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The President’s Medal

I’m going to take myself to the International Convention Centre in Birmingham, later today – the Royal College of Psychiatrists is holding its 2015 International Congress in my adopted city, the place where I started my policing career and got interested in mental health issues.  In February, Professor Sir Simon WESSLEY invited me to attend and “honour the College by accepting a President’s Medal for a significant contribution to the lives of people with mental illness.”

WOW!   just WOW!  WOW!!  WOW!!!

I will admit, when I read Sir Simon’s letter inviting me to accept the medal, I smiled very broadly indeed … and then I unintentionally laughed out loud at the very thought of it. A policeman banging on about mental health law and mental health guidelines is something I still find fairly unlikely and somwhat hilarious for the impact it appears to have, if I’m honest.

Far more seriously – and having learned a bit more about the President’s Medals and who the Royal College gives them too – I am just utterly overawed by the honour and very, very humbled.  It has typically been given to senior politicians like Norman LAMB, Lynne JONES and Charles WALKER; or to Chief Executives of our major mental health charities like Paul FARMER, Paul JENKINS and Sean DUGGAN.  Add to that mix various other international academics, politicians and psychiatrists who have also had a particular impact and I’m just stunned, grateful and amazed to be listed alongside them in the Royal College of Psychiatrists’ Roll of Honour.

So tonight, after spending many evenings and weekends blogging, tweeting and taking phone calls – especially during the time when none of this stuff was really any of my business and especially when I probably should have been doing any number of other things – I get to take myself off to an awards’ ceremony at the ICC and a slap up meal in the Great Hall at the University of Birmingham (my alma mater) … what’s not to like?!

I actually started writing this BLOG for frontline cops who are given very little training on mental health issues and mental health law before being sent out on the frontline of British policing, protecting vulnerable people.  I’m grateful to those in policing and especially to those beyond it who tell me they’ve used it – over one million times. In particular, I’ve always taken heart from feedback that patients and heir families have used the information to stand up for their rights when dealing with police officers or mental health professionals.

No blogs for the next week and a half – the BROWNs are off on holiday tomorrow for more celebration and some certain relaxation.


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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One Million Hits

The BLOG tripped quietly over the one million hits mark earlier today —  I have been laughing and smiling all morning: the idea of a BLOG written by a policeman moaning about mental health and capacity law as well as health guidelines being read over a million times is fairly hilarious.

A month or more ago I was at a College of Policing conference on Conflict Management, talking about mental health. In one of the breaks I was stood outside enjoying the sun when a Geordie sounding police officer walking past me patted me on the back and almost without really stopping said, “I love your BLOG: every time I get stuck or in difficulty with mental health jobs I have a look at it and I just do exactly what it tells me to do –  it always works and has got us out of various sticky situations” and off he walked before I could really thank him properly or ask his name.

I’ve no idea at all who he was but what I do know his generous remark was all the more gratifying for the fact that it came from someone I’d never met and do not know. I also know it is exactly why I wrote the thing – in the hope that some frontline police officers might find themselves better equipped to make a positive difference to their interactions with vulnerable people and mental health services and that some more senior officers would be able to go in to rooms with partner organisations and influence them.

I look forward to sharing some other incredibly positive news with you all on Wednesday in which I am sure the BLOG has played a significant part – then it’s time for a couple of weeks’ holiday!

Thanks to all those who read and use this blog, in whatever capacity and for whatever reason – if people weren’t reading it, I wouldn’t be writing it.

Michael./

PS — there will come a day where there’s nothing more to say and only the question of there being loads more to do.  We haven’t quite reached that day yet.  My own view – for what it’s worth – is that some of the activity we see at the moment is making things worse, not better, in the long-run.  But maybe one day …

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The Mental Health Cop blog

Badgewon the ConnectedCOPS ‘Top Cop’ Award for leveraging social media in policing.
won the Digital Media Award from the UK’s leading mental health charity, Mind
– won a World of Mentalists #TWIMAward for the best in mental health blogs

ccawards2013 was highlighted by the Independent Commission on Policing & Mental Health
– was referenced in the UK Parliamentary debate on Policing & Mental Health
was commended by the Home Affairs Select Committee of the UK Parliament.

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HMIC

Remember when you were at school at your handed in your maths homework, they would check your answers and your methods?  Having been asked to do 11×44, you wrote ‘484’ (probably because you did it with a calculator?!) and then the teacher declined to give the extra marks as you’d not shown your working out?!  I felt like that when I read the latest report from Her Majesty’s Inspectorate of Constabulary on Surrey Police.  HMIC conducted an unannounced visit in January 2015 and have recently published the report which makes various remarks about mental health matters.

The answers intrigued me, so I wanted to see the working out to understand how the inspectorate is looking at things, I thought I’d read through it.  I’ve read various reports they’ve written over the last few years (including their Criminal Use of Cells report (2013) and the Core Business report (2014).  I’ve previously been confused to know how HMIC have approached their work report work on mental health but I know they’ve emplyed mental health professionals like Heather HURFORD as an inspector which was evident in the thought put in to the HMIC report on vulnerability (2015).

For this localised report into Surrey Police, how did they end up at the conclusions they reached? This was not an exercise in elementary mathematics, so the confusion around methods also caused me to wonder about the answers themselves …

SURREY POLICE

The report makes a recommendation in paragraph 3.12 about Chief Officers reviewing s136 Mental Health Act (MHA) policies to make sure that custody is only being used in exceptional circumstances for those detained under s136.  They recommend a reduction in the use of the power and a reduction in the use of cells.  Fair enough – this is what the MHA Code of Practice demands: the least restrictive practice and custody only on an exceptional basis.  The report hints towards why this recommendation was made (in paragraph 6.23) by explaining that 45 out of 573 detainees held under s136 were taken to custody (just under 8%) and that there was scope to reduce the numbers further, although it doesn’t say how or what the particular problem is.   However, the report also says (in paragraph 2.37) that “there is no evidence of police custody being used inappropriately.”

I cannot find anywhere in the report, anything that alludes to who was detained in Surrey cells, why precisely they were detained there, or how that stacks up against various pieces of guidance that are relevant to consider where the appropriate place of safety is for any particular detainee. For example, did they detain 45 people were under constant restraint for hours because of serious attempts to resist detention and injure themselves because the local health service refused to accommodate them; or was it 45 people who were detained because they were perceived to be vulnerable, at risk and without capacity to consent to other pathways at a point where the preferred Place of Safety provision was simply unavailable? There is obviously a difference between the two and a broader view of relevant guidelines (like those from Royal College of Psychiatrists, National Institute for Health and Clinical Excellence) might have something to say about those situations ending up in custody.

Of course, there is no accepted definition of what ‘exceptional’ means, but I remember a discussion with a government official in which they said it usually means between 2-5%, depending on the issue under discussion. Well, running with that definition, 8% is over the top and therefore there would be evidence of over-reliance upon police custody, for reasons we can’t see from the report – factors influencing that may be beyond the direct control of Surrey Police and this isn’t made clear one way or the other. It would also be great to know where and how the numbers could be reduced and whether this is an issue for Surrey Police alone or, far more probably, the wider partnership in which they sit. A final point on the Surrey report, was paragraph 3.8, which surprised me: the authors expressed concern that accident and emergency was listed in the local protocol as ‘an exceptional place of safety’. They don’t explain their concern and it did make me wonder because Accident and Emergency is, infrequently, used as a MHA Place of Safety for those detained under s136.  I will admit it: I don’t understand.

PART PICTURE

Of course, something the report doesn’t examine – because no-one ever does – is the criminal arrests going to custody which lead to a formal Mental Health Act assessment to identify whether there is learning for the arresting officer, reminding them that s136 exists to focus upon early diversion from criminal justice for trivial matters: that is clear from the history of the power and from long-standing Government policy in Home office circular 66/1990. All forces will have a residual number of criminal arrests which lead to detention in custody where officers would have had it available to them to use s136 (or to link to other health services like crisis teams or street triage services.) Unless you know the extent to which forces may be criminalising low-level offences by those in crisis where the mental health and wellbeing of the offender has to take the immediate priority, you’ll never know whether there is scope to reduce use of s136.

For all anyone knows, Surrey could be over-using it the sense that they are relying upon the power to connect vulnerable with mental health services because there is often no other way of doing it, but simultaneously under-using section 136 and need to increase its use, to avoid criminalising people by arrests for low-level offences. If we could click fingers and put that all in place, I don’t know whether use of section 136 would go up or down … but obviously the more available Surrey and Borders Partnership Trust can make themselves to work in real-time with Surrey officers, the greater likelihood that they could reduce the use of all legal powers of detention for those in crisis.  This is true of every police force in the country, it just happens to be the publication of the Surrey report that grabbed my attention when a headline that appeared in my Twitter timeline said they should ‘Reduce the Number of Mental Health Act arrests’.

If I’ve understood it correctly, having fully read the report, HMIC appears to be saying, “You’re not using custody inappropriately, but you need to reduce the use of custody and the use of the power even though we don’t really know whether you’re using the power enough to start with because we haven’t examined everything that is truly pertinent to an assessment of that.”

I’m not sure how helpful I find that, if I’m honest.

USE OF SECTION 136 MHA

We hear so much about s136 usage and it’s potential to be reduced.  Before we go much further with that idea, I could do with someone explaining to us all what the correct level of use is? If Chief Constable Lynne OWENS CBE issued a direction that MHA powers will not be used where any other legal option exists, you would see it fall substantially, almost overnight – she could fill up the cells with hundreds of vulnerable a year who would be criminalised to an even greater degree (and probably for a greater period of time) and there would be a massive tick in the box for having sorted the recommendation in paragraph 3.12.

I’m sure that nothing will be further from her mind, but it emphasises the point about arbitrary notions of what is the right level of use – it’s not quite a target, but if some s136 use is too much, then it suggests that less is right and that there is almost a target to hit.  So if Surrey put themselves to work on all of this and got things down to 30 people going to custody out of 500 detained under the MHA for 2015, would that be OK or not enough? – who knows?!

Hello to my friends in Surrey – I didn’t mean to single you out in particular! … it just happened to be your HMIC report that caught my attention on publication.  I know you’re all working on very hard on all this, from the top to bottom of the organisation and doing it sensibly and with great care. Keep cracking on!

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The Mental Health Cop blog

Badgewon the ConnectedCOPS ‘Top Cop’ Award for leveraging social media in policing.
won the Digital Media Award from the UK’s leading mental health charity, Mind
– won a World of Mentalists #TWIMAward for the best in mental health blogs

ccawards2013 was highlighted by the Independent Commission on Policing & Mental Health
– was referenced in the UK Parliamentary debate on Policing & Mental Health
was commended by the Home Affairs Select Committee of the UK Parliament.