The latest report by the Independent Office for Police Conduct in to Deaths During or Following Police Contact has been published today, covering 2022-23. It relates to a lot of mental health related cases, as it always does and covers both those deaths which occur during arrest and detention, as well as suicides which follow on from police contact, whether it be detention related or not. The IOPC’s acting director general, Tom White called for other agencies to ensure the police are relied upon less as first responders to mental health related calls for service., promising the IOPC would monitor the Right Care, Right Person initiative as it was rolled out nationally.
In case you are unaware and want ease reference to it, all of the IOPCs reports on this topic are linked on one of my resources pages, as well as another link to archive material for previous reports from the Independent Police Complaints Commission, the predecessor organisation to the IOPC.
As with previous IOPC reports, there is no mention in this edition about street triage or schemes which operate under a similar name so we still don’t know much about incidents where a death follows contact with these multi-agency approaches and I still think this is a shame, because we do know there have been such cases. Given the different cultures and accountability mechanisms which exist in policing and in health services, I would have expected by now for an inspectorate or regulator to be interested in how such ‘new’ cultural factors such as healthcare advise affect police decision-making, especially because we know there have been debates about how the police make decisions about s136 MHA or detention, when faced with NHS advice. I wrote ‘new’ as I did because street triage is now more than a decade old and it’s still widely operated in various parts of the country, albeit in different ways.
HEADLINE STATISTICS
In 2022-23 there were —
- 28 road traffic fatalities
- 3 fatal police shootings
- 23 deaths in or following police custody
- 52 apparent suicides following police custody
- 90 other deaths which were independently investigated by the IOPC.
There is a table (2.2, p8) which shows the trends in these categories over the last ten years and by way of example, 23 deaths in or following police custody represent a more than 100% in such deaths on the year before, matching the peak figure in the last decade from 2017/18. This latest report amounts to a “significant rise” and is above the average level over the last decade. Meanwhile, suicides following police custody are down to their lowest point in the decade.
NB: important to remember when taking in these statistics, “custody” does not just mean detention in a cell at a police station. Someone who is under arrest but still at the scene of their arrest is in “police custody”, legally speaking and for example, twelve people reported were taken ill at the scene of arrest and either died at the scene or at hospital after being removed directly there from the scene.
CUSTODY
Within this third category, however, there were thirteen deaths where it was known people had mental health problems, including four related to the Mental Health Act 1983. The report doesn’t specify which provision of the MHA was being used, but various case examples used throughout the report mention nothing other than s136 MHA. This is higher than previous trends over the decade, albeit we need to bear in mind that during the decade, use of s136 by the police service has risen considerably to its highest point in the last MHA reported statistics. There was a Mental Health Act relates death in the fifth category, where officers had attended a home where mental health services had ‘sectioned’ a patient under s2 MHA and police assisted in removing a reluctant patient from the house to an ambulance and then resumed to other duties. The patient sadly died after that police contact whilst still in the care or contact of the NHS.
In addition to those four MHA related deaths, of the 23 who died in or following police custody,
Eleven of the twenty-three who died had been subjected to a use of force, including ten who had experienced physical restraint by police or by members of the public. Of those who were restrained, eight were white, one was black, one was Asian and one of mixed ethnicity. Three of these incidents involved use of taser and four involved use of leg restraints (ie, big velcro straps a little like a seat belt, which are wrapped around ankles and knees to prevent people kicking).
SUICIDES
The IOPC includes a death in the suicide statistics either if it occurred within two days of time spent in police custody or is thought relevant to the death. Also worth bearing in mind the police do not always know of a death which occurs days after contact so the numbers may understate the issue and suicide does not just mean a coroner’s verdict of suicide. For example, a coroner would not issue a suicide conclusion unless there was clear evidence of intent to die, where some inquests relate to people who may have died accidentally whilst attempting to harm themselves non-fatally. The IOPC report covers any “intentional, self-inflicted act”.
49 men died and 3 women – 75% of people in this category had known mental health concerns, including one person who died by suicide after discharge from detention under s136 MHA. 12 people died on the same day they were released from custody; 25 happened the following day and the final 15, two days after release.
It is within this category that I’d love to see the IOPC doing more work around post-incident contact with multi-agency schemes were healthcare advise or input may be affecting police decisions.
OTHER DEATHS
I mentioned above, a person who died after being ‘sectioned’ under s2 MHA where the police assisted to remove the person from their dwelling in support of healthcare staff. The person died of medical factors after police had resumed to other duties. There were 20 people who died whilst reported ‘missing’ to the police, 12 of whom were thought to have mental health problems which rendered them susceptible to self-injury whilst at risk and they died before they could be found.
There was a further sixteen people who had been reported to the police as being at risk of self-harm, suicide or because of mental health problems. The IOPC give an example of one such person as someone who “may have failed to attend an appointment of welfare check, or showed signs of being at risk of self-harm or suicide” but where the person is “not reported missing”. Of the 16, 14 died by a self-inflicted acts.
What occurred to me whilst reading this section is that it relates to people reported to the police as being at risk in some general terms – but it does not state who was reporting the concerns for welfare, ie, other agencies, friends or family. It made me think of how different police forces will approach these requests as Right Care, Right Person rolls out. As we learned in the National Partnership Agreement, the “RCRP Threshold” for police involvement is crime or an immediate risk to life or immediate risk of serious injury. The IOPC report does not indicate how many of these fatal incidents involved such a threshold or whether / how the police were responding to the calls – it would therefore allow us to start thinking about how many cases which do not involve a report of the RCRP threshold being met, do go on to have a fatal outcome. It will be very interesting, given the caveat the IOPC applies to their suicide category, to wonder how the IOPC will capture data about calls to the police service which are declined in accordance with RCRP principles and practice, which then lead to an untoward outcome.
Plenty to think about and still more I wish we could know to understand these complex and sensitive matters.
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 