So here’s a knotty one – on the subject of police training. We know that the police need (more) mental health awareness training because Lord ADEBOWALE told us so in a report with receommendations that were accepted after publication.
So it gives rise to a list of questions –
- How long should the course be?
- Who attends it?
- What should the course contain?
- How will it be delivered?
- Who would deliver it?
In reality there are multiple audiences amongst the police – if an inspector with no previous background in mental health policing and partnerships were to be promoted to Chief Inspector and be told to lead on the issue for their area, what would they need to know to be effective? Whatever the answer to that question, it would probably be different if we tried to address the needs of a frontline operational sergeant running a response team. It would be different again if you were an officer with some interest and experience who was newly posted to a street triage team or a custody sergeant working where a liaison and diversion scheme was just being set up.
So can we agree: the police service needs a suite of options – perhaps modular and adaptable – capable of being delivered in a range of ways and that at least some of this needs to involve classroom inputs and partner organisations?
But what problem are we trying to solve – what is it that police officers don’t know that we need them to know, which we would hope effective training would address? What is it that we want them actually do differently?
PLAN A and PLAN B
One of the most difficult things of all will be to determine the specific legal training in circumstances where we currently know that the requirements of law and the codes of practice are not necessarily adhered to in all areas. It’s all very well running an input on AWOL patients and pointing out to officers that para 22.13 states that where a patient’s location is known it is for NHS services to re-detain and return them to hospital. What are the implications of training that to police officers, if some of them work in areas where the NHS argue they don’t have resources or capacity to recover missing patients? You may think that it will empower police control room staff to ask the correct questions to allow them to say, “No – that’s a matter for you to undertake” where necessary. But many officers know that there can be other reactions from staff on wards who are physically not in a position to leave a ward or call upon colleagues in other mental health teams to undertake those jobs on their behalf.
So we have to think this through!
It’s all very well lining up the lessons learned from IPCC investigations and Coroner’s inquiries before drawing conclusions about what the police need to do differently but some change may involve the need to adapt partnership approaches. How do you provide training to protect officers and vulnerable people that takes account of all of this, if certain aspects of partnership working is yet to change or is struggling to do so? The question is not abstract: training around the proper response to a mental health emergency involving acutely disturbed behaviour – possible excited delirium: amidst restraint by several officers I can of some areas of the UK where little resistance would be met some NHS areas and it would be hotly contested in others. How do you train for that, bearing in mind that it is possible to highlight several force areas that cover multiple MH trust and acute areas where the NHS approach is not consistent? I must stress: I’m not trying to particularly knock the NHS by saying this! You could say – and I have said! – similar things of the police on various issues in this interface. These are the difficulties of partnerships and of trying to get national consistency on important issues amidst highly devolved local services.
Is training and an improved, raised awareness of legal and clinical risks something which should be trained for it’s own sake in the hope of improved awareness driving change; or is it irresponsible to suggest a course of action that may set in train a conflict between operational officers and colleagues in the NHS? The reality is it would do both, because partnership arrangements, structures and the role played in different areas by ambulance and A&E services varies – or at least the capacity and involvement of them does.
So what about multi-agency training? Getting police officers into rooms with mental health nurses, AMHPs and psychiatrists – not to mention getting into rooms with paramedics with whom the police work so closely at a lot of mental health affected incidents. What is best delivered to police officers alone and what should be delivered in a partnership setting? All four of the above bullet point questions above apply thereafter and you would have to be careful to make sure all of this didn’t involve significant duplication.
Of course there is also a practical reality to be observed: even if you answer the above questions and conclude that just SOME officers are going to need as comprehensive a set of training opportunities as we can possibly offer – force mental health leads, street triage officers, etc. – it still doesn’t address whether or not there is an appetite to allow the time for it to happen. Indeed one thing that has been discussed for years is whether Britain would benefit from the adoption of a ‘Crisis Intervention Training’ model that we have seen in the United States, Canada and Australia? So many reported benefits to this approach to policing and mental health but nowhere in Britain has trialled it. Do we need to design what that would look like, in outline, to help convince one senior officer that it would be worth seeing whether it improves things in a British setting.
So the major question is – do we train for the world we are actually policing or does training have a role in setting standards that could or should be delivered?
This is what we now have to wrestle with to determine what good training for the police will look like. If you have a view – please leave a comment below as this post really is a part of my attempt to gathering different views and ideas to build a balanced perspective.
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