Take That Victim to the Cells

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Imagine this scenario and the fiction in which you think it may appear —- you are the victim of a very serious crime.  So serious that it has life altering consequences, not least in terms of your mental health, because you struggle to come to terms with what happened to you.  OK, let’s be frank: you FAIL to come to terms with what happened to you.  You know EXACTLY who hurt you, you can name them to the police and for a range of reasons that you fail to understand, that person was not prosecuted at all.

Meanwhile, back in your life, you continue to live or maybe, just exist, in a place where the person who hurt you can do as they will and you spend hours each day failing to grasp the enormity of it.  Although you don’t have any previous history of mental ill-health, you find with time that you have started to self-harm.  It becomes serious enough for your family to express their concerns and they support you in seeing your GP.  After a few months in which you are not able to control the urge to hurt yourself and you start to neglect your welfare, you agree to admission to a psychiatric unit and are admitted voluntarily, unable to stop thinking about the trauma you experienced when you were hurt and unable to control voices in your head telling you that it was your fault and that you deserve punishment for what you did.

After period of time as an inpatient, you are discharged, although you are not quite certain that the time is right as you leave.  Later that evening, you cut yourself so severely, that you have cut to the bone of your leg and you find both paramedics and police officers at your home who are keen to help and safeguard you.  You are not sure about what to do when the paramedics offer to take you to A&E so that you can receive treatment to the serious leg injury

Now it doesn’t matter whether you are a man or a woman or what the offence is:  this vignette is an amalgam of a few stories I’ve been told over the years.  It could be a woman who was raped and publicly degraded; a man who was subject to GBH in a deliberate, disabling attack.  There are versions of this story all over the place with many variations on the background, the reasons for it and the consequences.  Some victims who physically self-harm, some who overdose on medication in life-threatening consequences.  This may occur in the weeks or months following an attack or some years later where the someone had been the victim of childhood abuse of one kind or another where children are forced to grow up in contact with those who so badly abused them.

CRISIS RESPONSE

So imagine what it feels like when the police step into your life and for legitimate reasons to do with keeping you safe and hoping to get you some support, assessment and care, you find yourself incarcerated to the very cells that your attacker got nowhere near.

Imagine what that must be like – you are the VICTIM of a crime.  You know this because you were there and no-one else except your assailant was.  Yet you are the one that gets banged up; and RIGHT next to the kind of people that offended against you, when you’ve done nothing wrong.  You’ve done nothing wrong.

I’ve made this point before: we are far too casual about thinking police stations are suitable places to detain someone who is mentally unwell.  Do we fully grasp the implications of this kind of action?  Putting victims of crime, who are struggling to cope with the trauma that was caused by the offence they lived through, in the very environment their attacker may never have reached, but knowing that the person next door to them will quite potentially have done to others what someone did to them?

So it’s not just about the environment — cells are cold, bleak places.  Concrete walls, hard benches and stark furnishings.  It’s about the symbolism and the semiology.  We don’t put people in that part of a police station unless they are alleged to have done something wrong – rape, assault, theft; even immigration issues and matters connected to the administration of justice.  All involve the suggestion that people had broken a law, of one kind or another.  The provisions of the Mental Health Act seem the only exception to this principle, which is an interesting proposition when set against our commitment to international human rights law.

And think about what you see and hear in custody — they are noisy, disorienting places.  I’ve heard prisoners singing songs all night, banging the hatch of the cell door all night and screaming obscenities all night.  And I really do mean all night – for periods of 8 to 12hrs.  I’ve heard men screaming threats of sexual violence: listing what they would like to do to the female custody officer or a male custody sergeant’s female relatives, in detail that could not be repeated here.  Imagine if that had been heard by the hypothetical rape victim, above?

And what if this was done at the express wish of the NHS — what if the the police have decided to use s136 to stop someone from hurting themselves and after treatment for those injuries there is a request to remove the person from A&E because they are now “medically fit” – this usually means in terms of physical injury.  Local place of safety provision being unavailable, the view is offered forward, “well it will have to be police custody for MHA assessment then.”

Against this known background? – seriously?! — and what if provision in the NHS was actually available, but the exclusion was against arbitary criteria or where PoS provision was available in the area immediately adjacent?  A slightly longer journey across a bureacractic boundary or incarceration in the cells.  Para 10.22 to the Code of Practice anyone?!  <<  The last version of this story I was told, a PC who'd taken trouble to understand the background that A&E hadn't asked about once, just simply refused to move the person and explained why.  Antagnoistic, but understandable?

In one area where there was a sticky patch in progressing to NHS place of safety provision, I took a senior NHS manager on a tour of custody.  The large central custody area of Birmingham central police station is a 19th century gaol.  Having marched him round what looked like the set from Porridge and shouted at him to make sure my voice was audible over the shouting and screaming, I asked whether or not he had any children and whether putting them in this environment when they were disturbed and ill would be acceptable to him?  It did the trick.

These are nasty, noisy places and dangerous places for anyone put there.  People put there with particular backgrounds like in our stories above, have got particular reason to think such a decision, however it ends up occurring, is an outrage.  And I admit that I agree.

50% of people detained under s136 MHA still get taken to police cells as a place of safety —– it doesn’t have to be this way.  Just 3% of those in my force area are so treated – I still think that’s too many.


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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10 thoughts on “Take That Victim to the Cells

  1. Our local 136 ‘suite’ isn’t safe in the same way that Custody is and is just a room, an office area and a bathroom, manned by one member of staff. Waits for assessment are typically many hours – never less than 8- 10 hours if you are detained in the early hours. Meals never seem to be offered, and drinks only occasionally. With those sort of waits the combination of boredom, stress, literally nothing happening, just you and one staff member,and lack of safety can be a dangerous combination. At least in Custody other stuff happens, providing a distraction, there are other people and you are kept genuinely safe with many offers of food and drink, – albeit not necessarily in very nice circumstances. The 136 suite won’t take anyone who is resistant, and isn’t equipped to. I wondered how you mange these things in your area?

    1. I hope you won’t take this response as being about your post, you just happen to be the Nth person this week to make a similar point —–

      We need to stop having a debate about poor designed, insufficiently commissioned and inspected services and then say “look, police custody is better.” Police custody is, by statutory guideline, the very last place someone should be. We all have our opinion about the way the world should work and we get past those differences in a democracy via the rule of law. What was the point of Parliament legislating and then providing statutory guidelines if we then say, “the microwave meals are better in custody?” Ensure faster, appropriate assessment in an NHS PoS or buy better food for those detained, then.

      Michael POWELL and Sean RIGGs family don’t think their loved one was kept safe, nor do the families of a couple of people a year on average who are detained under s136 and over half a dozen a year with MH problems.

      The 136 should should accept people who are resistant and aggressive – see the 2011 Royal College of Psychiatry guidelines and if it isn’t equipped to: equip it. Custody isn’t equipped to provide for medical needs, nor should it be, nor will it ever be. We don’t need to equip it to do so either, because we have statutory guidelines and multi-agency, nationally agreed principles on the RCPsych 136 standards that point out we shouldn’t be going there.

      Other countries do this stuff without using cells. There will come a point where we don’t either. The only question between now and then, is how many (more) people will be killed and degraded by virtue of this unwarranted criminalisation before we get it? As I repeat: not directed at you specifically – you are very far from being alone.

      1. Take all of your points, and totally agree but as a concerned friend of a ‘service user’, the reality is very different here and seems as though it will be for the foreseeable future. No idea if any changes are even faintly on the horizon.

  2. With the right political will using police cells could be eliminated within 12 months, make the provision of health based places of safety mandatory for all CCGs, linked to funding if required.

  3. police cells should never be used for the mentally ill in crisis. They should be seen immediately by a CPN and quickly by a doctor or consultant depending on the need who should be available 24/7. If someone had a serious physical injury (e.g broken leg) and was screaming in pain they wouldn’t be taken to a police cell because they were disturbing the peace, they would see triage nurse, then doc or even consultant. When is our NHS going to get it into their head that the police aren’t doc/nurses and this has to stop now. If not someone needs to charge our NHS Directors with torture.

  4. This came as no surprise to me. You say that you only have 3% detained in custody as a place of safety. How have you managed to do this, and what is your solution for the remaining 3%?

  5. I was speaking to an AMHP recently and I asked why assessments never got done at our local A&E even though the trust says they can be. I sort of expected them to say it wasn’t really safe enough or something like that, but what they actually said was that the wait for the assessment team would take A&E over their target treatment time, so because they can’t get a team out in under 4 hrs you end up in custody, seemingly to avoid ruining the hospitals targets. I am a little biased here, but I really can’t think of any other medical issue that would be dealt with in that way. It often seems like the NHS just don’t see 136s as their responsibility, as they’re so quick to pass these people back over to the police.

    1. Correct – and in just some cases I understand why. Some police force areas really overuse section 136 and some officers deliberately misuse it. In some areas the outcomes from 136 reveal few people with a mental health problem – many just go home having sobered up and / or calmed down. In other areas, 80% of people are either admitted MHA or referred to the community mental health team, with almost 100% of them getting some kind of “health outcome”, even it is just signposting to their GP.

      As such, some areas have evolved tactics, however awful, for deflecting that misuse or abuse back to the police. I’m not defending this, I’m just explaining how I’ve come to understand it after a years of trying.

  6. It would be really nice to see appropriate ‘suites’ in all areas for people who are 136d. My area does not have such a ‘suite’ and when I was sectioned under a 136 several years ago, I was taken to police custody. I have to say that the police were very professional, but the experience was very difficult. (I would like to point out that there was no need for me to be restrained at any point – I was co-operative). Upon being checked in, I was told I had been arrested. I was confused about this, and was sharply informed that it is the same as being detained.

    I was taken into a cell with two female police officers who asked me to remove my clothes (except my knickers). As a survivor of sexual abuse as a child, this was probably the most upsetting bit of the whole experience for me, especially as they pulled on latex gloves and I was unsure what they were for. (They did not do anything else). I could not have my bra back for reasons relating to my safety, but was given loose clothing and shoes to wear. I spent the rest of the night in the cell, which was locked but with CCTV and a button I could press if I needed anything. A police officer came in intermittently and I was offered food. I don’t remember much of the interaction between myself and the staff as I was quite unwell, but I don’t remember any further difficulties beyond the natural unpleasantness of being locked in a police cell. They did seem professional and generally empathic.

    I was assessed during the night by various mental health professionals, and then transferred via police van under a section 2 to the nearest psychiatric ward the following morning.

    It wasn’t a very nice experience, but I have no complaints about how the police handled it. I just think it’s a shame there isn’t the money to have a safe place outside of the custody suite for people with mental health problems in acute conditions in my area.

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