The Strategic Command Course

The Strategic Command Course is the months-long training and assessment to which superintendents and chief superintendents must subject themsleves if they dream of leading the police service.  Promotion to the rank of Assistant Chief Constable and above – known as ACPO ranks – is contingent upon successful completion of this course and you cannot get on to it without active support from your own Chief Constable AND without passing a selection process.  (ACPO is the Association of Chief Police Officers).  The below picture is Henry VIIIs Manor House which is the centre-piece of Bramshill.

Amongst other things, the candidates are set projects and assessments by existing chief officers around current policing issues and this year, the ACPO lead on policing and mental health, Chief Constable Simon COLE, has set the syndicates a challenge!  Chief Superintendent Gavin Stephens from Surrey Police is on the #SCC13 and has blogged on the challenge, to solicit ideas and feedback.

Firstly, I will list the challenge and invite you to respond to his blog with your ideas.  Secondly, I will provide my own response!

THE CHALLENGE

“The long term reduction in spending on policing is already raising questions about how far the police role stretches beyond narrowly cutting crime.  Using the particular challenges of police involvement in mental health cases, outline how forces should reconcile what has been the wider mission of policing over recent years with changed economic conditions while staying faithful to core values?”

Chief Supt Stephens highlightes how his group have held three meetings already, identifying these key issues:

• Local practices that really work: identifying evidence based local practices that should be replicated nationally

• Partnerships that make a difference: Identifying the components of successful mental health partnerships from national and international experience.

• Future challenges:  forecasting ahead to identify opportunities to intervene and influence earlier.

• Culture:  Identifying cultural barriers and enablers – what will really make our fail or succeed?

There it is – if you would like to directly influence this group of aspiring chief officers, click here for the original blog and leave a comment.  If you want to leave a comment below, either in addition or instead, I will make sure they see them before the deadline for their project work.

I would just like to say – I think this is great!  One of my complaints as a frontline cop is that too few senior officers are genuinely interested in this stuff and it’s often in the “too difficult” basket.  Having the focus of future Chief Constables and Deputy Chief Constables of UK policing, as well as some international candidates – I know of one French senior officer attending the course – is potentially very significant.  That they will emerge from their training and assessment, particularly sighted upon the fact that over 15% of ALL POLICING DEMAND is connected to mental health issues, bodes well for us all.  We just need to help them hang their hats on the right pegs when addressing the issues.

Michael./

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MY RESPONSE

I want to argue that there are three things we need to get right, from which everything else, including the above four agenda can flow as the natural consequence of getting basics right and the service focussing correctly:

SENIOR MANAGERS:

We know that there are areas where BCU commanders have not ensured that they have proper joint protocols with mental health and broader health services, which are written in accordance with Codes of Practice and other relevant standards like RCPsych guidelines and NPIA Guidelines for policing (which are badged by the Department of Health).  We also know that some senior officers take little active interest in this area and this could be for a range of reasons.  << There: I’ve said it.

What is needed to succed in basic terms isn’t that difficult to conceptualise – see the Senior Officers Checklist, which I wrote several years ago and which was circulated last year by the Superintendents’ Association to all of its members – but it will take a strategic leader to carve up what is best done at Force or Regional level, from what is best done locally and ensuring police commanders account for progress.

And this will take difficult conversations: too often, we know that some mental health services will unilaterally say, “Sorry we can’t accept intoxicated detainees in our Place of Safety, they must go to the cells.” or “Your officers must stay here through all of the 136 assessment” and this will take many hours in some places.  There are arguments to move on these issues, within my blog.

Making progress in these areas may involve some very difficult conversations and potentially having to deal with other agencies’ difficulties in prioritising their own budgets.  We need to convince our partners that proper MHA arrangements are not optional extras and “nice to do”, but legal requirements which can no longer be allowed to impact catastrophically upon the public and upon policing because we kept trying to do “the wrong thing righter” in handling “failure demand”.

One major problem is that an interface between policing and mental health does not necessarily naturally occur within the previous frameworks for inter-agency partnership working.  Crime and Reduction Disorder Partnerships, Child and Adult Safeguarding structures; MAPPA and MARAC arrangements: each of these will see the interface in part, but none of them is not looking at it from an overarching strategic point of view.

Health and Wellbeing Boards could in future provide this, but one problem with them is that they are not exclusively focussing upon mental health and the interface with criminal justice: nor are police services a compulsory member of them.  A second problem, is that forces often struggle to situate mental health as a policy area in their headquarters and subsequently struggle to brigade BCUs and HQ departments into a cohesive whole.  This is why leadership on the issue is crucial – in my view and why senior officers may need to forge a path where none naturally exists.

MENTAL HEALTH TRAINING:

This week, I have had two days away from my main role to undertake my annual “personal safety training” refresher.  In April, I will have three days away to undertake my annual “public order” refresher.  This is a full working week to re-do training that I have done as an inspector ten times.  The first time I did it as an inspector, I had already done it five times as a PC and a Sergeant and it wasn’t massively different wearing two pips to three stripes.  Don’t get me wrong: this is important training, but I would like to make a comparison with mental health training – of which I have had two hours in the last fifteen years.

The publicly debated controversies around the 2011 riots were not the personal conduct of police officers with calls for better training for them – it was, amongst other things, about how quickly senior officers ramped up the response and whether sufficient numbers of officers were trained to be deployed. Controversies around restraint and personal safety tactics are not necessarily about whether officers need better training: it is usually about whether they put that training into practice or why they did not also recognise the potential medical impacts of restraint.

So my question and challenge to the #SCC13 to address their overarching is “Why do police officers, including senior officers, get far, far less training in mental health issues than they do in public order or personal safety – or for that matter fire marshalling and diversity – given the strategic threat this business represents to the UK police service?  And when we get training, why is more of it given over to identification and diversity, than to legal powers and procedures and the initial management of clinical risks?”

We know that almost half of deaths in custody are connected to mental health issues; we know that some of the most high profile criticisms of we have ever seen in policing – Sean Rigg, most recently – are about how the service handled emergency mental health responses and the ability of such incidents to massively impact upon public confidence in ALL policing is obvious.  We know that (at least) 17% of police demand is connected to mental health issues.  We also know that the legislative framework within which our frontline officers must operate is complex: it is at least as complex as PACE or RIPA and yet we give custody sergeants a one week course purely focussing on custody law; another one week course focussing upon first aid and Safer Detention and custody sergeants have had to pass a detailed law examination just to get promoted to that rank.

Why do we think we can expect officers of any rank to survive contact with all the different situations they can encounter unpredictably on the front line of policing; or within the partnership structures that we will need to invent to make this work, with 4-6hrs of training, alot of which is often given over to identification of mental illness and diversity?  What about understanding these legal topics in terms of what officers can and cannot; and should and should not do:

1. Section 136
2. Section 135(1)
3. AWOL patients
4. Prosecution / diversion of offenders
5. Mental Capacity Act

Obviously, this blog lists hundreds of posts on other topics where we need to know that officers can either recall or research a range of topics quickly and they need to do this in an environment where the protocols and guidelines put together at National level, like the NPIA and RCPsych guidelines – will match the locally devised protocols put together at BCU level and that all of this amounts to the same thing as the law of England.

VISION AND VALUES:

I want to put an argument that policing involvement in mental health related cases should be predicated upon the legal responsibilities of the Office of Constable, which we all swore when were were attested:

1. Prevent Crime
2. Bring Offenders to Justice
3. Protect life
4. Protect property
5. Maintain the Queen’s Peace.

I would like to suggest that this approach will also position the service far more subtley than one which looks simplistically at pure legal obligations.  These five principles are guidelines to senior officers in agreement of strategic and operational protocols: how does the police service agreeing to move patients from “this” mental health unit to “that” mental health unit, contribute to these five things if a patient has become violent and threatened staff safety?  Well, once the police have immediately mitigated that risk by attending and possibly by restraining or detaining, it doesn’t – and our involvement should then be scaled back and the situation returned to being a medical issue.  But for frontline officers to do this, they will need good training and leadership at both tactical, operational and strategic levels because it is way outside the expectations of the NHS, currently.

NOTEWORTHY PRACTICE:

In my experience nowhere has got this nailed.  There are individual areas of noteworthy practice in certain aspects of MH – for example, I’d put in a shout for West Midlands on s136 and PoS services where over 97% of detainees don’t go to the cells.  Other forces are good on Liaison and Diversion or reducing missing people volumes.

But few forces have a proper lead on MH issues at inspector (-ish) level, and some don’t have an identified ACPO lead as suggested in the NPIA Guidelines (2010) in the way that we have such leads at those levels for Domestic Violence, Child Protection, Firearms or Public Order.  Where forces do have such leads, they themselves have to pick it up (or make it up?) as they go along because there is no training to access.  We need to normalise our understanding that mental health issues are core police business across our functional and geographical areas and lead our people to give them every chance of success.

You need an ACPO lead in each area driving this; you need an HQ department driving it as a “business as usual” and you need people at HQ who can work through the bringing the organisation together across the disciplines that are all affected by this.  You need training on law first, as well as awareness issues and you need to think about whether deploying every officer with minimal training is the right way to do things.

WEST MIDLANDS POLICE PILOT

In a few months, West Midlands Police will start a pilot in some BCUs where we train four or five people per response team with far better MH knowledge and awareness, especially on law and risk management and we deploy them more constructively to the right jobs to manage the risk.  This way, we are investing better in a smaller group of people and then using them more creatively for better impact.  This is precisely what the service already does in CID, Firearms, PPU work – we need to do this in MH work and understand how this is just keeping step with international developments.  In the US, Canada and Australia and elsewhere Crisis Intervention Training (CIT) is a developing phenomenum – along with using these trained officers to undertake joint patrols with either mental health social workers, psychiatric nurses or in some cases psychiatrists.  I have been pushing for this approach to be tested in the UK for seven years and if we agree that increased knowledge brings confidence to do the right thing, this has to be worth testing.

There is much to do – GOOD LUCK!

Update on 01st April 2015 – since writing this article, a new Code of Practice has come into effect in England.  It doesn’t substantially alter the post but certain reference numbers have changed.  My summary post about the new Code of Practice (2015) is here, the new Reference Guide is here and the full document is here.  The Code of Practice (Wales) remains unchanged.

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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, 2013

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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