Could do better - MUCH better

An interesting article in Police Oracle today which says the police officers are spending, on average, an hour a day dealing with mental health issues. I think any serving cop in the country would tell you that this is a conservative (with a small ‘c’) estimate.

Of course, there are days when we don’t have to deal with any mental health issues but they are quite rare and when we do have calls you can measure the time taken to deal with it in hours rather than minutes.

The mental health calls police get called most to would be:

1. Missing people – often having left or absconded from a mental health hospital.
2. Concerns for welfare – often coming direct from mental health services, sometimes very late on a Friday afternoon, asking police to check the well being of someone they have concerns about (often these concerns have existed for some time.)
3. Calls from or about suicidal people – often in private premises – sometimes in public.
4. Calls from mental health hospitals asking police to “assist” with a “violent” patient.
5. Calls from mental health hospitals asking police to investigate a crime (usually assault) allegedly committed by a patient on a member of staff.
6. Calls from mental health hospitals asking police to investigate a crime (usually assault) allegedly committed by a member of staff on a patient.

Added to this demand is the issue regarding Section 136 detentions. I have covered this in many previous blogs so I won’t labour it here but police will either be sent to, or come across, someone in a public place who needs “immediate care and control” because of a perceived mental health disturbance.

Looking at that list I would hope that a couple of things strike you:

1. That’s a lot of work
2. What has most of it got to do with the police in the first place?
3. How have mental health services allowed some of these situations to happen and what are THEY doing about them?
4. How much of that demand comes DIRECT from mental health services.

Taking “Missing People” for example – it is a very frequent occurrence for a mental hospital to ring and report one of their patients “missing.”

There are usually two ways in which this has happened. There has either been a lapse in security which has allowed the patient to escape or – more frequently – the person has not returned from an agreed leave period.

Even Sectioned patients are allowed leave as part of their recovery. This can be escorted or unescorted and can range from hours to days.

Where it starts to rub is at about the third call.
“This patient has not returned from leave and we are reporting him missing.”
“But this is the third time in two weeks that this has happened – why are you still allowing him leave?”
“It’s part of his rehabilitation.”
“But you know he’s not likely to come back.”
“……………….”

The expectation is then that the police will go looking for this individual whilst the hospital staff carry on with their day. Often making no enquiries of their own and certainly not going out to look themselves.

After about the 12th call for the same individual (yes really) it has gone behind a rub to a become a major bone of contention.

If someone goes on leave and fails to return on more than two consecutive occasions – why are they still being allowed leave when the outcome is quite predictable?

With Section 136 detentions the problem, as I have highlighted many times before, is the handover from police to mental health services.

Either they won’t accept because they say the patient is drunk or violent, they don’t have capacity or, in the case of juveniles in some places, they don’t have facility.

So it’s off to the cells in up to 50% of cases (something which really shouldn’t be happening) and so begins an indeterminable wait for an assessment team. This often takes hours – many hours – and during this time officers will be required to maintain constant observations on the patient.

Concern for welfare calls are another problem. It is extremely common for social services or mental health services to call the police directly and ask them to go and visit someone on their behalf.

About 4:45pm on a Friday is a usual time for a call such as this.

When police ask why they aren’t going themselves the answers are usually

“We don’t do welfare checks”
“There are only two of us”

Or there is some perceived threat which means they can’t do it themselves.

It is also common to find that they have been aware of an issue for several days so goodness only knows why they haven’t called earlier.

Suicide intervention is more common than you think. Either someone has gone missing with apparent suicidal intent or there is something going on in their house which suggests the same.

The call itself can tie up a call taker for a very long time as they try and engage with the person who is calling in desperation. They have no training for this I hasten to add.

In the absence of a threat to anyone else the police are actually powerless to deal with a situation like this. But we still get called by the person themselves, concerned family or mental health services.

Asked to go and deal with it – purely because we are “the police” when in fact we can do very little indeed.

I have discussed the need for legislative change here and elsewhere which will allow officers to take decisive action in these circumstances but it is slow to happen.

These calls happen every day in every station in every force in the country. It is not confined to one area – it is a national problem.

Not only is it a national problem but it is getting worse not better. We now have evidence of NHS managers deliberately deflecting demand towards the police as their budgets constrict.

As the Police Oracle article says – it has been a year since the Home Secretary announced that the police were spending too much time dealing with mental health issues and that something was going to be done.

Is there any evidence of this at the sharp end twelve months later?

(Insert sound effect for Family Fortunes ‘uh uhhh’ here  )

Look at the language used by the Home Office in the article.

Last year Mrs May said she was going to liaise with her counterparts from Health and Justice.

Last week in direct response to a question from Inspector Michael Brown (@MentalHealthCop) at the Home Affairs Select Committee, Mrs May repeated that she was speaking with her counterparts at Health and Justice to sort this out.

This response was repeated again in the Home Office response to the Police Oracle article.

So given all this talking by ministerial heads – what EXACTLY is there to show for it after twelve months?

What was also obvious from their response is that, actually, they are expecting someone else to sort it out.

The Home Secretary has written to all PCC’s instructing them to make dealing with mental health a priority. Their response then talks about how some forces are “making improvements” in this area.

The issue is that it shouldn’t be the police making the improvements – it should be the NHS.

By simply writing to PCC’s and expecting them to deal with it is to completely miss the point that legislative change is required and it is arguable that provision of mental health services requires statutory regulation in terms of its quantity and capacity.

Only the government can amend the law with regards the Mental Health Act or Police and Criminal Evidence Act. These changes are as important as any local discussions about commissioning and provision.

How can the Royal College of Psychiatrists provide guidelines on Section 136 detention and yet the reality on the ground looks absolutely NOTHING like it?

In twelve months it seems that the Home Secretary has spent a considerable amount of time talking to her counterparts but having little or no impact. Her other action was to write to someone else and ask them to deal with it locally.

Locally, the issues are still not universally high enough up the agenda despite the Home Secretary’s letter.

We know that NHS budgets are getting tighter and we believe that mental health work is being deflected to the police on purpose.

The Police Oracle article was written by @hollieclemence who later tweeted the question:

“A year on from Home Secretary’s pledge to reduce police time spent on mental health incidents, has anything changed?”

The answer – quite simply – is “No.”

A big fat “No.”

There appears to have been a lot of talking and instructing and whilst I am quite certain that ACPO lead, Chief Constable Simon Cole of Leicestershire, is doing his level best to take this forward it appears to have all the urgency of continental drift.

I doubt very much that this is because of ACPO – I suspect that the resistance is elsewhere. It is this inertia which needs to be met head on. The police are going to have to take a very strong stance and force the issue.

HMIC have just announced a thematic inspection of police detention of the mentally ill. I could save them a fortune and write it for them.

If you ask me – which nobody has – I would urge HMIC to look beyond 136 and at the total impact of mental health on the police service.

What is needed is an official, probably scathing report from someone with clout which will document all this in great detail and ask the simple questions:

“Why are the police spending so much time dealing with a medical issue and what is going to be done to change that?”

If a report card on this particular subject were being written there would only be one comment

“Could do better – MUCH better.”

Courtesy of Nathan Constable