisms within the police has also been important and includes access to officers who are trained in initial support following critical events and can include formal, professional support from counselling services, over a long period of time, if required.  Specialist support for officers involved in particular roles is also available: child protection detectives; firearms officers, road traffic investigators and many more besides.

I note with interest that there have been academic studies of the impact of dealing with suicide on mental health professionals, however I can find nothing comparable for police officers or other justice professionals.  (Any pointers from readers who know of any would be appreciated.)

Of course, one of the most difficult jobs a police officer could potentially deal with, could be the suicide of a another police officer.  I’m instantly unable to stop recalling the suicide of PC David RATHBAND just over a month ago and the police officers and paramedics who dealt with the initial response to the discovery of his death.  I’m also aware of others such as the suicide in a mental health unit in Sussex of Sgt Richard BEXHELL in 2009.

This article is continued in a second part concerning “Suicide by Cop”. >>>

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14 thoughts on “Suicide

  1. Of course it would never be admitted, but surely any suicide while in psychiatric care is a failure of that care? Anywhere else, including police custody, can be subjected to a reasonable steps to prevent harm filter but while in the care of the MHS it’s a failure which should be treated as negligence until proven otherwise?

    1. That’s why I think blog post in it’s own right it justified, you’re not the only one with that view and I get it completely – as does ‘Inquest’ and others. I agree with you, there should be a police response to all deaths in psychiatric care and I had cause recently to have an interesting debate about police rights to seize medical notes – to ensure they were preserved in their original form ASAP after death to ensure they weren’t ‘added to’. Barrister’s advice on that pending …

      I’ll put that on the list of ‘to do’ blogs.

      1. Good to read that; the psychiatric wards often operate as if they were outside the law and I have heard too many stories of deaths that were never investigated, that the 15 minute checks are always done everywhere every shift (as if) even common sense says that ithe suicide would have taken longer than 15 minutes to arrange. Death by hanging is only more or less immediate if the neck is broken. I am a civilian with no formal beyond basic first aid but I know that the discoverer’s first action needs to be to take the weight off the noose just in case the body is not yet brain dead.

        Separate issue, you and your colleagues might like to read an account of life in the words. Written after my discharge but based on the notes I was keeping at the time albeit carefully written to avoid identifying any staff or patients http://2012warriet.wordpress.com/2012/03/29/an-involuntary-stay-in-wotten-lawn/

      2. As ever thank you for the opportunity to tell my story and if any of it helps an understanding then please feel free to make contact. Update is PHSO Has asked to meet and SHA has given long list of documents they allege were used in the Care and Treatment Report (completed 5 years later!!!) I have been invited to seek some documents under FOI but I believe I can access as next of kin!
        Pending too!

      3. Apologies if I’m speaking out of turn, but I think a failing in this area (inaptient deaths) would bring up some interesting finds about consultant psychiatrists on the wards. It seems in many cases they overrule the judgements of staff who actually see and interract with the patients all day, every day. An awful lot of errors seems to begin here.

      4. agree, parts of the MHS operate in an environment of secrecy that would do credit to the Special Branch/MI5/Mi6 but is not appropriate for health care. Patients are by definition mad so anything they say can be dismissed immediately and the staff live in fear of losing their 1.5 pensions.
        The greater the resistance to police investigation, the more there is to be hidden from external scruitny?

  2. Having presented,, according to National guidance as in the highest risk group for successful suicide being “young male with a violent self harm history” (however short) , my bright, academic , musical 29 yr old son was ‘eventually’ sectioned “for his own safety”! I have since found out he was moved (identified trigger) within psychiatric wards 6 times in as many days. He was “found” fatally wounded (how do you find someone you are observing?) and moved to life support in London where we had to make the tough decision to turn off support.
    I am aware @MentalHealthCop is blogging on inpatient suicide in a future blog but just to say I fully agree with the previous blogger….an avoidable death whilst a person is detained under the MHA is in duty of care of MH services and its FAILURE! Its not a “service delivery issue” its systemic failure! Needless to say the police weren’t called, the potential crime scene was disturbed, the alleged weapon was not secured and key documents were withheld from the eventual Inquest. The verdict of “suicide” was based on the “balance of probabilities” (as self-harming twice had taken place) Given that the Trust were investigated for in-patient murder at Broadmoor and Feltham Young Offenders Institution (which they also manage)couldn’t I (in the absence of a police investigation) think my son could have been murdered (given the balance of probabilities!)

    But to this blog…..I applaud MHC and his informative blogs and I also applaud every professional who has to deal with any tragic death especially the suicide of a colleague. I will research the academic studies and see what I can find….I dont expect there are any. There should be of course!
    Other matters of interest in the blog…..yes the highest risk group are young male under 35 and figures from 2009 are quoted as this is being used as current data. National and local Suicide indicators were “reluctantly withdrawn” by the Healthcare Commission in 2009 and National Suicide Prevention Strategy was also withdrawn in same year. But in Oct 2010 Health Minister Paul Burstow told Chair of APPG On Suicide Prevention Madeline Moon MP (who is also MP for Bridgend) that a new National Suicide Prevention Strategy would be published in “Spring 2011” http://news.bbc.co.uk/democracylive/hi/house_of_commons/newsid_9127000/9127737.stm
    Following consultation, SP Strategy has still not appeared and latest from DH is “later this year”…still no word re Suicide Indicators for spotting trends,clusters. and potential system failure….which brings me on to Bridgend (Madeline Moon’s constituency) http://www.vanityfair.com/culture/features/2009/02/wales-suicides200902 where it has been confirmed by Ms Moon at the time that there was “significant system failure” so why didnt authorities investigate under Health Service Guidelines (HSG) I was only rectly aware of HSG so my questioning is retrospective. HSG(94)27 Independent investigation of adverse events in mental health services is the key DH guidance on this subject http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4113575.
    However if no indicators are reinstated then how will “suicide clusters” and “significant system failure” be discovered? As stated previously currant suicide data has been confirmed as having “historical prevalence” aka OLD!!!
    PS However an Army recruitment Office was opened in Bridgend around that time .
    PPS To add insult to injury my sons possessions were sent home in a black bin liner marked NHS Household Waste….and this became my driver for justice!

    1. Dear Dee
      I am heartbroken to read of your tragedy.
      God bless your son and may you find what you are seeking.
      Rosemary

  3. i would agree that all suspected suicides in any type of care setting should be investigated by the police but not that all are negligent yes they could be but the starting point should be we don’t know. A lot has been done in the design and environment of new mental health units to reduce suicides to good affect but unless you advocate that every patient should be on direct obs at all times it wont be eliminated. In our trust paper notes were taken from the office as soon as the death was reported and our IT system shows any further entries as additions regardless of the “date of entry” can see no reason for this not to be the norm everywhere. Agreed that more should be done for the aftercare of all parties involved its part of the who cares for the carer debate and quite often its no one peer support is vital but more structure needs to be put in place and we need to look at the affects further down the line when people think its been forgotten

    1. As someone who works at the crisis end of mental health service delivery, the picture of secrecy and corrupt professionals is one that is quite foreign to me. Suicide is notoriously tragic both for the individual and their survivors. One however needs to be rather careful lest your call for police to investigate all suicide may not lead to a criminalisation of the process. On the surface it may sound like a common sense thing to do but I doubt how this may help in doing the one thing that I hope we all want – reducing suicides. It may not feel that way if you’ve recently lost a love one to suicide but suicide prevention has been one of the areas that UK mental health services has excelled at in the last 10 years. Overall suicides rates have never been lower. What we need to do is to build on those achievements and I’m afraid moving towards a blame culture, as will be inevitable outcome of your suggestion, will represent a sprint in the wrong direction.

      1. There are many cases of a patient or service user committing suicide after a lack of supervision or even basic care in some cases; and many, many more where they were at a high risk of doing so. (Sources: experience supporting suicidal people, having been one myself, friend working in search-and-rescue retrieving broken people, user and carer forums, national news.)
        A proper investigation into any apparent inpatient suicides (as they do in the ‘outside’ world!) would uncover any neglect or failings in the system, leading to a better understanding of how this could be prevented. Yes, there would be blame, but I’m pretty sure the finger would be pointed at systematic failings, or at least individuals who should not be working with vulnerable people. Dedicated, caring professionals trying to do the right thing are not at fault – and presuambly there would be evidence to show this (paper trails if nurses are indeed right about excessive paperwork!)
        It is excellent that the suicide rates have fallen (though apparently rising again – recession related…?) but I do wonder what happens after a suicide has been prevented – does the patient receive appropriate treatment/support and recover? or become a revolving-door patient when services stop at any hint of improvement?

        Also, I find it interesting that you cite “criminalisation of the process” as a reason against investigating inpatient deaths, considering the heavy involvement of police in other areas of mental health – sectioning, ‘welfare checks’, places of safety, patients agitated after waiting to be seen in A&E for six hours, etc, etc. – all seemingly encouraged by MH staff.

        Please don’t take any of this as a personal criticism (except perhaps for being oblivious to the existence of shocking practice in MH) as it seems clear the system is at fault – inflexible and grossly underfunded. Shame, as even the economical costs of swift, comprehensive treatment would add up in the long run.

  4. May I ask, do the Police consider a person’s medication and it’s side effects ( often worsening of depressive symptoms, increased anxiety and increased suicidal thoughts in the first few weeks of treatment or in abrupt withdrawl, also known as somelance) to be contributing factors or quite possible causes of suicide or suicide attempts? I think it is vital that they do so. In my own experience I have found certain medications to be exactly the cause of my 3 genuine suicide attempts. Thank goodness I was not successful as I would have left my two wonderful children without a mother and devastated my whole family. I am also acutely aware of others who have suffered the same or worse due to the medication prescribed by their GPs or Psychiatriasts. If the risk of suicide is not properly expained to a “patient” then I feel that any death that comes about as a direct result of that prescribed medication, be it suicide, or homocide as can sadly be the case, should be considered a CRIMINAL and the medical proffesional and/or drug company should be held responsible. I wish to add that I am now, thankfuly, experiencing good mental health and have found a medication that works for me. There are however certain medications that I would never wish to take again and it causes me great concern that others will be offered these medications and may very well take their own lives, or those of others as a result. Thank you for your article and I extend my sincere thanks to yourself and your collegues for the work you do, under very difficult circumstances, to support the families effected by such tragedies.

  5. My father was a detective and frequently confided in me events at work. I think many fellow officers resorted to a bottle of spirits in the drawer to deal with stress. I can remember my dad getting very upset one day because his colleague had sat in the bath and cut his throat.
    I can remember when dad came home from work after having been to an autopsy of a victim at the pathologists (who drank a bottle of scotch a day.) He said he was an expert at looking at the ceiling, and the smell was horrible. He usually missed dinner on those days.
    Fortunately dad was not too affected by death and killing which is probably why he ended doing this job which he loved. I would classify his physiology as very unusual, and his attitudes to PTSD as unsympathetic. I think his hardness (or deficits) could upset vulnerable (normal) officers and be dismissive if his private feelings were.made evident.
    For example, he was called one day to arrest a man who cut his throat infront of him and bled to death because he preferred to die rather than go to prison. Despite his best efforts, the man died. He wasn’t particularly upset and just forgot about it. He just carried on his normal.day. that is odd!
    His attitude at home was that people who develop.PTSD are screwing the system, whether in the police or in the military. (He was in the army before).
    I don’t agree with his views.

  6. Other debriefings,
    Man who raped woman whilst drowning her in a sink. Various shootings. Man who raped woman whilst holding a knife to baby’s throat. Someone nailed to a door. Who did it? Number 34 bus. (What does that mean?.) Torture by electrocution. Murder victim found in car, badly decomposed. It just goes on and on. If I wasn’t so useless I should get a job as a police counsellor……disembowelment whilst struggling on the bed by mercenary…..curry all over the place…..you.know I got so pissed off with it that he was lucky he didn’t end up being a murder victim himself.

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