Policing and mental health as a subject cuts right across all of policing. We often end up talking about section 136 and places of safety – even when it’s completely irrelevant to the outrage prompting discussion – and I suspect that this prevents us from talking about, or even identifying, the larger and far more important issues and philosophical questions.
Remember that last September, Her Majesty’s Inspectorate of Constabulary highlighted in their report ‘Core Business‘ that Nottinghamshire Police had approximately 1,100 detentions under s136 per year, which compares very roughly with the number who are detained by West Midlands Police, before the introduction of each forces’ street triage schemes. I’ve mentioned before that in terms of both officer numbers and resident population, the West Midlands is just short of three times the size of Nottinghamshire, so it seems superficially surprising that their use of s136 is so similar.
What we’ve never fully explored, nationally, is something which might help us understand the context of those s136 figures: the prevalance of mental ill-health in the group of people who are detained or arrested for legal reasons other than the Mental Health Act. How many alleged shoplifters, drunks and other suspected criminals are assessed in custody under the MHA? – and what are the outcomes?!
I know the answer for this in the West Midlands but not for elsewhere and I have often wondered what we’d find if we looked. What would it tell us, for example, if we learned that in Nottinghamshire, a much smaller percentage of criminal suspects were assessed under the MHA and then diverted into the NHS than in the West Midlands? – what would it tell us if it were roughly similar?! You could repeat this exercise in any two areas where obvious questions should be asked about 136 usage. For example, I’ve often wondered why West Midlands Police – the second largest police force in England – is using s136 less than West Yorkshire, Devon and Cornwall and Thames Valley Police. Each of those places is smaller in terms of resident population and officer numbers so why are they using s136 more often than one of our country’s largest forces?
In some cases there are obvious but only partial explanations to consider – Devon and Cornwall’s resident population expands by many, many millions of people every year because of it being such a popular tourist destination. That will account, in part, for raised usage as police forces don’t obviously just use section 136 MHA on people who are resident in their area. But there will be other explanations and this is what I want to see Liaison and Diversion services looking at.
What if we discovered that West Midlands Police were using criminal offences more often than Nottinghamshire in circumstances where a choice between MHA and criminal law could be made? For example, a man on a bridge threatening to jump onto the motorway or railway line below is committing an offence – if he is successfully persuaded down, what do we then choose to do and how do we make that decision? Maybe Nottinghamshire and West Midlands have two different views or more likely they have two different evolved cultures, hence different usage of the MHA?
Which of them is ‘right’ – what is section 136 for, strictly speaking? What would a street triage nurse think – perhaps their access to NHS information might help inform the decision one way or the other. This links to the point made by Lady HALE, the deputy President of the Supreme Court. In her book on Mental Health Law (2010) she wonders whether s136 is in fact underused, partly because it’s potential to safeguard overlaps with our substantive criminal law. She went so far as to say that we could argue that s136 is under-used. It’s a though-provoking idea especially in light of initiatives like street triage which openly aim to reduce the number of people who are detained. So I suggest we need to understand more about what is going on and have a clearer view about what we’re trying to achieve here. We need, in my view, to articulate without prescription how we want officers to think about these decisions and exercise their discretion so we don’t unnecessarily criminalise people, but so that we don’t fail to protect the public where that is the balance to be struck.
It’s an absolute pain in the posterior aperture to collect new data in policing but we can’t work out too much about this stuff because police IT systems were not designed to capture it. Any data gathering exercise would have to be done by designing an ad hoc form and which operational officers would need to fill in. Having spent most of my career as a frontline cop, these sorts of ideas are usually viewed as additional bureaucracy which has to be inserted into an already busy shift but we also have to accept across policing and mental health that unless we try, we’ll continue to be blinkered, not only about what we’re doing and what we’re trying to achieve but also about how we go about making progress towards those goals jointly with our partners in mental health and social care, putting patients and the public foremost in our thoughts.
WHAT IS THE RIGHT THING TO DO?
So whether you want to get consequentialist about all of this, or whether you just have a political (with a small p) instinct about whether and when some people should be criminalised, notwithstanding some degree of mental vulnerability, you end up having to have something of a plan for how you are going to ask police officers to make detention decisions when faced with operational ambiguity or plurality. For what it’s worth, this is something I wanted to start working on with partners after starting my current role at the College of Policing and I’m going to a meeting in Newcastle to talk about this next week. Once I’ve been, I’ll put out a blog highlighting where I think we’re getting to, but it seems it won’t be a million miles away from what I first wrote on this BLOG a few years ago, which you can read for yourself. If you have a view on any of this stuff, please do make it known – either write a comment on this post, below; or if you prefer not make your remark public, go to the BLOG’s homepage and scroll down: there is a contact form that sends an email straight to me.
It’s difficult stuff: criminalisation; fairness; social justice – how do you balance these things off to provide the requisite balance between consistency in roughly similar circumstances and a population level impact that doesn’t further stigmatise already vulnerable and stigmatised groups amongst us all.
The Mental Health Cop blog
– won 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
– 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.