The Home Affairs Select Committee has today published its report into policing and mental health after a year-long inquiry. There is a series of recommendations and conclusions to note, affecting both the police service and the NHS as a whole.
The main things are –
- The need for proper, mandated training for every police officer.
- The need for the police to reduce of section 136, with qualified, positive encouragement of triage initiatives.
- Amendment of the Mental Health Act 1983 to reduce time in detention to a maximum of 24hrs;
- Removal of the word ‘police station’ from s135(6) so it is no longer a default Place of Safety.
- An immediate end to the use of police custody as a place of safety for children.
The most unequivocal statement, for me at least, was their use of the word ‘failure‘ to describe the achievement of NHS commissioning arranegments to ensure s136 provision. By extension, this therefore applies to their Primary Care Trust (PCT) predecessors who we should all remember had money made available to them in 2005 to establish a PoS service accessible to every PCT area. I remember having to implore the old Strategic Health Authorities to apply for this money when I suddenly found it had become available and was stunned to find that some PCTs were making conscious choices not to apply for it, despite having no PoS provision at all? Why on earth would that be a responsible position?! Even those areas who did apply for it, didn’t always spend it and it took right until 2014 before every area had provision and even then a third of them continue to exclude children.
Taken together, the HM Government review of ss135/6 and today’s HASC report is a clear message: there is a threat and a will to legislate unless areas bring themselves to the position that many of us think they should have been in when Nik KERSHAW was keeping the sun up in 1983.
The media coverage that we have seen this morning has somewhat inevitably focussed on section 136 and the use of police custody, including pieces on the BBC interviewing various concerned parties. We need to move beyond that – section 136 and allied issues like conveyance are not unimportant and there are still arguments to be made and won on that subject but there is much more to Policing and Mental Health – prosecution and diversion; calls to enter inpatient psychiatric units; calls to restrain patients so they may be forcibly medicated; the high volumes of calls for welfare checks and quite preventable missing persons enquiries. Remember the victims, too: you are far more likely to be a victim of crime if you live with a mental health problem than if you don’t. We could go on, but remember this statistic: however important it debate around detention in custody may be after use of s136, there are double the number of people in police custody who are so acutely unwell, they are deemed to need a Mental Health Act assessment and a similar amount who have mental health problems but are not acutely distressed. These are quite staggering figures and they show the extent to which our system wants people in distressed criminalised, for a variety of reasons.
Notwithstanding that this report could be seen by many as something of a kicking for the National Health Service, we shouldn’t lose sight of the fact that policing itself still needs to improve and not just in relation to training and more appropriate use of s136. The problem I am increasingly concerned with is the slightly more philosophical problem of what purpose our police service should have in our broader mental health system and the HASC report alludes to that. There are expectations of police forces filling gaps in NHS Commissioning; of forces becoming the ‘coercive arm’ of the NHS in so many different ways. This mission creep fundamentally alters the policing / public relationship between officers and those of us who live with mental health problems. remember, British policing is founded on the fundamental principle of consent. What message does it give if the interactions those people experience are potentially coercive in nature, especially where it follows an inability to access other necessary services or following a request by others that officers pitch up and use force.
The HASC invites the Government to define what ‘exceptional’ will mean for the use of custody and we know from the Government review in December that there are various problems if your definition is predicated upon assumptions that all violent behaviour will be non-clinical in nature and that people will be safe in police cells. That has been the story of death in custody inquiries for decades and the debate needs to mature beyond the naive. Remember, it’s police officers who spent decades facing calls for prosecution and continue to appear as defendants in court so it’s not unreasonable to point out that we’re being continually asked to do things that get us charged with crimes. And let’s not lose sight about what impact that ironically has on the mental health and wellbeing of the officers concerned.
What is our involvement for and what do you want us to actually do?!
Meanwhile, I’m going to print off a copy of this report and place it on top of the Government Review into the Operation of ss135/6 (2014). That sits on top of the HMIC Report Core Business (2014), the Bradley Report: Five Years On (2104), the Crisis Care Concordat (2014), the the CQC Report: a Safe Place (2014), HMIC Report A Criminal Use of Police Cells (2013), The Adebowale Report (2013), the Bradley Report (2009) and the Independent Police Complaints Commission report A Safe Place (2008). I think we can all now agree: the point has now been made, if not actually been nailed on!
Responses to the HASC Inquiry Report —
Other Links —
I add more reaction, if there is any, as I learn it becomes available!
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