This post involves a number of hyperlinks to the website of Guardian Australia – you may need to register to be able to access them, but it is entirely free to do so.
“As useless as udders on a bull”.
This is the way the current “system” was described by Neil Wilkins, whose stepson Todd McKenzie was shot by the police in New South Wales (NSW) in 2019 during a mental health crisis. Coming across this article reminded me of the tragic police shooting of Courtney Topic in Sydney in 2013 and it made me read more widely about more recent deaths after contact involving the police in New South Wales. This year alone, there was a notable succession of deaths – four in four months – which have contributed to calls by families for an independent inquiry or a Royal Commission in the state on the subject of policing and mental health. This article certainly got me thinking because it covered some of the statistics in NSW in recent years.
- Fifteen people in the twelve months to June 2023
- Six deaths in 2021-22,
- Eleven deaths in 2020-21
- Sixteen deaths in 2019-20
- Four deaths in 2018-19 …
- That’s an average of ten per year – according to the data obtained by Guardian Australia.
My immediate reaction is: this is a lot. NSW has a population of just over 8-million people, in 2022. By contrast, England and Wales has a population of just under 60-million and the numbers of deaths quoted above is about half the typical average seen here, despite a population which is almost eight times as big. And of course, there are far more fatal shootings in Australia quite simply linked in all likelihood to the fact the majority of UK police officers are simply not armed with a gun.
You can read, for example, about the deaths Clare Nowland, Steve Pampalian, Jesse Deacon and Krista Kach in NSW – all occurred during 2023 and some included use of taser or bean-bag rounds (so-called less lethal alternatives, ironically). In the case of Clare Nowland, a police officer has been criminally prosecuted after an investigation alleged his actions with a taser were “grossly disproportionate” and investigations are ongoing in to the other deaths so no specific comment upon them but collectively, families have called for an inquiry or commission to look at police training and the roll of the police. I’m hoping that would also look at non-policing issues like the provision of healthcare and health support to the police.
MHIT
Nowhere in these articles is Mental Health Intervention Training in New South Wales mentioned. This has been running for many years and has mentioned in previous Sydney inquests. It is closely based on the Crisis Intervention Training idea from the US where a certain proportion of first-responding police officers will undergo a four-day training course in mental health related content. It will emphasise de-escalation training, the importance of communication and obviously, increased awareness of different kinds of mental health conditions. After the Sydney inquest in to the death of Jack Kokaua, who died in 2018 after an incident involving repeated use of taser and restraint, the NSW Coroner recommended all police officers should undertake the training programme. I can’t work out whether the lack of reference in this recent coverage is because the programme has stopped or because the journalists just weren’t aware of it?
This is a slight tangent however, because regardless of MHIT, the number of people dying after contact does seem worth understanding further if NSW are experienced the loss of vulnerable people at half the level of England / Wales despite a population one eighth of the size. Of course, the obvious point to make is to repeat the point: officers in England and Wales are not routinely armed and a number of incidents in NSW history do involve non-specialist front-line officers who all happen to have a handgun, responding to non-critical incidents. The death of Courtney Topic was an example of this. Courtney had attended a retail park fast-food venue and bought a milkshake whilst in possession of a large kitchen knife she had taken from home. She had not used or threatened use of the knife when buying her drink and was stood in the car park, outside the venue, as members of the public called the police.
A double-crewed police car was dispatched along with a police dog handler and they found Courtney still in the car park, drinking her milkshake and the knife being held passively by her side. They approach her in a triangulated way: one officer with his handgun drawn, another with her taser and the dog-handler with capsicum spray. Their approach and calls for her to drop the knife appeared to induce panic in her and she became startled, raising the knife. As they continue to shout for the knife to be dropped she walked towards the officer with the handgun and he discharged his firearm in self-defence. She very sadly died from her injury after tactics which the NSW Coroner described as “entirely inappropriate”. During the inquest, expert evidence was heard from the UK that the incident would almost certainly not have led to firearms officers being authorised to attend, so by definition, the attending officers would have been unarmed, but with access to taser and capsicum spray and a dog handler (also unarmed) potentially dispatched.
DE-ESCALATION TRAINING
The families now understandably campaigning for an inquiry and greater examination pointed out several other things which we know are true and relevant. Firstly, it was pointed out that uniformed police officers turning up to a mental health crisis incident can escalate tensions and promote anxieties and confusion – you get a sense of that in the way I’ve just described Courtney Topic’s death, above and it’s difficult to address. Obviously, the police turning up anywhere can exacerbate tensions and escalate situations, we know that can often be more marked where those of us experiencing difficulties with our mental health and in distress. It’s also difficult to imagine how you structure an emergency system to deal with incidents involving weapons in a public place without involving uniformed police officers.
Such situations are not just about ensuring the vulnerable person knows who these people are when they’re shouting “drop the knife”, it’s also about the fact that such incidents involve the officers potentially protecting other members of the public, or at least keeping those members of the public away from the incident so as not to make it worse. Trying to police things in casual clothes is not always easy, from my own experience of off-duty incidents and some plain clothes operations. But this in turn just re-emphasises the need for adequate de-escalation training and this is a subject I’ve covered on this blog before, at least in the UK context. Its a complicated subject and I’ve also written about a personal experience about the difficulties of de-escalation in mental health crisis situations – a story I’ll remember for the rest of life.
In recent years it’s become a standard critique of use-of-force incidents to say that the police need more mental health awareness training and much greater de-escalation training. It makes sense, doesn’t it? – the outcome has been bad, investigation or inquests have criticised the officers’ actions and therefore more training is the answer to this problem so we reinforce what to do and what not to do. And again, I’ve written about this before because we often see UK Coroners stating that more training, better training or regular refresher training is required for police officers. That against a background where His Majesty’s Inspectorate of Constabulary reported in 2018 most police officers had still not received the training developed for them as part of the UK’s Crisis Care Concordat initiative, published in 2014. To my knowledge, that remains the case, seven years after such baseline training was made available published.
“DO SOMETHING”
However, something is going on here worth examining in greater, otherwise I suspect it’s unlikely a population as relatively small as New South Wales would be experiencing mental health related deaths per 100,000 after police contact which are far higher than we see in England and Wales. Is it the fact Australian police are routinely armed? Well, that would only be a part of the explanation – evidence was UK police would have been highly unlikely to have authorised armed officers to attend the incident involving Courtney Topic and I doubt whether armed officers would have attended some of the other incidents I’ve reviewed whilst researching this post and where a firearm was subsequently deployed by the police. But it’s a difficult call about these matters: I have also come across cases where my best guess from nothing more than reading media coverage is the UK may well not have sent armed officers to some situations where an Australian officer’s use of their firearm may well be considered justified. We do know several UK police officers have died in knife incidents involving someone who was seriously unwell and it’s always a risk in any such report.
Yet again, this could hardly be more sensitive and complicated.
We know New South Wales police has invested in mental health related programs and training perhaps to a greater degree than UK policing, yet the inquests and inquiries still call for more because of the nature of the outcomes – so perhaps this isn’t mostly about training? Can training actually ensure more often the kinds of outcomes we would all want? Is it about pre-police contact? – we know in the UK, many deaths after police contact have a specific healthcare context where failings, omissions or difficulties in accessing mental health care preceded the fatal contact and UK coroners have shown themselves willing to criticise mental health services in addition to the police. For reasons we all fully understand, the UK deaths of Kingsley Burrell, Sean Rigg and Seni Lewis are primarily thought of as deaths after police contact and they were: they were also deaths in psychiatric detention or following failures of community psychiatric care where coroner’s criticism were directed towards mental health providers.
Given calls by Australian families for mental health responses which are not police-led and I can understand why. That said, I know of no mental health system operating anywhere in the world which would agree to deploy mental health professionals to any incident thought to involve a weapon. It was therefore extremely curious to read in the original article which prompts this post, that mental health professionals are prevented from even advising police by telephone during the police response to a crisis incident involving a weapon. Whatever you think the problem is here, it’s not going to be helped by agencies not talking to or helping each other and thereby ensuring police officers are blind to information which could help inform the quality and nature of their response. Ultimately, however – as I’ve always argued – you cannot police your way to better mental health care and the police can’t fix this for us. What we need to prevent these kinds of outcomes in all countries, is timely, relevant and accessible mental health care – and then we won’t need to over-rely on the police as the paramilitary-looking mental health service they were never designed to be.
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 