Many times in my career, along with every other police officer in the country, I’ve been called upon to do something as part of someone else’s contingency plan – can the police support paramedics in attending an address, because it’s flagged as being connected to violence; can the police attend an address on their own to undertake a ‘safe and well’ check, also known as a ‘welfare check’ on a patient who has rung the crisis team. We know that many patients, or parents of younger patients, have been told to ring the police if things become difficult at certain times – usually connected to the non-operating hours of the service giving that advice; and we know that many patients have had ‘ring the police’ written in to their crisis plans without their knowledge.
There are a few things to say to this, that I thought were worth focussing on –
Firstly and most importantly, I’ve never known these plans be put in to any kind of action with anything like an adequate amount of information being relayed. “Can you back up an ambo crew, patient with a history of violence.”
Well, frankly, what on EARTH does that mean? – did this guy shout at the previous crew and threaten to hurt them, did he try to hurt them; did he succeed in hurting them, but fortunately not too seriously; or did he cave in a paramedics head using a wooden fence post and then stamp on and break their hand (real example)?! And when, did this happen – if it was in 1997, should we review the approach? – if he was only ever a bit shouty, and we’ve been there a dozen times since without problems, maybe we should review it when it’s so historic; if it was in 2015 and we haven’t been there since, it seems fair enough that the police are involved. If he did brutally attack a paramedic, then the age of the incident may not matter at all because of its seriousness.
Secondly, the control room or the duty sergeant is going to have to make a decision about police resources: do we send one, single-crewed officer or a double-crewed car? – maybe a Taser officer would be a good idea if the previous incident involved wooden fence poles? Maybe the nature of the ambulance job also effects this decision – if this incident involves a person who is experience a mental health crisis, we might want to send a sergeant or a street triage resource (if available). I once received a call like this and initially took a sergeant and six Constables; once there I ordered another sergeant and another seven Constables in a van with riot gear, releasing one of the double-crewed cars. Understanding risks is not about just curiosity, it’s directly relevant to decisions that are ultimately legal decisions about Health & Safety law – we are still under a duty to risk-assess jobs to ensure safety to the maximum degree: yours and ours!
Finally, where the police have been structured as the individual crisis response by a mental health organisation, we can occasionally create this 999 exchange in reverse. I remember an incident where a family were struggling to meet the needs of their 14yr old son at home and he had been ‘sectioned’ one evening by an AMHP and two DRs. However, the bed wasn’t available until the following morning and the family had been asked to convey the lad there at 9am with someone saying as they left the address, “Any problems between now and then, just ring the police.” All of points one and two, above, remain relevant here but there is an additional reason to be frustrated: what are the legalities here? Assuming this incident was ongoing in private premises when the police arrived, they have no legal powers at all unless there is a criminal offence going on! Do the parents realise this? – or have assumed or been told the police will be able to resolve whatever is happening in a way that seems logical, caring and appropriate?!
The eagle-eyed amongst you will have noticed I’ve been deliberately ambiguous in the sentence that talked about legalities: if there is no bed available, I usually get really pedantic in asking whether or not the AMHP has completed their application for admission or not – because the answer alters the legalities for the police. If they have completed it, and the police attend a crisis incident, then we can start having a think about s6 MHA by ringing the out-of-hours AMHP and discussing things. If they haven’t, then it will have to be a different discussion. Of course, either way, the police will be waking in blind to a situation that involves laws that I’ve known MH nurses and AMHPs misunderstand so my final point is that putting the police in to this unprepared and un-briefed is just bloody unfair on the officers who have no legal powers to ensure that can come across as being logical, caring and acting appropriately!
WHAT THE POLICE DO
Remember what the police can do: we can talk to people or use force – I’m guessing that if talking to people we’re going to be successful, the police wouldn’t have been called! If we are going to be called, we need the chance to do a good job by being given the right information and where it is known that the police are going to be the back up plan at some stage in the future, why not ring the police in advance and let them know they’ve just become part of a plan? “Hi, this is the CAMHS CMHT – I just want to let you know that we’ve advised two parents to ring you tonight if things become difficult. Their 14yr old son James has autism and a learning disability and will be going in to hospital at 9am tomorrow. If the parents call you, you should be aware that James occasionally has a form of meltdown and can be aggressive towards his parents and others but the best way to deal with it, would be for officers to just contain a situation to stop it getting worse, make the situation as calm as possible by turning off blue lights, sirens or radios and try to give him time. You can ring this number when you get there and speak to [name] about what’s going on and they can talk the officers through the options. An MHA application for admission has been made so s6 MHA will apply in the situation, but you will need to think about whether that is the appropriate way because the hospital are not expecting him until 9am tomorrow.”
Now – whether or not I agree that this is an appropriate role for the police – at least I stand half a chance with that information calmly explained by a control room operator. “This is what CAMHS told us this afternoon” … imagine if officers arrived and were having to be told this by a distraught father whilst they were already in to some form of restrictive intervention because they worried James would hurt himself or someone else?
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