In EMS, we are eyewitnesses to the inevitable decline of the human body and to death. That’s why when a young person dies it shakes us deeply. They are not supposed to die. It is hard to disassociate yourself from such an event. On those rare occasions that my Pandora’s box of bad EMS memories comes open, the emerging spirits that haunt me are the sights and sounds of those scenes, burned into the memory of my eyes and ears, undiminished by time.

When we start in EMS, for many of us, we believe that what we respond to will not happen to us, but as we age, immortality slips away along with our bravado. In my 60s now, I do truly appreciate each day, individual moments seem wondrous, I marvel that I am still here. An old girlfriend of mine, a true love, used to play Elton John’s “I’m Still Standing” at the end of the night, as beer cans littered the room and her cigarettes ran out and our bold dialogues and our love made us feel like gods. She’s been in the earth nearly fifteen years now and I can still see...

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Another recent Preventing Future Deaths notice from a Coroner has pricked my attention, concerning the sad death of Hannah Breadshaw from Greater Manchester.  Inevitably, PFDs are brief and not all details are included, but to my reading, this may be about the ever-blurred distinction between a threat to life incident and a somewhat more routine “welfare check”.

The relevant timeline regarding a call to Greater Manchester Police (GMP) about Hannah’s welfare is given as –

• A friend of Hannah’s rings GMP at 12:30pm to raise “welfare concerns” and it was allocated a 1hr response time;
• An ambulance was requested at 12:45pm and they arrive on scene first, at 2:10pm;
• They request police for force entry at 2:26pm and chase GMP several times over two hours until police arrive at 4:47pm;
• Entry forced, patient found deceased.

The IOPC were informed of the incident and they flagged three particular concerns prior to the inquest.  1)  a failure to escalate the incident, 2) a failure to make method of entry equipment more...

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It is being heavily trailed in the media that the Queen’s Speech this year, will contain a Mental Health Act (Reform) Bill – the beginning of the process of amending the Mental Health Act 1983, in its first significant upgrade since 2007, but trailed as a first major upgrade in forty years, since it was first enacted.  In fact, much of the 1983 Act is just the 1959 re-numbered, so it’s more like 63yrs old, but I disgress.

We do not yet have sight of the draft Bill but for those who want a quick catch up ahead of seeing what happens, the recent history is —

• In 2017, Professor Sir Simon Wessely began chairing a review of the Mental Health Act which reported in late 2018.
• In 2020, the Government produced a White Paper, outlining various ideas for discussion and public consultation.
• In 2021, the Government produced its response to the public consultation on the White Paper.
• 2022 – we are likely to see an actual Bill placed before Parliament for its consideration.

The links above are to the posts I wrote at the time on...

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I’ve often known police officers wonder aloud as to why patients detained in mental health units under the Mental Health Act are permitted to have leave from hospital when they are a known flight or suicide risk.  Section 17 MHA allows the Responsible Clinician (MHA term for lead clinician in charge of someone’s care, usually a psychiatrist) to permit a patient to leave hospital, sometimes with conditions attached and it’s a crucial part of the process of mental health care, ahead of patients being discharged as part of their recovery.  Some patients can be detained for a considerable period of time after being acutely unwell, to imagine a person who at one point had lost the ability to make many of their own decisions and just keep them detained until they could be fully discharged, would be weird and fraught with risk – authorised leave is a part of preparing patients from discharge and building up resilience and decision-making capacity, ahead of full discharge.

GRANTING LEAVE

But none of this means all leave granted is...

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One of my lifelong heroes is Joshua Lawrence Chamberlain.  He was the Maine school teacher who volunteered to fight in the Civil War and found himself leading the 20th Maine on Little Round Top, a rocky hill at the end of the Union line at Gettysburg.  After repulsing several attacks, his battle weary men were out of ammunition and facing yet another Southern charge up the wooded slope.  Chamberlain ordered his men to fix bayonets and charge down the hill in a sweeping movement.  This resulted in a stunning rout, and the Union held the position.  Had they been flanked, the battle and the war might well have gone the other way and what we know as the United States may have ended up as two separate countries.

Chamberlain, who was wounded in battle six times during the course of the war, was chosen by Ulysses S. Grant to accept the Southern surrender at Appomattox.  There as Chamberlain watched what was left of the Southern Army coming down the road, heads bowed in defeat, he ordered his men to “Carry...

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The All Party Parliamentary Group on Women in the Penal System has published a briefing on “Women’s Health and Wellbeing in Prisons”.  This post is about one specific claim only, within that briefing – that prisons are regularly but inappropriately being used a “place of safety” (PoS) and this is an unintended consequence of a change of policy to prevent women languishing in police cells (presumably, there as a place of safety). The briefing itself is short (10 pages) and this one point is only mentioned in brief, relying in turn on a report from Her Majesty’s Inspector of Prisons and Probation about an inspection which obviously must have wider implications across the prison system.

Before I get in to this: of course, prisons are over-relied upon to accommodate highly vulnerable people in circumstances where they should be able to access mental health beds in a much more timely way.  Additionally, but separately, it can be said there are difficulties securing access to MHA beds for those who require admission...

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A number of winters ago, I responded for the “welfare check” in a local apartment building.  Carrying my gear I trudged through the snow to the door where the super met us and we walked through the bare lobby. He told us “his hands and feet are all blue.” By the way he said it, I knew he was talking about a body and not a person who needed help.  We walked up two stairwells to the third floor, where the super led us down a dim hallway and then opened the door of a one room apartment, and gestured for us to enter.  On the floor, there was a collapsed clothesless body, head faced into the wall.  The legs and arms were blue as the man said, and the rest of the body, a wazy white. There was vomit on the ground outside the open bathroom door. A small TV was turned on to the Andy Griffin show in black and white. The place smelled of cigarettes. There was uneaten food on the stove and the trash overflowed the bin.  In the corner of the room there was an open rabbit cage. I knew it was a rabbit cage because I...

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