Policing is not the problem here: the extent to which we rely upon policing – that’s the problem. This doesn’t not mean the police have no role to play, that the police are perfect and that we should never rely on them to act as society’s safety net. Sometimes it is inevitable the police will be the first point of contact for someone in mental health crisis and we are right to expect officers and their organisations to be competent in ensuring immediate safety and appropriate referral to relevant forms of assessment and support.
Nor does my argument mean that what the police know about mental health issues in our society is irrelevant and uninformed: the police see things that are outside the norm and we know like no others what it’s like to be that safety net. This gives us an insight in to how mental health issues operate in society that is different. If you doubt this: imagine what it’s like to be a police officer at 3am on a Thursday trying to use s136 of the Mental Health Act and finding, for all intents and purposes, that our NHS is closed and that when things go wrong, you may find you’re being asked questions under criminal caution even though your actions complied with the policies that were set down in your area.
Here are some thoughts, in summary: the detail that sits behind this little off-load is elsewhere on this BLOG, spread across countless posts –
- Almost all of the major untoward events in policing and mental health, reveal failures or omissions in health, as well as in policing.
- This might be about the days and weeks preceding the police contact or it may reflect the difficulty our healthcare system faces in offering real-time support to our officers when they must act as that safety net.
- How soon can we involve other agencies and have them take responsibility for the slower-time decisions which follow the intervention of the police? – that time span is often measure in hours or days, when the theory and the agreements suggest it’s there within minutes.
- More than a few police officers who have found themselves in criminal courts of gross misconduct hearings accused of wrong doing have had to point out that their actions, largely or entirely represented compliance with local policy and procedure, often set down by the NHS and endorsed by senior officers who didn’t necessarily realise what was wrong.
- In fairness to our bosses: why would they realise?! – they thought joint policies were about adopting practice based on NHS expertise. Turns out, there was a deliberate and fairly subliminal strategy to push risk, liability and often cost towards policing against the direction outlined in national guidelines.
- Major reports on policing mental health make far more recommendations about the health and social care systems and their interface with policing than they do about policing itself – see the Adebowale Report and Angiolini Report as just two recent examples.
- I’m yet to learn the detail of a death in police custody where I did not end up being just as concerned with healthcare provision or policy, if not more so, than I was with the policing response.
- Any focus which is just on policing and a need to improve it, is missing the point – almost entirely missing the point!
- We seem to have fallen for the seductive trap in thinking that what we must focus on is improving police responses through training and partnerships – I think this is merely ‘doing the wrong thing righter’.
- You can have as much early intervention as you’re prepared to pay for – and if you don’t pay for it, you’ll just end up paying more anyway, ensuring ever-later intervention with blunt tools which are far more likely to go awry.
- We can make a choice to do things properly, or not – it would probably end up being cheaper, if we did.
- And we all too often choose ‘not’ because the lessons of things gone awry are learned the hard way in policing, if they’re learned at all; but they are rarely learned in ‘health’.
To entirely misquote and misconstrue Carl von Clausewitz’s aphorism, “Policing is a continuation of healthcare, by other means.” Just like war can represent a failure of politics, policing mental illness can represent a failure of social justice when it comes to ensuring timely access to relevant care and support. If all we are going to do is focus on what is wrong with policing when it responds and improve that, we might as well pack up and admit we don’t care – policing is not the problem here: the extent to which we over-rely upon policing is the problem here. We must rely upon it less as a de facto mental health service, without pretending that there is no role for officers to play – and if we don’t, it will cost us more and lead to poorer outcomes. The police service cannot, on their own, make that happen – the choice is for others to make and they do make it, even if just be default of the status quo.
Earlier this week, I had to listen to a phone call made to a mental health crisis team and whilst the content of that call is not my story to share, I was nothing other than stunned to hear for myself the reaction of a mental health professional to a request for some support: “ring 999!” Absolutely nothing within the incident suggested this was even vaguely necessary … indeed, it would have just set up the police or paramedics to fail. So let me put this another way: there is plenty that is visibly wrong with policing responses we could spend our time fixing – and we probably will because it needs fixing regardless of what else we don’t do. But when we’ve finished doing all of that, it will have had, at best, a marginal effect but it won’t be able to affect all the outcomes we don’t like where we’ve over-relied upon the police as a de facto mental health service.
Policing is not the problem here – the extent to which we rely upon policing: THAT’s the problem here; and I worry that we will continue to make deliberate choices by default, as we have for decades, to make this problem worse, not better by focussing on the more obvious, but secondary problem we face. And then we’ll wonder why all the guidelines and all the training for policing made little or no difference, whilst failing to realising we didn’t do anything about the fundamental problem.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All views expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2019
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – http://www.legislation.gov.uk