Imagine you’re the front line police officer called in to a mental health ward. Reports have been received from a patient’s family that the patient is being held on the ward without legal authority and they want the police to assist in extricating the patient from their hold, alleged to be unlawful. The control room sergeant has spoken to the caller who said, “The patient is my brother, his mother is with me and she is his nearest relative. Four days ago she gave written notice under s23 of the Mental Health Act that she was ordering the discharge of her son from hospital and as the hospital authorities have not issued a barring notice within 72hrs, they are obliged to release my brother – they are refusing to do so and he’s being held against his will, unlawfully.”
A few questions, then! –
Is this actually any responsibility of the police?!
Can the man’s mother actually order her son’s release against the wishes of the hospital?
This is a written version of a talk I gave last night, where I had fifteen minutes to summarising my thoughts on the overall topic of policing and mental health. It’s a while since I had such a short period in which to condense my thoughts and it was a useful exercise in rooting out the extraneous junk from my mind!
If you look around the world at adverse incidents that cause us to discuss the police roll in mental health issues, you see a range of problems:
The extent to which the police are relied upon as first- responders
Problems in the use of force:
Restraint related deaths
Fatal police shootings
Controversial use of things like Taser
Normalisation of the police as a de facto crisis service
Criminalisation of vulnerable people:
Prosecution almost entirely for the purposes of accessing clinical services
Incarceration in prison where upstream interventions would have prevented the need.
From that lot and much more besides, you can start to form your own view about whatever it is that you think the fundamental problem might be. Whatever...
Earlier today, the Royal College Nursing voted at their National Congress in Liverpool “to lobby to ensure that Emergency Departments are no longer designated places of safety for the purposes of mental health legislation”. So, I’ll cut straight to the chase: that’s not a really thing – in the sense that the word ‘designated’ does not appear in the Mental Health Act, and only appears four times in the whole Code of Practice to the MHA, never in relation to sections 135 and 136 which relate to police powers and places of safety. It’s just not a thing around which to have a meaningful debate because, as a police officer, I simply don’t need to care whether somewhere is designated or not. Those who urgently need ED care because of the nature of their medical needs are going to go there under s135/6 regardless of designation; and those who are detained and don’t require ED in the strict medical sense but where no alternatives exist, may also end up there, especially after the Policing and Crime Act amends the Mental Health Act later in...
The Metropolitan Police and the South London and Maudsley NHS Foundation Trust were subject to a damning verdict in the south London Coroner’s court earlier today – each of them facing criticism for contributing to the death of a vulnerable man. The death of Olaseni Lewis in September 2010 is one the most sensitive, controversial and difficult of all the death in police custody cases I’ve known connected to mental health issues. I had the opportunity to hear Mrs Lewis speaking in Brixton last year about her family’s ongoing ordeal: it was nothing short of absolutely heartbreaking to listen to the experience of someone who’d already waited six years to learn how her son died, and to hear first hand how the post-incident system had exacerbated the distress of what must have already been a devastating incident.
I’m all too aware of comments realised in recent weeks by frontline officers on social media that demands and responsibility connected to mental health are rising and it’s getting harder and harder to manage this demand across response and neighbourhood teams which are under pressure around how they spend their time. We have also seen senior figures like Sir Tom Winsor, HM Chief Inspector of Constabulary, voicing concern about the extent and the nature of the role the police are now playing in our wider mental health system and the effect this is having on frontline policing. I can’t be the only police duty inspector who has stood in the middle of the night making the decision to order two police officers out of a Place of Safety where NHS staff had asked them to stay because it was the...
So, we’re still discussing the fallout of Sir Tom Winsor’s comments almost one week after they were made. A few of us have blogged our thoughts on this and many of you have commented on those posts and social medica more generally. We all share a view that there is a problem, but I’m not sure we share what it is, never mind a shared sense of what we should do about it. Some people have spent the week arguing that we are criminalising mental health and mental illness by relying upon the police to the extent that we do, but what I think has been interesting this week is the number of representations that we’ve got this the wrong way ’round: we’re not criminalising illness, we’re medicalising human behaviours.
Look at the literature on this stuff and you’ll see both positions well represented. The US academic Professor Linda Teplin did a lot of work in the 90s arguing about criminalisation; another US professor, Allan Horwitz wrote a book called ‘creating mental illness’ which argued we over-medicalise...
Yesterday, Her Majesty’s Chief Inspector of Constabulary, Sir Tom Winsor said something extremely important in his annual review, known as the “State of Policing” report. The main headline from the document was his argument that the police are now filling gaps in mental health services and that this represents a drain on resources which are being diverted from other policing responsibilities. It was his clear view that “the provision of mental healthcare has reached such a state of severity that police are often being used to fill the gaps.” He makes the point that the police “have often been used as the service of last resort. In some areas, particular where people with mental health problems need urgent help, the police are increasingly being used as the service of first resort.” He goes on, “We are still finding cases of mentally ill people – who have not committed any crime – spending the night in a police cell. This is because they are too vulnerable to be left alone but there is no bed for them in a healthcare facility....
No matter what you think the problem is, there are only ever two solutions in policing and mental health —
The police need more training; AND / OR
The police need to work in partnership with mental health services.
All the emphasis is on the police here, isn’t it?! It’s almost as if the only thing we need to talk about going wrong or which is in need of improvement, is policing. It’s a part of a subtle narrative that is actually far more widespread than we realise, if we just look for it consciously. And it works because it’s highly intuitive: the police are not mental health experts and we’ve seen incidents where things go badly wrong when they come in to contact with vulnerable people … ergo, some expertise (achieved through training) would be good, but better still would be actual expertise (achieved through collaboration).
You can see the flaw with this, though, I’m sure – whilst the police are not perfect and no-one is pretending they are, whilst the police would undoubtedly benefit from real, good quality training on mental...
This blog is part of the series which will cover, in detail, the amendments to the Mental Health Act 1983 within the Policing and Crime Act 2017. This post is one of several which relates not the amendments themselves, but to the implications arising from them.
For background to the series, see the introductory post which outlines why I’m doing this and what other specific issues will be covered concerning laws that will come in to effect in the next few months. Current Home Office estimations of timescales suggest early May – but this is subject to a number of factors and may change.
It’s now a dozen years since I first read section 140 of the Mental Health Act 1983 – and I recently met some senior mental health professionals who never ever read or even heard of it. I came across this neglected provision because I decided to read the Mental Health Act cover to cover, as well as the Code of Practice to the Act, in lieu of being able to get any police specific training at all for my first job working properly on these...
Today, a police custody sergeant and two detention officers have been cleared of manslaughter following a retrial at Bristol Crown Court. The trial follows the death, in 2012, of Thomas Orchard a 32-year-old man from Exeter who lived with schizophrenia who had been arrested and removed to a police station whilst in crisis. In terms of me covering these events on here, I want to put on record that I have had no involvement in any way with any process that followed the incident or any contact with any parties involved. What follows are only my own thoughts after following the investigation and trial process over the last five years. It touches on the most difficult of issues: the criminal prosecution of police officers following the death of a vulnerable man.
The police received a call from a member of the public to the place where Mr Orchard was arrested under the Public Order Act. He was restrained upon arrest and removed to a police custody suite. Upon entering custody, it was contended by the police officers who were cleared that he was...