Some years ago, the (then) Independent Police Complaints Commission (IPCC) investigated two separate incidents in a police force in the north of England where two separate ‘concern for welfare’ calls had been received. The call handlers had failed to identify that what was, in fact, being described was a missing person – probably because the words ‘missing’ and ‘person’ had not been used and the caller had been asking the force for a ‘welfare check’. There was a subsequent failure to follow missing persons procedures and one of the incidents ended with the sad discovery one of the missing people was deceased.
There is a difference to be understood between whether there is a concern for someone’s welfare and whether someone is missing – and it’s a distinction you’ll want to keep a really close eye on if you’re making decisions about whether the police should deploy to something.
Some cases are easy, of course:
- A man hasn’t been seen for a few days, his family have been ringing his phone and there’s no reply, they have visited his flat and using a key they have, they have entered it to look for him and he’s not there.
- They have contacted everyone they can think of who may know where he is and ask those people to spread word that concern is mounting and still no obvious explanation.
- This is all unusual for the man who rings his family every few days.
- He’s missing, isn’t he? – this isn’t just a concern for his welfare. Nobody in his life seems to have any idea where he’s gone.
- In another example, a concern emerges when a man fails to show up for an outpatient mental health appointment.
- His community psychiatric nurse rings his mobile, no reply and a message is left for him to ring when he hears it.
- None of this is unusual for this patient who has often missed appointments. It’s happens regularly as he lives a somewhat chaotic life, not helped by his condition.
- They now ask the police to do a welfare check on the man but no-one has visited his home address, no-one has contacted his known relatives or other contacts.
- He’s not yet missing and the NHS has not exhausted their reasonable options to enquire after him.
We need to look at the definition of ‘missing’ and consider why he’s not (yet) a missing person.
DEFINITIONS
“Anyone whose whereabouts cannot be established” is missing.
This is a multi-agency definition, accepted across public sector organisations and the reason out second vignette is not a missing person yet, is we haven’t obviously exhausted other reasonable lines that may reveal what’s going on. As above, at face value, the mental health team has not checked the man’s home address, they have not rung other family, friends or professionals who may be relevant or have knowledge – or if they have, they didn’t say so. I’ve known situations like this where CPNs visit home addresses and find the patient answers the door and they seemed OK – they just hadn’t gone to their appointment for whatever reason. Perhaps they just forgot?
Of course, not all patients will have or will give other contact details to their GP or mental health team. My GP certainly has details for my wife and vice versa, my mother’s GP had details for me and my son’s GP has details for both of his parents, etc.. Should I fail to turn up somewhere, it’s reasonable to think the GP will try my mobile phone number and if that doesn’t work, they’d ring my wife. If that adds to concerns – for example, I don’t answer and my wife confirms she’s at home and has not heard from me either and was starting to be worry – we’re starting to hit missing person territory. Equally, she may be able to confirm that she’s aware I’m cycling home from work so unlikely to answer my phone and had left work that day, presumably I’d forgotten about my appointment?
Etc.! .. but not all people have family or friends or want them involved in healthcare issues.
CONCERN OR MISSING
So, where a situation is being reported to the police, there are a few things to try to be clear about –
- What exactly has led up to the report?
- Are we concerned about someone because nobody knows where they are or because of some other reason (like the missed appointment)
- Has due diligence been done by the person reporting to exhaust all the reasonable avenues they should? – for example, by ringing a next of kin or other contact?
- Has a home address visit been done – if not, why not?
- There may be a reasonable reason why a check hasn’t been done, but it would be useful to know it was considered and the reason for it not being completed.
The home visit is an awkward point, isn’t it? It may be considerably more difficult, if not impossible, for some agencies to do that than others. Community mental health teams, for example, do visit patients at home and will have access to vehicles for that purpose. It may be reasonable to think that would be tried, especially as the patient and address will most likely have been risk-assessed as part of care=plans being established, so nurses or healthcare assistants know who they’ve visiting and what they’re walking in to. Much more difficult for someone in an Emergency Department to do a home visit. Clearly, they won’t be leaving the ED to do it and it may be difficult to persuade another part of the NHS to do it, like the ambulance service. Do we want paramedics tied up just checking on whether someone’s at home?
DUTY OF CARE
Of course, legally speaking, the Right Care, Right Person programme is pulling back the police from welfare checks and if any duty of care is owed to someone who, for example, walked out of A&E or failed to attend an NHS outpatient appointment, then it is owed by the NHS organisation connected to the initial concern. Given some of those organisations may not have the capacity or capability to conduct certain aspects of their checks, how should be done where it does not trigger obligations for the police. That’s a policy question for NHS managers, ultimatley.
But there should be a basic expectation that what can be done by the person reporting, should be done by the person reporting and that this will be explained to the police if it reaches the point where someone is claiming, “this person’s whereabouts cannot be established” in order to promote consideration of whether a missing person’s investigation should be commenced. And of course, if there is an immediate risk to life inherent in the report, it should be made immediately so we can get all hands on deck to find the person as quickly as possible to safeguard them.
Just because a caller doesn’t use the word ‘missing’, it doesn’t mean they’re not reporting someone missing. What matters is the person’s whereabouts cannot be establish after initial, reasonable attempts to contact them.
If you want read the police’s national guidelines on missing people, they are available on the College of Policing’s website.
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, 2024
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 