A Story About De-escalation

A story about the difficulties of de-escalation –

With two other officers, I once had to try to urgently ‘de-escalate’ a situation involving a suicidal man – most of us have had to do this at one stage and I’ve done it more than once. All the other efforts, thankfully, were successful, but this one wasn’t. The incident took place many years ago and I suspect it will be one of the few incidents from my career I vividly remember for the rest of my life.

The man involved had covered himself in flammable liquid and was suggesting he’d set himself alight – we knew he had a history of serious mental illness and were primarily concerned about his welfare, but what we couldn’t do (as police officers) was the one thing he wanted in order to be persuaded to put the lighter down: a guarantee he wouldn’t go back to prison for the serious offence he’d recently committed. And the offence was very serious, committed shortly after his release from prison after serving a sentence for a very similar offence, towards the same victim.  Even if we’d lied in the hope of persuading him, he’d have known we were lying because no officer can guarantee such a thing.

So we had to try other persuasions to influence him and he had to decide between two things: the overall context did not seem to allow for a third way and this is still how I see it today –

  • Either he puts the lighter down, is arrested for the offence and almost certainly goes back to prison; OR
  • He harms himself in life-altering or life-threatening as the only way to avoid the other ending.

The dynamics of that incident influenced in a very obvious way, the outcome. Sometimes, police officers are at events involving suicidal people where there is no offence whatsover, or an offence so trivial it’s never going to be the priority in an incident involving a life-threatening risk of suicide.  Where more serious offences are involved, especially where they are especially serious, repeated and indicative of massive risk to a victim, it massively affects the dynamics of police attempts to keep people safe.

CONTEXT IS EVERYTHING

My point here is this: in the seconds and minutes we had to try, we attempted to give him space, we tried to calm things down, we tried to talk to him and persuade. Tragedy occurred despite our best efforts as we saw them, to de-escalate things and I went home wondering if my actions or decisions had contributed to the outcome. He suffered serious, life-altering injuries and I later learned he’d died of his injuries. The fact that there had been an investigation of the incident to establish whether there was any wrong-doing and the fact we had been entirely vindicated in our approach didn’t stop me reflecting again on whether we could or should have done anything differently.  I think of that man every time I’ve been involved in professional discussion about de-escalation and improved training for officers; and every, single time I come across self-immolation.

Many years later, I still cannot see how the context in which we were trying to do it did not influence how that interaction unfolded – that context was not created by the officers trying to talk him away from harming himself, they had started work on a late shift entirely unaware of that man, his previous history or the allegation against him.  They just found themselves responding to a report of a suicidal man and whilst en route, learned who he was and a short summary of the background.  Less than 10mins or so after being despatched to the incident, they were in the mix of all this.  Had he been found by the ambulance service or by family or friends, the dynamics in play would have been different because the background to the encounter was that further offence – we were obviously police officers. Had there been no offence involved, it could all have been so very, very different. Police officers responding to crisis or suicide calls are not doing so in a vacuum, free from other considerations where they may be able to legitimately promise the world in a reassuring and calming way – that’s not how incidents occur.

In other types of incident where we hear calls for de-escalation, officers are not responding to situations where they have all the time in the world to contain a situation and negotiate – it is literally true that some officers must take detention or use of force decisions within seconds of arriving at a job. Policing being an emergency service, it is one of those professions where decisions must, by necessity, be taken without always having the full information and without an opportunity to discuss it with others to ensure it’s the best decision – officers often work alone and sometimes their responsibility is to identify the least worst option amidst a range of awful choices and run with it because nothing else is better.

MECHANICAL PROCESSES

Attempting ‘de-escalation techniques’ is not about the scientific application of an objective intervention – applied by a MH nurse in the community, it’s one context and set of dynamics; on a ward it’s different again. I sometimes liken the discussion I hear about these things as if people believe we’re putting a screwdriver in to a screw and turning it ninety degrees. When you do this, the movement of the screwdriver elicits a predictable amount of turn on the screw – turn it less, the screw turns less; turn it more, the screw turns more. The same thing happened when you use the equipment from your boot to change a car tyre – there is a predictable and objective relationship between the turn of the jack and the lift of the car, between the turn of the turn and how much effect you see on the wheel bolts. This is not what happens when humans communicate in crisis situations involving mental health problems – or crime.

I can tell you that if I ask someone to pick up the litter they’ve dropped whilst I’m off duty in my own clothes, the reaction is not the same as when I do that on duty in uniform.  Policing is different to other professions and police officers are not the same entity as other humans – that’s not irrelevant to the outcomes we see.  We are uniformed agents of the state in a way many other public sector professionals are not, because we come inherently equipped with the power to take your liberty and we are empowered and trained to use force to do so. We have obligations other professions don’t have when it comes to crime and public safety so the power dynamics at play are different when officers are involved in resolving any incident. We are not public servants – we are crown servants: the distinction really matters on occasion.

I spent a lot of the year listening to academics and officers from other countries talking about de-escalation techniques because of suggestions that officers are insufficiently trained in their application and whilst I (think I) understood what was being argued, it strikes me that a lot of assumptions were being made about what police training involves, especially in the UK where the police are not routinely armed. I’ve never once heard a description of ‘de-escalation techniques’ which did not cause me to just think, “That stuff has been included in all police personal safety and tactics training I’ve ever had in the last 20yrs.” Even other tactical training, like public order training, Taser training and UK police firearms training involves the upfront requirement that we use negotiation and if necessary containment, in order to try to de-escalate situations without the use of force, or with a lesser use of force.

EVIDENCE BASE

Some years ago, I gave evidence to the Home Affairs Committee inquiry in to policing and mental health and was asked about whether we needed to bring in de-escalation training from mental health professions in to policing? My answer at the time was, and it would still be, that we do train these tactics and approaches, it’s just that we don’t call it ‘de-escalation’. Over the years we’ve talked about verbal communication, tactical communication, conflict management and the foundation of all of that has been persuasive communication to de-escalate. The committee still felt this was something the police service should look at, so we ended up contacting Professor John Baker from the University of Leeds.

He and his colleagues at the University of Manchester have undertaken research on de-escalation in mental health nursing and his views were very interesting.He wondered why we had rung ‘mental health’ because, having seen police tactical training, he thought police training was in many respects better than than in mental health nursing. He also made two further important points: policing is not mental health nursing! – the dynamics are different. The training given by the NHS is delivered to those staff who are going to work on mental health wards, in the main, where much is known about patients, their condition, their background and so on. Policing might have to do this in the dark, on a bridge at zero notice with a man or woman who is simply not known to them. These differences are important.

He also made two devastatingly important observations after that: his research with nurses had revealed a) de-escalation techniques are not objectively relational – two different nurses trying the same things with the same patient in the same context would not automatically see the same results, because the nurses are different people and that alone may be enough to mean it ‘works’ with one, but not the other; AND b) the training they were evaluating did not actually improve that much on the natural de-escalation skills their cohort had anyway. If you were naturally rubbish at de-escalating crisis or conflict situations, the training would only marginally improve you; if you were naturally good at it, it wouldn’t improve you much either! And either way, there would then be a regression to natural levels of competence over time. (Hope I’ve represented that correctly, John!)

DECIDE FOR YOURSELF

So! … put all that junk together and decide for yourself! Of course, we want the police to resolve as many incidents as possible without using force or by minimising the intensity and duration of whatever force is used. But! –

a) the British Police are fairly good at this anyway, not least because we have to be – we’re not armed; AND

b) everyone needs to remember this is not a mechanical process – it’s a human process and people are unique; it about human relations and these are complicated and uncertain at the best of times.

The main point here: just because a police officer has used force to resolve a difficult and sensitive mental health situation doesn’t automatically mean they’ve failed in their duty to de-escalate. On-lookers will often have no idea at all what else may be going on in the background to that incident which may influence the officers’ decision-making. They wouldn’t know if there was also a serious allegation against the person; they wouldn’t necessarily know what the PNC is saying about risk history, weapons or violence risks; they wouldn’t be aware of what the police had been (correctly or incorrectly) told about the person when the reports first came in.


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


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