My colleagues in green seem a bit upset and not for the first time; my Twitter notifications are full of indignation and frustration. The Home Secretary delivered her annual speech to the Police Federation Conference earlier today and spoke for longer than ever before on policing and mental health issues – this in itself is very welcome, incidentally!!
During the speech, in an attempt to reassure the officers present that she was working to minimise the impact upon them, she stated:
“Police officers have many skills, but they are not in a position to be psychiatrists diagnosing and treating mental illness – nor are you meant to be social workers or ambulance drivers.”
I’m well aware of social workers who object to the description of non-crime related police activity as “social work” and I just knew that the term “ambulance driver” was going to lead us somewhere we didn’t want to be. It reminded me of the time another parent at my son’s school asked my wife if she was pregnant when she wasn’t … the world almost came to an end!! The dog and I were immediately placed on diets and we can all understand why our pre-hospital, life-saving superheroes felt well put-out today –
Ella SHAW, author of the Ambulance Blog, has already written to Theresa MAY protesting the use of the term and pointing out the training that has to be undertaken to qualify as a Paramedic. Ella is not the first to point out to me today, that “Paramedic” is a legally protected term which we are all prohibited from using unless we have undertaken the requisite qualifications and registered with the Health & Care Professionals Council. We see the increasing promotion of the role with the College of Paramedics pushing professionalism and the importance of the inter-relationship between the police and the ambulance service is something I’m investing time in building, both on this blog and in operational life.
But for me, the term “Ambulance Driver” indicates a deeper point about the debate we’re trying to have about policing and mental health when we’re asking for the ambulance service to play a greater role, as the Adebowale Report suggested it should. If the only important point about the transportation of someone who has been detained by the police was the important-enough issue of patient dignity, I could actually just call a taxi.
But that’s missing the point.
I don’t just want paramedics next to me after the police detain someone under the Mental Health Act because of the big yellow truck and the implicit status of “patient” that it immediately affords the person I’ve detained: I want a paramedic next to me because they are highly trained healthcare professionals who have a mass of knowledge and kit that I simply do not have. They can help me establish whether my instinct to suspect a mental disorder is roughly on track; or – as with a real case in my force area – they could tell us that despite honest efforts, we got it utterly wrong and had detained someone with diabetes. Incidentally, I was very glad they were there to tell us how wrong we got it because the bloke collapsed in the ambulance shortly after the blood sugar test and was rushed to A&E in the big yellow truck. The consultant told us that this action could well have saved his life – it certainly averted serious medical problems.
Medical conditions that officers could confuse with mental ill-health are very numerous – a stroke or a heart attack, epilepsy or Addision’s disease (which can lead to psychosis of a particular kind.) The list goes on … examples exist of paramedics pointing out to mental health professionals that someone being sectioned after what was thought to be a serious case of post-natal depression actually needed to go to A&E to have unusual physical symptoms checked out. It emerged they had a brain tumor and required emergency surgery.
And even where police officers were absolutely spot on, mental ill-health can also amount to a medical emergency –
Paramedics in any situation when police officers are having to engage in high-intensity instances of restraint to keep people safe are crucial – both in terms of the prevention of medical problems and in reaction to them. We know that the need for ongoing restraint is under-recognised as the medical emergency it is; and I don’t want a medical emergency of any kind in the back of my police car on in my custody block. I want trained, professionals with drugs, kit and competence to keep the patient in good medical nick, whilst I try to keep everybody safe in terms of personal security.
I once drove an ambulance car – when I was a sergeant, a first-responder paramedic jumped into a police vehicle with some green bags along with two of my officers and the patient we had detained. Driving that vehicle to A&E so he wasn’t stranded after delivering the patient into urgent care didn’t make me a paramedic any more than him being in the police van rendered him an attested constable who should go and deal with a riot.
These two 999 services overlap more than people realise – we share ‘customers’ on so many occasions and paramedics do deal with situations involving crime and risk. They don’t distance themselves from this any more than we should believe it’s possible to prevent mental health demand coming our way or the occasional need to administer first-aid. We’ve seen ambulance services issuing stab-vests, because they recognise that some paramedic work is risky business. However, when a certain level of risk presents and they assess it as too high, they seek police support because we know how to manage violence and risk. If having done so, we find violence and risk with a clinical undercurrent, we need them back in the situation supporting our intervention and vice versa.
Every frontline cop and every frontline paramedic gets this: our affection for them is shown in every reminder we issue that they are the second best emergency service(!) and it’s why you see hashtags on Twitter like #999family.
You need more qualifications and training to be a paramedic than you do to be a police officer (or for that matter a politician!) – it’s why every police officer knows that our colleagues in green are far more than “Ambulance Drivers”.
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, 2019
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 – http://www.legislation.gov.uk