Since September 2014, when I started at the College of Policing, we have been working on the development of a document about those situations where the police are called to a mental health unit and asked to do something coercive. Â Iâ€™ve been on mental health wards many times, as an operational police officer: calls to investigate and potentially prosecute patients for alleged assaults or damage; requests to assist in restraining patients so nursing staff can administer medication; requests to assist in moving a person from one part of a mental health unit to another â€¦ or even to move them to an entirely different mental health unit. As a probationary PC, my colleagues and I were called in to the old All Saintsâ€™ Hospital in Winson Green in Birmingham to a range of things where disorder and distress were manifest and the police were being asked to help.
These issues are as important as they are sensitive: we know that we donâ€™t want to over-police anyone, least of vulnerable people already detained in hospital at a difficult time in their lives, not do we want those places to be dangerous and beyond the reach or scope of the law, where that is necessary. We know that care in clinical settings is primarily a matter for healthcare professionals and itâ€™s for their organisations to ensure they address their own health and safety obligations; however, we also know that some things happen on mental health wards that may need the police. Â For a start, around 67% of the 70,000 assaults on NHS staff take place in the mental health sector and whilst most of that is not reported as crime, some of those matters are very serious. Â Recently, a murder inquiry was launched after a patient was killed on a mental health ward; in 2016 a mental health in Croydon was killed on a ward and in 2014, a healthcare assistant in Gloucestershire. Â No-one can serious argue that where such incidents breakout, that the police donâ€™t have a role to get in there and try to stop things from becoming any worse to prevent these kinds of outcomes. But it needs to be carefully considered and controlled.
There are two problems this document aims to address â€“
SO WHAT DOES IT SAY?
This is the three-line summary of this document â€“
The Restraint Document, as we kept calling it, is a multi-agency Memorandum of Understanding. Â The College of Policing have coordinated its production and it is agreed between the National Police Chiefsâ€™ Council, mental health charity Mind, the Royal College of Nursing, the Royal College of Psychiatrists and the Faculty of Forensic and Legal Medicine. Â In the course of its production, independent legal advice was secured from a QC and junior counsel with experience in the legal matters around police powers and mental health law. In addition, it was been supported and welcome by Amber Rudd, the Home Secretary; by Lord Adebwoale, the chair of the 2013 Commission in to MH and Policing in London; the charity Inquest and several others. Iâ€™ll you find details of what theyâ€™ve said, if youâ€™re interested, by going to their social media feeds or to the College of Policing website.
FREQUENTLY ASKED QUESTIONS
Already, some questions have emerged a few times so let me address them â€“
Remember the two problems weâ€™re trying to fix, above? Â Here are some real examples which emerged in discussions of the working group. They came from professionals in policing, nursing and psychiatry.
So what is going on here, in terms of the thinking? Â Whatever was behind the nurse in the first example calling the police, we can probably agree itâ€™s not appropriate â€“ no current disturbance or violence, nothing that links to crime or serious risks to staff. Even if there were certain risks, as long as heâ€™s sat on the floor in the corridor, there should be contingency for bring staff together to undertake this task. In the second example, we can see that it is necessary for the police to attend to assess things, but upon arrival, they havenâ€™t done a huge amount because itâ€™s not quite as serious as first reported. We can debate all day long whether it was â€˜rightâ€™ to call the police, but thatâ€™s the judgement staff made â€“ why not attend and assess things? Doesnâ€™t mean the police automatically will do anything or will do very much, but at least we can say weâ€™ve assisted in assessing whatâ€™s required and that any decision not to act is taken after a proper understanding of the circumstances.
We obviously canâ€™t do that in the third situation because the police didnâ€™t go! â€¦ it doesnâ€™t need much explanation, does it?! â€“ if nurses are being stabbed, we should be going! Itâ€™s a real shame that even needs saying and thankfully, such examples were very rare but in those sorts of things, if there is anything to discuss about it, thatâ€™s for later, not for now.
In the final example, it gets most controversial: the assessment the officers made at the time was that it was more dangerous to disengage and argue a point, than to help. One nurse and already suffered GBH injuries, two others were assaulted and three were, put frankly, completely knackered. There was one nurse left to actually administer the medication and no others available from nearby wards (for whatever reason â€“ right here, right now, there were none available). If the police had not continued to assist, there could have been further serious assaults. Remember, when medication is authorised by nurses or doctors under Part IV of the MHA, nothing expressly prevents the police assisting â€“ but we should obviously only be doing so in circumstances like this where there is no other option, at all. Â We should also remember s139 MHA, which provides that â€“
â€œNo person shall be liable, whether on the ground of want of jurisdiction or on any other ground, to any civil or criminal proceedings to which he would have been liable apart from this section in respect of any act purporting to be done in pursuance of this Act or any regulations or rules made under this Act, unless the act was done in bad faith or without reasonable care.â€
I hope the document helps you out!
Winner of the Presidentâ€™s Medal from
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award.