Iâ€™ve had to ask myself recently whether Iâ€™m guilty of potentially exacerbating tensions or conflict between the police and mental health services, after a number of suggestions on social media and elsewhere that this is the effect of what I am doing. It didnâ€™t take long to work out that this is precisely what I am deliberately doing, on just some occasions. I would argue this is of necessity, other options being unavailable or unacceptable. In addition to thinking that the management of mental health demand cannot just be about what the mental health system thinks the police should do, I have also come to believe very profoundly, the key to determining the role of the police lies in the rights, protections and views of those of us who live with mental health problems. And somewhere in there, even without us considering the roles and realities of policing, lies tension.
I have always listened very keenly to a number of mental health professionals who have helped me over the years, people to whom I will be indebted for all the coffees and beers shared and the books loaned and read; and incidentally, itâ€™s clear that front-line mental health professionals also see difficulties, tensions and conflicts on a daily basis, whether or not itâ€™s something that involves the police. But I am really clear that most of what Iâ€™ve learned about mental health and policing I got from talking, often at length, to those of us who have lived the system â€“ that and actually reading the Mental Health Act 1983, the Mental Capacity Act 2005 and the Human Rights Act 1998.
It makes you realise there is conflict there already and it needs resolving, if possible â€“ or managing, if not. When conflict borne of disagreement or ambiguity exists between two different professionals or organisations, you have just two choices about your reaction. You can stand your ground and hold your position, or you can compromise. But hereâ€™s the rub for me and for the police: we cannot compromise on certain things â€“ and THIS is where suggestions arise that I have â€˜exacerbated tensionsâ€™. I would and will here argue, that it is my legal duty to do so and that I have always thought this because of the Oath of Office swore when attested in 1998. And this is why we sometimes see other police officers, including very senior police officers, doing the same thing.
Let me tell you why, for those who are worried about my approach â€“
Early on in my career and repeatedly since then, it was obvious to me that by doing as told or by â€˜the systemâ€™, I could on just some occasions risk jail, the sack or be killed. This all sounds very dramatic, doesnâ€™t it? â€“ itâ€™s not intended to be falsely so â€“ like several others, I have had the experience of being under criminal and gross misconduct investigation, overseen by the Independent Police Complaints Commission (now the IOPC), for doing my job as well as I could after a man died following my contact with him. And like those other officers, I believe my officers and I were just trying our damnedest to get him out of the situation alive. Our efforts didnâ€™t prevail, albeit not just for reasons to do with us and I will remember his screams until the day I die when he set himself on fire right in front of us.
This is intended to convey the reality of what we deal with and how I see some (but I stress again, not all) operational police work to which we often send junior police constables with a few yearsâ€™ service at most. The examples of this kind of stuff are included all over this BLOG and are in the news for all to see. There are yet more cases under investigation and within the Coronerâ€™s Courts of the country as I type this, highlighting this again and again. One of the most precious bits of feedback I ever had from a frontline police officer followed me interrupting his willingness to do what an AMHP wanted them to do. The officer, a really keen young lad, admitted to me that he had told his partner that night, â€œThe fucking boss has gone off on one AGAIN about fucking warrants and mental health â€“ letâ€™s just get in there and get this sorted!!â€ Suffice to say at the end of the shift when he was kind enough to admit this because he wanted to add, â€œBut if youâ€™d let me, Iâ€™d probably be dead now. So cheers.â€
There is conflict and tension inherent in this business â€“ it was there before I joined the police and it continues to this day. It needs addressing in some way because ignoring it is not an option, but hereâ€™s the thing: when there is a disagreement between two people or two organisations and you cannot find a way to compromise that is acceptable to all, you are forced to a decision. Do you set aside your concerns and queries and do as the other party would wish, or do you â€¦. not do that? I know that in the last twelve months I have been called to appear in Coronerâ€™s Court four times as an expert witness (and there are other legal proceedings pending for other cases), where these issues are at the forefront: why did the police just do as locally expected, why didnâ€™t they push back in accordance with national standards?
A difference of position or opinion between professionals or their organisations may have various things underpinning it. But in my experience it is most usually a clinical or legal issue â€“ if I wanted you to do something which breaks the law or puts someoneâ€™s safety at serious risk, you obliged to decide: are you doing as expected or are you going to resist? You may well wonder about the context and the risks versus benefits. If this request was me telling you to drive the wrong way up a motorway entry slip because I had established a controlled way doing this to help you escape a massive queue caused by a serious collision that will close the road for most of the day, youâ€™re going to set aside the law prohibiting this manoeuvreÂ because a police officer told you to do it. If I ask you to unlawfully and inappropriately sedate patient who wonâ€™t â€œcalm downâ€ or â€˜sectionâ€™ someone because â€œit would be better that wayâ€ youâ€™re going to say â€œNo way!â€ or something similarly blunt.
Real example, presently apposite if you use Twitter to follow whatâ€™s going on: if someone needs to be â€˜sectionedâ€™ but thereâ€™s no bed available and the timescales have run out so detention is now unlawful under domestic and international law. Do the police just continue to sit there, unlawfully holding people, saying nothing and getting on with doing as theyâ€™re told? Or do they start potentially exacerbating these tensions by escalating to senior managers, agitating for a solution, or even considering legal action, which has been known? We know that some senior officers have gone public about these matters and one can only imagine what senior NHS managers thought of it.
What we do know from history is, if the police donâ€™t escalate, agitate and consider all their options, delays can continue for days and days; and if they choose to start pushing back against the assumption they should just help out by acting unlawfully, solutions are often found shortly after the escalations are assertive enough. No-one wants to work like this, do they?! â€“ Iâ€™m sure weâ€™d all say we want to work in partnership and work collaboratively and jointly make the world a better place. But the opposite of a world where the police service now know nearly-enough about the clinical risks, legal threats and other risks because of a decade of to understand reality is not a world where things are naturally collaborative and tension free.
There was conflict in this entire agenda before I joined the police. I merely walked in to it in 1998 wondering how it can be police officers can find themselves under criminal investigation because they tried their best to handle a situation where the over-arching infrastructure and policy framework, not to mentioning the legal and other training, was woefully inadequate? I could also see tensions within the NHS from the start: are there many NHS professionals who donâ€™t think that they could do with more staffing, more services and facilities and that the absence of them doesnâ€™t, on at least some occasions, lead to requests for police support that should not be necessary and theyâ€™d prefer not to ask for?
Hereâ€™s the reason my approach could quite reasonably be accused of being conflict based: I donâ€™t look at mental demand on the police from a clinical point of view. I take the view that peopleâ€™s health is a matter for them up until the point where the state must intervene to keep them safe or until they break the law. Thatâ€™s my threshold for getting directly involved. More than happy, following any contacts I have where someone may have health or social issues that have not put them at direct risk or on the wrong side of the law, to suggest things that may help them and signpost or refer accordingly. But how people live their lives is a matter for them.
My own view over the last decade is, that the weâ€™re trying to fix the wrong problems and in so doing, the solutions weâ€™ve come up with to the problems we think we have are more resource intensive on the police than the real problems we should have been trying to fix. So as things stand, I see my role at least in part, to slow down the acceleration of the problems weâ€™re perpetuating because we mis-focussed in the first place. So conflict management is necessary, because conflict resolution doesnâ€™t seem possible for as long as all services are doing more with less and in objective agreement that all our systems are under significant pressure.
You canâ€™t ask me to break the law or risk peopleâ€™s safety and then object that any resistance is exacerbating tensions, because Iâ€™m just going to point you to s6 of the Human Rights Act and remind you Iâ€™m a police officer. Iâ€™m not on anyoneâ€™s side. You canâ€™t object that Iâ€™m planning for how best to handle those situations either, by raising difficult discussions about things that should not and cannot be compromised because such discussion is about effecting change demanded by law. Â Thatâ€™s about seeking conflict resolution and, if thatâ€™s not possible, conflict minimisation. And in any event, â€œwe were told to do it like thisâ€ just doesnâ€™t wash in Coronerâ€™s Courts.
Iâ€™m very motivated around this stuff and have spent the best part of fifteen years trying to understand all perspectives on this â€“ I remain willing to learn: but having deliberately driven my career in a certain direction to be able to focus on it, I am actually fighting for something here â€“ and this should only represent any kind of challenge to those who would over-use the police in a way that makes things worse or have them assist in undermining the law. Â Itâ€™s outlined in something like 750 posts on this BLOG written over the last seven years: I couldnâ€™t have been clearer about what that is â€“ the right of the public to take their own healthcare and wellbeing decisions; and the protection of front-line police officers from risks and liabilities that may cost them their jobs, or more.
I look at this from a legal point view, not least because itâ€™s what I largely think is missing in our approach to mental health matters. So Iâ€™ll end this, by re-affirming that Oath I took over twenty years ago, by way of illustrating precisely where Iâ€™m coming from. (The bold emphasis is mine.) â€“
â€œI do solemnly and sincerely declare and affirm that I will well and truly serve the Queen in the office of constable, with fairness, integrity, diligence and impartiality, upholding fundamental human rights and according equal respect to all people; and that I will, to the best of my power, cause the peace to be kept and preserved and prevent all offences against people and property; and that while I continue to hold the said office I will to the best of my skill and knowledge discharge all the duties thereof faithfully according to law.â€
Winner of the Presidentâ€™s Medal from
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award.