The forthcoming year is the sixtieth birthday of the first piece of modern mental health legislation – the Mental Health Act 1959. It’s worth noting this milestone, in my opinion, because sixty years on we are still struggling to think about how we give effect in the real world to some of its requirements. Section 132 of the MHA ’59 is the same legislative requirement as that which is currently imposed upon the National Health Service by section 140 MHA ’83 – and yet earlier this month, as we approach the sixtieth anniversary of this legal requirement, meetings were taking place to discuss how this will be done.
That’s just a part of where we’ve come from and in many respects we need to look forward, so this post is just a New Year’s Eve run down of various things we will see in the next year on policing and mental health.
PUBLICATIONS AND EVENTS
- In January, the Misconduct Hearings are due to start after the death of Sean Rigg – whatever the rights and wrongs, it’s not fair on Sean’s family or the officers involved that it’s taken almost 11 years to reach this stage.
- Also in January, we should learn the more detailed response from the UK Government after the publication of the Wessely Review in to the Mental Health Act 1983.
- We will see the conclusion of the parliamentary process for the Mental Capacity (Amendment) Bill 2018 which will change aspects of the Mental Capacity Act 2005 including the Deprivation of Liberty Safeguards.
- We will see Misconduct Hearings at some stage after the death of Thomas Orchard – not quite 11 years to reach this stage, but almost 6 years is also a considerable burden for everyone to bear.
- We will learn the order in which we may see any inquest or misconduct proceedings after the death of Leon Briggs in 2013, more than 5 years after his death.
- The National Police Chiefs Council and the College of Policing will publish a national strategy on policing and mental health.
- NPCC and the College of Policing will publish a new definition of a ‘mental health related incident’ in early 2019 – this arises from an HMIC requirement to define such things, so that forces are trying to be consistent about how they record and flag mental health related jobs to allow for more precise understanding of demand.
- Although not specific to policing, we should see publication of the NHS England ‘long-term plan’ for the health service. This is a 10yr vision of how health strategy will unfold across the coming decade and will involve details about the emphasis being placed (or not) on mental health services.
- The Crisis Care Concordat should reconvene after a meeting in December was cancelled to control how the necessary partnership working will be progress which is so vital to success in this area.
PROFESSIONAL TO DO LIST
On my own professional ‘to do’ list for 2019 is to complete certain pieces of written policy work and to further update and amend some things you’re already familiar with.
- I have to write-up the details of the ABD Conference, held in December 2018 so that we begin production of a ‘practice guideline’ on ABD for the police service, hopefully endorsed by organisations like the (Royal) Colleges of Emergency Medicine, Nursing, Psychiatry and Paramedics, as well as the Faculty of Forensic and Legal Medicine.
- There will be a workshop in January 2019 on ‘street triage’ which will also lead to a publication – this will probably be some kind of ‘assessment framework’ which
- Work will continue with the Crown Prosecution Service and NHS England, to finalise guidelines, as already exist in Wales, about the investigation and prosecution of offenders with mental health problems, especially in relation to assaults on NHS staff.
- College of Policing Authorised Professional Practice will probably need updating because of several of these issues: legal changes, improvements to police practice around ABD or street triage and certainly around the criminal investigation and prosecution of offenders.
- In March 2019 the National Mental Health Forum chaired by Chief Constable Mark Collins will convene in Birmingham, I’m thrilled to say. This follows on the back of my own force, West Midlands Police, agreeing to co-host a two-day CPD event for police force mental health leads and partners they may wish to bring. It will allow for a formal ‘launch’ of some of this stuff, as well as ‘learning the lessons’ and partnership presentations.
- In September 2019, the 4th national conference on Policing and Mental Health will convene in Liverpool. One idea for this year’s event (yet to be confirmed) is to focus one of the days on the theme of child and adolescent mental health – always amongst the more sensitive of these sensitive issue, CAMHS related policing demands always bring extra complexity.
PARTNERSHIP TO DO LIST
Of course, in the background of events and publications, there is an ongoing need to develop partnerships. This will be a constant theme on all years to come. Some areas of the UK are clearly getting on well and working well together; other areas are … err, not. One force mental health lead recently said to me, they find it hard to see their local partnership working as any kind of partnership, more an abusive relationship, but knowing some details from that area that aren’t in the public domain, I can understand why such a view might be held. That said, there are problems in policing and their approach towards mental health. I’m not sure we can honestly say we’re “there” with police attitudes towards mental health demands.
Can’t see say this loudly enough: not all demand faced by the police, related to mental health crisis is preventable and predictable, even where it involves people who are ‘well-known’ to mental health services. Policing is always going to have at least some role to play, not least because its obvious we still have too many police officers who think that where someone with mental health problems has offended, they have offended because they have mental health problems. This is not true, most of the time; and even where it is true some of the time, that doesn’t mean the police don’t have a role. Remember this at all times: some powers under the Mental Health Act 1983 are only available to the criminal courts – as such, some situations involving very unwell patients who have offended, where there is a need to untangle the relationship between mental health and behaviour may need to go to a criminal court and it may be necessary for the judge to take certain decisions which assist in protecting the public.
The partnerships discussions which need to occur in 2019 are key: we are still in a state of conflict about what the roles and responsibilities of the various services are – both police and mental health leaders need to recognise that there is still considerable ambiguity playing out in practice about who does what, when and how. The law and policy often say two different things, if they say anything at all, about how certain situations will be handled and if we are to do justice to the learning from 2018 in the forthcoming year, we need to get managers at all levels to start discussing these very difficult and complex areas in meetings and moving beyond the quite bland platitudes that arise when people are skirting complexity by talking in vague terms about the important of working together. If the law doesn’t make all coercion under the MHA outside of hospital the job of the police, we need to start talking about who is going to do this in the various circumstances where the Codes of Practice state it is the role of non-police actors. And if we don’t, we’ll continue to see verdicts on neglect in Coroner’s courts, as we have done as recently as this month.
A PERSONAL NOTE
There we go – a very short post without attempting to make any particular point. It’s just a heads up of things you may see or hear more about in the coming twelve months which touch upon the natural venn diagram(!) of policing, mental health and criminal justice. But of course, and inevitably, there will be various things from the real world which also get in the way and tragically punctuate or experience during that time.
For my own part, I will click past two milestones next year which are of personal significance. In February, I will move beyond 21yrs of police service which probably means I do need to realise I’m definitely a grown up in policing terms! In September, I will click beyond the point where I only have 10yrs of police service left to do – very conscious that can sound like a long time but it doesn’t seem 10yrs since my nearly-14yr old who thinks I’m a boring and grumpy old man looked at me through 4yr old eyes as if I were some kind of hero. So I hope next year to put arrangements in place to start doing a PhD so I can begin to think of what life may involve after policing, because there is so much more to do in this field and I’m already convinced this won’t be finished by the time I retire in 2029, all being well.
Plenty to do – so enjoy your New Year, have a drink and dance and on Monday 7th when the hangovers have worn off and the tree is binned or packed away, let’s get on with it and do it properly this time.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions 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