I frequently can’t help but wonder whether I’m irritating people? I think I’ve irritated a few people over the last fortnight or so and reaction to that is the reason behind my taking a few weeks off the tweeting and blogging – this post and a couple of others have been written and scheduled to auto-publish whilst I’m taking a break from it all and I’ll reflect on this again at the start of November after a much-needed break in the North-East. I need some solitude on a Northumbrian beach in the cold, pre-dawn. It’s been far too long. (Look left.)
It seems that by asking questions about what the police are asked to do, occasionally resisting or insisting upon other approaches is irritating. In so many aspects of the policing / mental health interface, I get the impression that people would just prefer the police not to ask questions and just do as they’re told. It has happened many times in my career that I have been invited to put myself in a position where I could be blamed if things went awry and I will admit that I really don’t like it very much. So where I think it is both necessary and professionally appropriate, I resist and push back; these being the cumulative lessons of policing / mental health tragedies over the last twenty years.
It wasn’t my decision to under-resource our mental health system or to fail to prepare for the very predictable implications of our mental health law. When I find others occasionally quite desperate to be able to say that the police said everything was fine or that it was the police who used too much (illegal or inappropriate) force, I start thinking out loud. If anyone is under-resourced and I am in a position to help and support them, that’s fine. Many cops challenge me when I say this, but there are some things that we really should muck and in a help with which in an ideal world we wouldn’t have to. In that ideal world there wouldn’t be any robbery or rape, either.
But I don’t live in or police an ideal world. So I have to be able to see where I can make a positive contribution to our collective safety and distinguish it from where I can’t. There are some things that the police should stay clear or even refuse to do. There are some things we could never do, even if we wanted to help.
ALIVE, BREATHING AND CONSCIOUS CHECKS
My team was asked to do a “safe and well” check a few weeks ago after a patient made a suicide threat over the phone to the CrisisTeam. It wasn’t an obviously imminent threat, but standard practice is to tell the police and transfer responsibility for mitigating that risk to them.
Many mental health professionals think that police officers have training, skills and powers to do this. Pointing out that we don’t often appears irritating and I could tell this when I rang back with my standard response. “She’s here, she’s alive, breathing, conscious and without obvious indications that she has self-harmed or taken an overdose. What do you want to do now?”
The reply showed what was really going on: “Well, as long as your satisfied she’s safe and well.”
Hang on – I’ll stop you right there!
I’m not saying she’s safe and well – not for one moment. I’m quite unable to confirm that, even though I’m trying to be helpful. I’m only saying she’s alive, breathing and conscious showing no obvious indications that she has self-harmed, taken an overdose or is intoxicated. Whether she has taken an overdose: I’ve got no idea. She says she hasn’t, but that doesn’t mean she’s telling the truth. Let’s remember the power dynamic here: this is a vulnerable lady in her own home, who was STUNNED to see the police arrive and stated that when she spoke to the CrisisTeam no-one had made her aware that the police would be sent.
There are only two broad scenarios here regarding self-harm / overdose: either there is a raised risk of it in this incident, or there’s not. She’s told the CrisisTeam that there is a risk – hence they called the police; but she’s telling the police that there is not. I’ve known this person for about seven minutes at the point where I’m being obliged to decide whether to take this inconsistency any further and I haven’t read her medical notes.
I’M NOT A MENTAL HEALTH PROFESSIONAL
Far more crucially, I’m not a qualified mental health professional – I don’t know this human being at all and I’m certainly not privy to the kind of history that you will have if she’s open to your services. What I do know is that she must be thinking, “If I don’t convince these cops I’m OK, I’m probably going to get locked up.” Doesn’t matter that we wouldn’t have a power to do this, this patient may not know that. Even if she does, maybe she’s wondering if we’re the “step outside for some fresh air, it’ll make you feel better” police who will make s136 happen one way or the other?
So I’m sorry if I’m irritating you, but you’ll have to excuse me for not wanting to put my arm in someone’s mangle so the police can be blamed – as is currently happening to two officers from a southern police force who had a job exactly identical to that above and said, “Yes, safe and well.” Now being investigated after the person committed suicide. Guess what mental health professionals are saying? “Police said the patient was safe and well so we deferred follow up until the next day.”
Meanwhile, back in my scenario, I lacked any coercive legal ability to intervene so I passed this back for a decision about whether any mental health support was to be given, including whether any Mental Health Act assessment is needed. For the record: if she had been on a public street, I would have used section 136 MHA because I thought she was in immediate need of care in her own interests. I made that known, too.
But as she’s wasn’t, I couldn’t, so I didn’t – and back to you. Do let me know if support is needed to execute any s135(1) warrant or for any assessment that is organised. I’m not trying to irritate anyone or refusing to play my part in something I could help with. I’m just trying to resist being one of those who will be held responsible for a situation I didn’t create by being unwittingly pushed into thinking I’ve got skills and training I simply don’t have.
And that’s another debate altogether that could have been the story of my irritating people: section 135(1) warrants. The implications of these warrants are still not widely understood more than FIFTY YEARS after they were introduced in the Mental Health Act 1959. The 1983 Act just carried them from the old Act to the new, untouched. And we still don’t understand them.
Enjoy the other posts that I will appear whilst I’m away. See you week commencing 4th November.
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