Many areas of the country continue to consider the introduction of the “Right Care, Right Person” approach to policing and mental health which began in Humberside in 2020. In recent days, a public meeting of the Surrey Police and Crime Panel took place where the issues of police involvement in mental health calls was discussed and it has been reported in local press. Former police officer Richard Smith, now serving as an elected councillor, has contributed to the call by the Police and Crime Commissioner, Lisa Townsend, for introduction of RCRP in Surrey.
Mr Smith stated he was in agreement with the PCCs call and then said: “The first murder I went to was a non-critical [mental health] call to a person who then decided to stab the nurse to death with a carving knife out of the kitchen. I feel that’s where we are going to come unstuck when it comes to removing police from mental health calls.” The PCC stated calls involving such risks were “absolutely the right place for the police to be” and there would always be a role for the police in those incidents.
This discussion interested me enormously but I want to stress one point in particular before explaining why:
In what follows, I’m discussing situations where nothing predicts police attendance may be required. If there is an immediate risk to life or someone represents an obvious risk of breaching the King’s Peace or committing an offence, there will be a role for the police and nothing I’ve read or heard about RCRP suggests otherwise. This post is about nothing other than situations where those risks are not anticipated — at all.
NON-CRITICAL CALL
Mr Smith’s description of a “non-critical mental health call” seems to imply – at least to me – there was nothing in the incident which anticipated the awful, terrible outcome which resulted. It was “non-critical”. Of course, if someone was in mental health crisis and it was anticipated they would be violent towards healthcare staff – especially someone violent with weapons access – then the police would attend and nothing about RCRP suggests otherwise or ever has. The way any potential push-back seems to be described by forces like the Metropolitan Police is where a call does not suggest anticipation of crime or violence and where there is no immediate risk to life. That is where a police force may consider asking health or mental health agencies to undertake their home visits, welfare checks or the returning of mental health patients for themselves, as they are empowered and often bound to do.
You will therefore see the problem: we know there are incidents where professionals attend incidents without any reason to think there will be resistance, aggression, violence or escape – only for incidents to unfold in exactly that way, alas. It poses an obvious public policy problem about how to deal with uncertainty and you might summarise it one of two ways —
- Police attend all mental health calls — which they are asked to attend, without too much over-thinking of issues like proportionality and suitability, just in case something turns out to be unpredictably and unforseeably risky to others.
- Police attend only some of those calls — where the background risk assessment indicates an immediate risk to life or where it is reasonable to anticipate crime or violence and police involvement would be proportionate to those threats.
We almost have a sort-of type 1 / type 2 error problem: you either police everything you’re asked to on the basis there will always be threats, so you then risk over-policing some incidents in order to prevent those unpredictable, untoward outcomes which risk safety; or you don’t do that and it means the safety may be compromised in situations where it is simply not reasonable to predict or foresee the kinds of outcomes Mr Smith referred to. You might therefore wonder: is it more important to try and prevent all assaults and threats against NHS and social care staff at the expense of over-policing some vulnerable people which risks them feeling stigmatised and criminalised; or are issues of dignity, safety and rights of vulnerable people important enough to mean we tolerate situations where risk towards professionals is not predictable and preventable?
TYPE 1 / TYPE 2
The problem with the PCCs response appears to be this: there is, quite rightly, an acceptance of a role for the police to attend mental health incidents where there is a risk to NHS staff, but that view is being expressed in the context of an incident where Mr Smith implies the risk wasn’t known or foreseeable. So how do you decide whether to risk the type 1 or the type 2 error?! – if there is absolutely no way to know or anticipate an armed attack on a nurse with a knife, is it reasonable to ask the police to attend something “just in case”? One view would be that policing is a restrictive practice and officers attending when nothing suggests it’s proportionate is over-policing. We know over-policing is not benign: there have been incidents where the presence or even the mention of policing has contributed directly to someone’s death. But saying so risks the appearance of heartless indifference now we know the incident ended with the death of a hard-working professional who attended something without police support because nothing indicated it was a proportionate intrusion, justified by a proper threat and risk assessment and they came to harm.
So which error do you wish to risk, because you have to risk one of them?! — the legal frameworks imply you risk the type 2 error: if nothing appears to justify police involvement in an incident because it would seem to be disproportionate, you don’t risk it because of the unintended consequences which may occur. This principle extends beyond policing and mental health, incidentally and is a feature of how other coercive interventions are considered in policing, like public order or firearms policing. You don’t send armed officers to an incident if everything about it suggests unarmed officers are the appropriate and proportionate response.
I can only re-stress as LOUDLY as possible: I’m referring here only to situations where nothing in someone’s current presentation OR in their risk history, suggests police attendance was required. If there is an immediate risk to life or someone represents an obvious risk of breaching the King’s Peace or committing an offence, there will be a role for the police and nothing I’ve read or heard about RCRP suggests otherwise. This post is about nothing other than situations where those risks cannot be anticipated at all.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions 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 