The Police Federation on Mental Health

Earlier this week, the police Federation Magazine contained a call for the removal of police powers under the Mental Health Act.  It struck me as an unusual and courageous idea and it prompted a response.  Having since discussed it with the Police Federation lead on mental health and custody, Sergeant Kevin HUISH, I offered to publish any further remarks or replies he had.  This is Kevin’s blog:

2 + 2 Doesn’t Make 10

Mental health should be subjected to healthy debate!

I first started the debate on removal of section 136 Mental Health Act powers from police officers at our annual conference in May this year but it didn’t really take off.  Well all that changed this week with the comments in the ‘Police’ magazine and that’s a very good thing.  Sometimes you have to put out what seems really unpalatable in order through the debate to get to the right solution.  It is also very important to remember that the person in crisis is at the heart of our thinking and the best solution for their care is the outcome we should seek.

It’s important to point out that it isn’t Federation policy to seek the removal of the powers from police officers but an idea that through debate may prove unrealistic or inappropriate but then again if implemented correctly might just work.  Michael has some very valid arguments and sound reasoning to think that complete removal of s136 powers from Police may be a step too far and I value his expertise and judgement but let’s not just write the idea off without due consideration.   Let’s follow the debate through to its natural conclusion.   I have no doubts the debate will continue at the National Custody Seminar in Stoke on Trent on 11th and 12th September check it out at – http://www.polfed.org/ranks/1439.aspx

Let me put some background as to how I came up with the decision to spark the debate.  Like everyone else when it was first suggested to me (by a senior executive at MH charity) early this year that s136 powers be taken away from police I had the same reaction as many did this week, but then I thought long and hard about it and decided it warranted further scrutiny.  That coupled with a senior member of the NHS speaking at a conference and criticising police for over and inappropriate use of the power, questioning if we should have the power or not.  I concluded that it could be a real possibility but only IF and WHEN the right people working in MH were properly resourced, trained and funded to provide the necessary level of service as first responders to people in a MH crisis situation.  My suggestion is that MH Crisis Teams be the ones resourced and trained to provide that service 24/7, 365 days a year but there may be a more appropriate team.

In a submission to the Home Office I’ve said that it will take time, probably 3 – 5 years, before the removal of s136 powers could take place; that investment in Crisis Teams will be necessary to achieve this but that real long term savings could be made through patients’ crisis being more effectively managed in the community leading to less use of Health Based Places of Safety (HBPoS) and greatly reduced admissions to hospital.

In the interim period other changes are required to allow us to be more effective and additionally I’ve asked for:

  • Section 136 powers to be extended to include private premises with a power of entry;
  • Provision of Appropriate Adults for adults put on a statutory footing;
  • Police officers not called to MH premises to restrain patients;
  • Section 136 detention at police station reduced to 24hrs in line with PACE (if transferred to a HBPoS then reverts to 72 hours);
  • Mandatory MH awareness training jointly delivered by MH partners for all police officers (as per Lord Bradley’s recommendations);
  • The PACE clock stopped for those arrested for criminal offences but in need of a MH assessment (with statutory time limits for the assessment to take place);
  • Abolition of informal exclusion criteria by HBPoS around drugs, alcohol, aggression, children and learning disabilities;
  • Statutory requirement on commissioning boards to provide an adequate number of properly staffed HBPoS;
  • Removal of police stations as a PoS under the MHA.

Interestingly, when I presented this submission to the Bradley Group (formerly the National Advisory Group to the Health & Criminal Justice Board) which is made up of all the leading charities, Lord Bradley, the Children’s Commissioner, the National Appropriate Adult Network, the Royal College of Nursing, the Prison Reform Trust, Magistrates and Service Users amongst others – it was well received.  They thought there was real merit in considering the transfer of s136 powers to MH professionals in the medium to long term.

I’ve heard it said that the ‘street triage’ scheme is seen by some as an expensive secure taxi service for MH nurses (and worse).  It’s too early for a full and proper evaluation but they tell us that in Leicestershire it has led to a big reduction in the use of s136 powers by police, fewer admissions etc., and that’s just one car on ten shifts per week.  So why not go the extra yard and have an emergency response vehicle staffed by MH professionals equipped with the right training and powers?  Do you really need a police officer sitting next to them?  Or why not put a MH nurse in a fast response ambulance car?  At least then when they’re not attending a MH crisis incident they can still be of use whereas now Leicestershire have lost four PC’s for ten shifts.

What I have also said in my submission is that of course the police will still have a role to play in supporting health colleagues if members of the public are at serious risk of harm or the person is considered so volatile that police support is necessary to contain and assist in a person’s restraint in a public place.  But other than to provide an escort to the HBPoS police involvement should cease once the person is restrained and controlled.  Additionally we will of course continue to appropriately arrest people with mental ill health who commit serious criminal offences.

I will leave you with some information as food for thought: there is growing anecdotal evidence from around the country that police officers are not using s136 powers of detention but are instead arresting those in mental health crisis situations for a breach of the peace, section 5 of the Public Order Act or drunk and disorderly.  To me this is a worrying trend and far from the aim of diversion from the criminal justice system.  Is it because of the difficulty in getting a person into aHBPoSor because of a lack of them?  Work is certainly required to ascertain the reasons and impact.  It will certainly impact on the s136 figures and not be helping to give an accurate picture of those in need of help.  It is not the answer to the s136 problem and we should not be criminalising those in need of medical care.

NB:  Top blogger and top chap @NathanConstable has responsed to Kevin’s piece and it is well worth a read.


IMG_0053IMG_0052Winner of the President’s Medal from
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award.


 

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5 thoughts on “The Police Federation on Mental Health

  1. You are right that the Crisis Team should be the ones to handle and deal with most situations but the problem is they do not deal with things properly and the fact my daughter is under private care shows things do not work.

    It is the lack of care in the community that is the main problem plus the CTOs and forced drugging of a patient for instance who may have been experiencing serious side effects from drugs that are supposed to be safe yet are not. Whilst some patients are happy to take them – all well and good but what about others who experience very serious side effects – they need to come off the drugs safely and there is no facility in the UK and where is the proof of the diagnoses when there are about 5 in my daughter’s case.

    An acute ward is hardly the place to get better and I am not sure these professionals handle situations well at all as I have experienced. On an acute ward it is easier for the professionals to have someone drugged up like zombies and if that person is sectioned that person can be pinned down by several members of staff and forced to take drugs. What kind of a world do we live in that allows this treatment.

    I am currently campaigning for therapeutic communities & Chy Sawel – there are patients who I noticed returning time and time again onto acute wards. There needs to be choice and for some who are very vulnerable there needs to be special therapeutic communities where that person can be given one to one peer support and intensive trauma therapy as many are abuse victims themselves who have only been given drug after drug as care by these so called professionals but then on an acute ward a patient is easier to control – some are like prisons and worse because a patient is stripped of their human rights and some staff could not care less and abuse their powers. I have seen some shocking things going on. Someone may have been abused and never received decent care as the only care in the UK is drugging and you need a label to do this and my daughter has several. It is no wonder nothing has worked. The drugs companies should be more accountable and help the “victims of the pharmaceutical industry”.

    So it is not just the MH care failing it is the care in the community – lack of choice and facilities. My daughter is now not able to just return back to the community without proper care and support in place and I know of some cases where the patient is still in a hospital after years on end despite not being a risk to the public but because they cannot look after themselves. The longer someone is in hospital the harder it is to rehabilitate them. After 14 mind altering drugs which have not worked, she is unsteady on her feet, suffers panic attacks/anxiety, has lost her confidence. I am about to challenge her case in court and it has taken over a year to bring this to court. There are people stuck on never ending sections for many more years and the Government needs to look at the money being wasted – public money – not only with the long drawn out Tribunals process which can be manipulated by the team but also the length of time and cost to the public for keeping someone locked away when it is not a good enough excuse to say that person is a risk to themselves when they are not a risk to society. That person should be given proper care one to one if necessary in the community and my daughter responded to a “friend” more than any professional and that is what is lacking for many patients who are just thrown into society without having intensive trauma therapy and are no better and do not get enough support or the right kind of support.

    The system is rife with abuse and bullying and corruption and I have proof in my case.

    I also have proof on what the drugs are doing to my daughter through private tests and how you get treated when you dare to challenge the “care” like I have done.

  2. Oh where to begin. Back to basics: oncology services see people who have cancer, MH services see people who are severely mentally ill. Think psychotic or manic. Not drunk,drugged,odd,aggressive people. Remember under 20% detained 136 are kept in hospital when assessed. The level of understanding of mental illness in this blog is embarrassing and really can be summed up as we don’t know what to do with these difficult ,challenging people so we are going to call it illness,even though MH profs disagree, and we’ll get them to deal with it. The arguments put forward are so flimsy and bear no relation to the work MH services do with ill people that they wouldn’t even warrant any serious discussion. Be afraid police officers if this is the best your union can do

    1. The only disagreement I have with the above, is that some – just some – drunk / drugged / aggressive people are sometimes known at the point if police intervention to be suffering mental disorder and inner of care an support. We also know that a lack of infrastructure through which to provide it has sometimes contributed to tragedy in custody or following contact.

      But I agree that the argument needs to pitched differently and it needs to take account of what MH services actually do. Everything I would say to this post was said in my previous blog, to which this piece is a response.

      Incidentally, the 20% figure is an aggregate of a country where most PoS arrangements are deficient. In areas that aren’t, we see rates of hospital admission between 40-50% and rates of referral for GP or CMHT follow up at 30-40%. It’s about proper processes and proper training for everybody and MH services and managers are often as bad as some officers about the clinical and legal realities that 136 generates.

  3. Comments from a non-professional
    it would be interesting to see some MH professionals’ comments here on this type of debate. Maybe they might welcome the idea of an MH ambulance , possibly with a paramedic qualified to do mental health assessments . If the ambulance was to be first on the scene then it would surely need to contain at least one nurse trained in restraint and legally allowed to deal with volatile situations (otherwise the time taken waiting for police support could see some serious incidents ?).[Written while being very aware of what mentalhealthcop has said in a previous post about MH staff maybe not wishing to compromise therapeutic relationships by being involved in restraint] Then when not on emergencies the ambulance could be arranging to meet up with AMHPs to do mental health assessments on private premises. This might be an advantage to the police , and service users whose waiting time for assessment might be cut and for the NHS again in cutting the current waiting times for such assessments which can range from under 7 days to up to 14 or more (where a police presence is required).

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