More than once, I’ve known of situations where risk levels have been exaggerated to promote or provoke a police response to a situation that otherwise wouldn’t receive one. OK, it’s been way more than once. Those who have read the blog throughout may recall the mental health nurse who came in to a police station when I was a probationary officer, asking for police to accompany him to a nearby tower block to check on the welfare of a man who lived in one of the flats, without suggesting on obvious, police-related reason for the request. When I asked him why the police were required, he said it was “just in case”. “Just in case what?” was my reply and he explained it was in case the man became violent. “How was he violent before?” and it turns out he hadn’t been. “So why do we think he’ll be violent this time?!” and it turns out we didn’t think he would be. “I’m not sure I see the need for the police, then” and he said something that stunned me: “I’ll just tell you he’s got a knife and you’ll have to come, won’t you?”
Well, no – not really. Not because the ‘knives’ things don’t justify the police, but because the whole way the knife idea was introduced in to the conversation after an acceptance he’d not been violent before and wasn’t predicted to be violent this time, means I’m disinclined to think the knife issue is real. And more to the point, if you’re not attending a flat because the occupant will have a knife, then you’re never attending anyone’s house, are you? … most people have a range of knives in their kitchen, for reasons that won’t need explaining. So we’re firmly in the territory of the possibility that risk is being exaggerated here, to promote a police response.
It doesn’t end there: it leads to even more questions – because if we are now countenancing risk involving knives, the police are going to have to assess the nature of that risk and how to safely mitigate it for the officers’ safety when they attend. I was working on my own that day at a time before officers routinely wore stab vests, never mind carried safety equipment like a taser. So would I need another officer or two to come with me and the nurse? Would we need any specialist support from either a dog handler or officers with shields? Would it in fact justify a firearms team because, whilst risking accusations of hyperbole, it is sometimes required that armed officers attend incidents to negate risk from potentially lethal weapons like knives. Police supervisors have a legal duty to risk assess incidents for safety, just like all organisations’ supervisors do.
PROPORTIONALITY
All of this must be considered when contemplating a police response to ensure it a defendable response, proportionate to the threat and the risk involved. I saw that in another story I’ve told before: of a mental health patient who rang a crisis team for assistance in a circumstance where they were not self-injuring or suicidal, but where the nurse involved terminated the phone call whilst insisting they would need to ring the police if the patient wasn’t safe. The patient calmly explained they weren’t saying they weren’t safe, they were just after some support ahead of deteriorating. To no avail – the nurse ended the call and rang 999 claiming there was a suicidal patient at an address and the police duly attended. Receiving no response to their knock on the door, they forced entry to save life based on the nurses information, only to find a person within who was perfectly safe in the immediate sense but was now somewhat terrified the police had forced entry to their home for reasons that were not obvious to them.
We can understand why the patient was distressed by police actions, but also why the police did what they did: if you receive no reply at an address where you are told someone may be ending their life, you force entry to protect them – to fail to do so would be negligent! If you are told a person at an address simply isn’t feeling great and needs to talk to someone for mental health support, you probably decline to attend knowing that mental health services are involved with them and able, at least in principle, to give the support that person needs. You also bear in mind whilst declining to attend, that police intervention in mental health care is not benign: coroners have pointed out before how even necessary and unavoidable policing can contribute to serious, adverse outcomes for vulnerable people.
Why the stories?
I’ve been learning about “Right Care, Right Person” in recent weeks, reading up on what is available to know and after doing so, I had a chance discussion with an old friend from school who is now a mental health professional. After explaining the general idea behind RCRP, she just calmly said “People will just exaggerate risk” to get a police response that would otherwise be denied. It immediately made me think of these stories so of course, I shared them and suggested people need to be careful of exaggerating risk – it could have obvious legal implications for the professional that does it. You could imagine civil liabilities for organisations, as well as potential professional and even criminal responsibilities for the individuals. The Data Protection Act 2016 says some very interesting things, for example, about ensuring accuracy in the sharing sensitive personal information and it makes reference to various criminals offences and governed by the Information Commissioner who has authority to prosecute, where justified.
LEGAL RESPONSIBILITIES
Organisations who owe a duty of care to those they work with, still retain a duty of care even in some circumstances where the police may have a limited duty of care. For example, if a patient is in receipt of ongoing care from a mental health trust in the community and it did then become a real and legitimate concern that the person was at risk in their home address, it may be true the police can be asked to attend because of an imminent risk to life. So officers can attend, they may even find it is necessary and proportionate to force entry (s17 of PACE) to protect life and limb. But what happens when the officers then find the person is present, that they have not injured themselves seriously or taken an overdose which leaves them at serious risk if untreated and where the person is refusing to leave the address for further assessment elsewhere?
This happens quite regularly in my experience – and in the circumstances of the last paragraph, the police officers present (and indeed, any paramedics who attend) are legally powerless. This situation occurring in someone’s private home, police use of s136 Mental Health Act would be impossible and paramedics have no legal powers in any event. Even if the person concerned was felt to lack capacity around decision-making and in need of being ‘sectioned’, the MCA does not allow for intervention in a private premises purely for the purposes of MHA assessment.
So we’re back now to the duty of care owed to the patient by the organisation who called 999 – it may be necessary for them to ensure the person can be assessed and if necessary, assessed under the MHA by an AMHP. That duty exists, whether or not the organisation has prepared for that reality and of course, there has been civil litigation for Article 2 violations and adverse coroners outcomes for local authorities who cannot ensure timely assessment under the MHA for those who need it. All worth bearing in mind, when thinking the 999 call passes the duties owed to those police or paramedics who end up on scene with someone.
They really don’t! – and as some areas start planning for the wider implementation of RCRP principles, bearing in mind the Home Secretary’s recent letter to police forces, it’s worth remembering the adverse Coroners’ outcomes and the legal minefield being contemplated if people do find themselves inclined to exaggerate risk.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All views expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2023
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – www.legislation.gov.uk
Mental Health Cop 