I’ve been trying to think about the question posed by the Mental Health Foundation for this year’s mental health awareness week in the context of policing and our involvement in responding to mental health related demand: surviving or thriving?
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 lesser of the various things I must police and for which I did not have enough resources because of a quick succession of serious crimes.
Are things not just getting worse?
Indeed, if you look, you will find plenty of information which can help you build an argument that the police are, at best, surviving – and I’m sure some police officers would add “and only just”. You could point to the rise in our use of s136 of the Mental Health Act, it’s up 10,000 in 10yrs since 2007, which means more officer hours spend removing people to various settings and often, remaining there with them for many hours until assessments can take place. We could add that mental health professionals are struggling sometimes to arrange assessments in a timely fashion – national guidelines state s136 assessments should occur within three hours and we know it’s often double that and more. We have heard in the media recently that police coding of mental health incidents shows we have experienced a rise of around 26% in three years in the overall number of incidents which are classified as mental health related.
In his ‘State of Policing’ report, HM Chief Inspector of Constabulary reported that the police are all too often a first-resort contingency plan for our mental health system and that the extent of this problem is forcing Chief Constables and duty inspectors to make frequent decisions about what they will prioritise; and how. Only over the weekend, a mother who lost her son in one of London’s latest knife-attacks has stated that the police are not doing enough on knife crime. We could do more about knife crime and various other things if officers weren’t remaining in health-based Places of Safety routinely, because NHS commissioning decisions have ensured the facility they opened for assessment wasn’t fully staffed. You can only spend your pound or your police officer, once.
Could we look at this another way?
Since that report in 2007 on police use of s136, the proportion of people detained under s136 taken to police custody as a Place of Safety has massively reduced: from 66% in 2007 to 7.5% in 2016. That’s a drop in numbers from 12,000 a year to jail for being ill down the just 2,100 – I strongly anticipate this figure will reduce again when the next figures are published in a few months. I was beyond chuffed to learn, for example, that my own force in the West Midlands has had the first ever year where no-one was taken to police custody as a Place of Safety, thus demonstrating a total turnaround in the position from ten years ago where everyone went to jail.
I also get a sense that we know more about this stuff now: we find examples of police officers delivering training about policing and mental health to mental health professionals, not just the other way ’round. We see that partnership relationships on mental health have improved beyond measure: not just around the development of initiatives like street triage, although they are very positive examples of innovation in many cases, notwithstanding the longer-term questions. In the West Midlands, a senior police officer is seconded to the Mental Health Commission chaired by Norman Lamb MP as part of the overall revision and delivery of a wide-range of mental health services, not just those connected to policing or criminal justice. And although, I’m nervous about offering this next view, I’m starting to wonder whether we’re seeing a reduction in either the number or the controversy of some policing and mental health incidents. In the last IPCC report, the only s136 related ‘death in custody’ was, in fact, a death which occured in a health setting after the police involvement in the s136 process had ended.
Should we look at this more positively?
Mental health demand isn’t going to go away: the police service have been credited by many senior figures in mental health and in politics for driving the mental health agenda to a degree: it was a police officer, Commander Christine Jones QPM, who caused the creation of the Crisis Care Concordat. It was the police who drove the reduction in the use of police cells as a Place of Safety and convinced the Home Secretary that wicked problems could be solved, something which has since become enshrined in law. It was police forces who sought out the opportunity to create street triage schemes in many of the areas we see them and in many instances, it is ‘the police’ via Police and Crime Commissioners who are directly paying for that, not our NHS. It is the police service which came out better in the eyes of the public, better than many NHS organisations, for the positive impact of our attitude and response when dealing with mental health crisis incidents. We’re not perfect, but we’re more often valued by the people who call us for help.
So it all comes back to your perspective: we know the police have a role to play in our mental health system – we always have had and always will do because not everything is predictable or preventable. Of course, there needs to be limits on the extent of the role – we don’t want police officers on mental health wards handing out medication – but we need to understand and accept that we have a perspective on mental health issues in society that even some mental health providers don’t have and a key role to play in tough decisions about criminal justice issues. We are positioned to drive the agenda to a degree and are doing so. Indeed, history shows that if we don’t, we will be pushed in directions that are neither in the interests of police services nor the public we are here to serve. It also shows that if we are active in this arena, we can and will impact upon it.
In that sense, despite demand rising and things getting tougher, is this not a form of thriving we can be proud of? I think it is.
Winner of the President’s Medal from
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award.