‘Mental Health Related’

For some while, it has been suggested that the police service need to define what they mean by an incident being ‘mental health related’. You know those claims you’ve heard may times about how X percent of police demand or police time is connected to mental health related jobs? … well, it’s always been true that we’ve never been entirely consistent or sure of what we’re counting.

When I first ventured the 20% figure on this BLOG many years ago, I knew what I was counting: I’d been keeping tallies as a response inspector of things going on whilst I was at work and would often take a snapshot of –

  • Detainees in custody flagged as having a mental health condition, or a warning marker for suicide or self-harm.
  • What percentage of people who are currently reported missing are absent from mental health care or whilst suspected to be at risk of their mental state?
  • Of all the 999 and 101 calls that land in a snapshot period (usually one or two hours), what percentage were in some what ‘mental health related’.

I was very clear that I was looking at police demand, not police time.

DEMAND v TIME

As the service became more interested in making similar claims, forces applied different terminology and definitions. One force said that something was a mental health incident if the officers or anyone else identifies any element of the job involves someone with mental health problems. Some forces gave percentage figures involving how much ‘demand’ was MH related, others said they thought a percentage of their ‘time’ was spent – you’ll notice those are two very different things!

Compare these two jobs –

  • One officer deals with a man as a victim of crime who woke up to find his shed had been broken in to and his tools and lawnmower stolen.  It takes them 1hr to complete the response, the handling and the paperwork.
  • One murder investigation occupies 100 detectives for a week, then occupies 20 detectives for a further week, then 2 detectives for a further week, largely completing the paperwork for a full trial.

Two pieces of demand: vastly different amounts of time spent. Imagine if the shed burglary victim had mild depression, was cared for by their GP, with a low dosage of a common antidepressant and their depression was in no way, shape or form, the causal factor in the offence and nothing prevents them reporting their crime or even giving a statement.

Imagine the murder suspect was seriously mentally ill – sectioned shortly after arrest, interviewed and charged with the offence much later and then, at trial, pleaded guilty to manslaughter on the grounds of diminished responsibility.

Are both incidents ‘mental health related’; or just the second of the two?  I’d say just the second – the first incident is not about someone’s mental health in the way that a crisis incident is, and it doesn’t affect how the police responded to it.  Their mental health condition is incidental.  But to use the force’s definition, above – does anyone in this incident identify as having a mental health condition?  Yes, but it’s a non-serious condition that isn’t relevant to the incident or its handling.

OVER-MEDICALISED RESPONSES

This post is part-consultation: I have to come up with a definition of a ‘mental health related’ police incident, for adoption by the police service as a whole and one which could be used the HMIC, the College of Policing and others to influence how policing and mental health is looked at, defined and delivered. We have undertaken some preliminary work with some forces who have already started looking at this, taken some feedback from outside the police and now have a draft definition on which we need opinions to see if it survives contact.

This effort is to make sure that we don’t over-medicalise responses, that we can gather data more consistently and then have a better understanding of how mental health conditions influence behaviours and needs that may require a police response. We don’t want to over-medicalise our response to people; we don’t want to over-criminalise vulnerable people either. It is argued that if we get this right, we’ll avoid both. So the definition below arises from some limited early discussion with some inside and outside the service who have had to think about this already where I’ve taken all their ideas with some of my own and slammed them together. To that extent, if I’ve ruined anyone else’s good ideas, I’m very sorry – my jobs is to reconcile the various competing interests in to something we can all live with.

Here goes! —

Mental Health Incident Definition —

“A policing incident is ‘mental health related’ if the primary purpose of any response is –

– A concern for the safety or welfare of someone, connected to a mental health condition*;

– Any disability hate crime where someone has been victimised because of their mental health condition;

OR

– Any other kind of policing incident, including crime, where officers are responding to something which requires a reasonable or legal adjustment to be made in their handling of it because of someone’s mental health condition.

* Someone will be regarded as having a ‘mental health condition’ if the officers involved have any reason to think this may be the case or where this has been suggested in good faith by anyone else.”

Your thoughts on this are welcome.

Feedback in comments below, via Twitter (@mentalhealthcop) or on email to –

michael.brown2@college.pnn.police.uk


IMG_0053IMG_0052Winner of the President’s Medal from
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award.

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6 thoughts on “‘Mental Health Related’

  1. Very difficult stuff.
    I had sight of the calls our local police service regarded as mental health related. It bore no relation to what we in mental health services would consider to be so -page after page of ‘drunk guy with top off being aggressive with self reported depression ‘ etc etc

    I’d be super sceptical of *any*data on this . As police are consulted on mental health matters frequently, maybe in turn have a frontline mental health crisis professional look at this stuff with a critical eye?

    1. The problem with that is, the police service would be negatively appraised by all concerned if we took someone’s ‘self-reported depression’ and then worked on the basis that he didn’t have depression: MH professionals themselves keep telling us that 3/4 adults don’t receive and 6/10 children don’t receive MH care for MH conditions they do, in fact, have. I’m skeptical of all data on this, trust me on that!

      But finally, the problem with having a frontline MH crisis professiona look at this stuff with a critical eye is a) if there were a frontline MH crisis professional, the police would be uninvolved in much of this stuff – whether we look at s136 data or street triage encounters we frequently find that 2/3rds of all the people in contact are known MH patients, whether or not they are currently open to services and many of those who aren’t have disengaged and not been followed up. We also know that much of the MH related demand we face is actually generated by the NHS who are known to have inconsistent definitions, threshold and approaches! So it’s hard to know who or what the hell to believe, frankly.

  2. Needs to be simple… ?

    …Any police deployment instigated or affected by a mental health factor.

    You could sub divide into: 1) reactive from health/other agencies… Misper, AWOL, s135(1), welfare checks etc; or 2) spontaneous… MH crisis calls from MoP, victims of crime, suspects of crime, loss of control in MH settings etc ?

  3. I would keep the definition simple and not blur the lines/make the encompassing issues bigger than needs to be. I would also put a limitation within, to minimise the expectation of policing involvement where possible.

    “Any incident which requires police involvement, due to an immediate risk of serious harm or loss of life to any person, where it is known or reasonably suspected that the risk arises as a result of a mental health condition

    and

    the use of policing powers/tactics are the most appropriate means to resolve that immediate risk”.

  4. I can’t think of input right now but I think defining this is an excellent idea. I’ve worked in mental health services before and seen just how much police time is taken up with mentally ill or unstable individuals, even those living in supported living. So interested in this blog!!

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