This blog has now been running for over two years and this post should be celebrating that fact and having moved past half a million blog hits. (I just laughed out loud (again) writing “half a million blog hits” – a policeman banging on about out-dated laws and NHS guidelines.)
I started this blog because I found myself no longer working in the area of policing and mental health and felt there was still stuff to do and there were things to be said. And as I sat thinking through what to put in this post to mark two years and half a million hits, I found myself just becoming really angry, if I’m frank.
Because this blog shouldn’t really need to exist – not at all.
MY ORIGINAL INTENTIONS
1. To promote a debate about the role of the police in the implementation of the Mental Health Act – the police do not have legal powers to resolve every type of MH crisis and this is not widely understood.
2. To promote debate about the investigation and prosecution of criminal suspects who are mentally ill – when / how should we divert from justice, who should take those decisions and how?
3. To provide practical advice and links to resources for front-line police officers on how to navigate through a legal and medical minefield. Successful resolution of incidents involving mental health issues can involve “PlanA” when necessary partnership structures and responses are in place but “PlanB” needs to be understood for when they are not.
You tell me — job done? My sense is that I and many others have said what can be said, but whether the right people are listening is quite another thing. I’m not yet convinced but I’m also running out of ideas except to keep saying it: over and over and over again. And again.
As forces realise what threat and demand mental health work represents, they are appointing sergeants and inspectors to lead on project work for their force. It is obvious from the emails I get, that those officers are running up against the standard obfuscations that emerge when you first wade into this arena, intended to make progress difficult. Things I started seeing ten years ago. And of course, those officers are starting with the same knowledge base I had about ten years ago. None whatsoever.
So they’re being told “A&E is not a place of safety”, “resistant detainees must be taken to the cells”, “you can’t get a s135(1) warrant unless you’ve already tried to get in”, “it is the role of the police to recover and repatriate all AWOL patients” and “you have to convey patients when AMHPs direct that.” << All wrong, just so you know. But how would they know? They’ve probably had the same 4hrs of training that I’ve had.
I have started to feel like a dripping tap, saying these same few things with an almost monotonous regularity. Even very recently, following yet another death in custody after the use of section 136 of the Mental Health Act, I entitled a piece “Here We Go Again” and began by admitting I had cut and paste things from previous posts into the new one. Nothing new in it at all: just yet again pointing out that which has already been pointed out before – and not just by me. Within that post, following the death of Leon BRIGGS, I wrote, “Let us be clear about this, yet again — another death in police custody or following contact could happen tomorrow in any area where the procedure followed by the police is not built to mitigate against unlikely but highly significant risks.”
And guess what; it did, didn’t it?
Ten days after the death of Mr BRIGGS in Luton, we learned of the death of Terry SMITH in Staines. We have since learned of the death of Luftar COKU in Hereford, which occured in August this year. Three section 136 inquiries from a four month period. We also know that the CPS currently have investigation reports on their desks following deaths of Thomas ORCHARD and Kingsley BURRELL-BROWN; and that the IPCC have re-opened their investigations into the deaths of Sean RIGG and Seni LEWIS. Add to those the ongoing inquiries from the deaths of Rafal DELEZUCH in Leicester in 2012; that of Toni SPECK in York in 2011 and of James HERBERT in Yoevil in 2010. There is a lot going on there and we have over three dozen police officers being investigated and various health staff alongside them. At least one of the police officers being investigated is a Chief Constable, for potential corporate liabilities.
And all because, we – the United Kingdom, a major first-world democracy and the world’s seventh largest economy – either don’t have adequate basic procedures for safe restraint, or for emergency mental health partnership working; or even a concord across our NHS as to what is needed. Our NHS can transplant a human heart from a dead person to a critically-ill patient, extending their life by decades but it can’t agree where patients in mental health emergency should be taken by the police.
In chance conversation last month with someone relevant to this debate in NHS England (who carry commissioning responsibility for various offender health services and oversight responsibility for ensuring that CCGs commission correctly) I was told, “of course, where people are violent and aggresive, they’ll have to be taken to police custody.”
No, no, no – half a million times, no! What hope is there if the people leading the way so fundamentally don’t get it after all the tragedies and enquiries.
Apart from anything else, NHS staff lack the legal authority to make this happen and if this blog has got any underlying message at all, it is this one and it is directed to frontline police officers: go and learn for yourself what you need to do to try your best to safeguard the vulnerable people for whom you become legally responsible: learn what this looks like in an ideal world and even more importantly, learn what this looks like in the world we work in because it doesn’t look like we will see an end to the situations in which you’ll be left with your first-aid certificate fending for yourself and a vulnerable person who has medical problems that no junior doctor would manage alone.
What will you need to say you’ve done or tried in order to look the family of a death in custody victim in the face and with your hand on your heart say, “I tried my best and did everything I could.”
There’s not really much more to say, is there?
ARE WE GOING TO DO THIS, OR NOT?
We know that if we don’t do it, the body count and the family trauma will continue to mount; the police will then cite things like the Adebowale Report to show that we’re left carrying the can and the Rocky BENNETT report to show what medical opinion states about restraint-rekated mental health emergencies. Mental health trusts will point out that their budgets are being cut by CCG commissioners against backdrop of rising demand; and somewhere in there, we will put police officers and quite possibly NHS staff through the trauma of being investigated as potential criminals for trying to operate in a system that was badly designed – if it was designed at all.
And all of this will make us forget that actually – even more important than any of that – there is a long list of grieving families with unanswered questions who are campaigning for justice. And for every high-profile event like those referred to, there will be dozens of lower-level, thankfully less-serious incidents but which still leave vulnerable people feeling like they are second-class patients in a system that criminalises them and denies them parity of esteem. I won’t exemplify that claim: because I’ve done it all before.
Instead we will continue to see responses that fail to address the core problem, reactions like Street Triage and 136 facilitites that exlude more people than they accept: shiny new services that deny those is most need the access to which they’re entitled. We’ll pretend everything’s OK because we reacted (too late) to make things better without realising that all we did was do the wrong thing, righter.
I’m taking a break from blogging until after Christmas / New Year.
The Mental Health Cop blog
– won the Digital Media Award from the UK’s leading mental health charity, Mind
– won a World of Mentalists #TWIMAward for the best in mental health blogs
– was highlighted by the Independent Commission on Policing & Mental Health
– was highlighted in the UK Parliamentary debate on Policing & Mental Health