Did you watch Channel 5’s Inside the Force on Tuesday evening?! – episode 8 was all about mental health calls but I will admit 11pm is way beyond my bedtime so I caught it on catch up over breakfast yesterday. It was filmed with the cooperation of Cleveland Police in Middlesbrough and starts with officers being briefed and posted. The narrator soon tells us Cleveland Police had over 1,000 calls “last month”.
And off we go.
The programme sets a narrative about all the mental health related demand faced by the police and we hear officers telling us that as much as 90% of their work involves mental health issues.
“It seems like it gets passed on to us quite quickly and we have to pick up the pieces … primarily, police are there to deal with crime which I guess is why the police are looking towards not attending as many mental health jobs as they have previously.”
We haven’t seen an incident yet and there’s so much to unpack already. Firstly, it’s never really been true the police are primarily there to “deal with crime”, prevention of crime is the first responsibility of the police and prevention work means doing a number of things which do not involve “dealing with crime”, and yes: mental health incidents amongst them. Let’s never forget: about 80% of calls to the police are nothing to do with crime and senior officers are frequently held to account over incidents which do not involve crimes.
CRIME AND MENTAL HEALTH
I started making a few notes for a potential blog post as I watched the programme but by the time I was way over half way through I’d decided against posting – there wasn’t much within the first 75-80% of it which seemed like anything we haven’t heard before – police attending incidents where there was ongoing or recently occurring crime or disorder, making arrest decisions, etc. Fair enough: I was interested in the decision to arrest the young woman and wondered about s136 MHA, but neither of them seemed to be options which would lead anywhere worthwhile.
It was the final 20-25% of the programme that convinced me to post: specifically, the final incident involving the young man in shorts supposedly harming himself with a knife in public and the way that was handled along with the closing credits which summarised the programme and my point is this:
The officers in the programme were keen to stress mental health is better handled by other agencies, they didn’t seem convinced this stuff was police work and the programme framed all of this in the context of the Right Care, Right Person programme which it reminded us is due to save one million hours of police time as forces pull back from mental health demand. Interesting claim, given RCRP has never been evaluated either where it originated or anywhere else.
HOUSTON WE HAVE A PROBLEM
The difficulty with this narrative, the programme and the framing of it all by he officers involved is absolutely every, single incident in that programme involved someone living with mental health difficulties and every single one of them should trigger the so-called ‘threshold’ for a police response under RCRP.
- We saw a Royal Marines veteran arrested for an allegation of domestic abuse – last I checked, DA is a sensitive police matter which shouldn’t be set aside because the perpertator has mental health difficulties.
- Indeed a summary of domestic homicide reviews many years ago pointed out about half of the suspects in the cases reviewed were known to mental health services at the time of the killing.
- We saw a young woman arrested for arson after setting fire to her mother’s gate – last I checked, arson is a serious crime and a particular risk flag in some patient’s situation.
- We saw a young man detained for stop / search because it was believed he had a knife (albeit the officers arrested him for possession of it, before they’d searched him and found anything … only to then not find anything!) – it should have been a stop / search whose whole purpose is to prevent unnecessary arrests “on suspicion”.
- But last time I checked, investigating knife crimes was police business and if we’re going to say mental health must change that, we’ll have to rethink the entire strategy for youth crime and knife crime, because the prevalence of mental ill-health amongst gang members, for example, is quite breath-taking.
The first line of the RCRP threshold is about a crime which has happened or is in progress – all of these incidents involved this, so none of the incidents are things which should be causing the “not police work” in which the narrative of the programme was framed with the officers involved reinforcing this.
MAN WITH THE KNIFE
I can’t avoid more on the man with the knife who was arrested rather than stop / searched. The 999 caller has expressly said he had a knife and the man was being tracked on CCTV prior to officers turning up. Perhaps I missed something, but I don’t recall that footage being conclusive about the knife, so it’s fair enough to detain him and search him to confirm whether he is committing an offence. The search found nothing, so we soon see him without handcuffs (presumably having been swiftly de-arrested off camera!) and the officers note he has self-harm injuries which he claims to have caused with a piece of a brick – attention turns quite rightly to his mental health.
Officers become interested in ringing what they call “the crisis team” in order to get support for him. Now, it’s important to remember Crisis Teams do work differently around England and Wales – they have different roles and remits but on the website for Tees, Esk and Wear Valley mental health trust which covers Middlesbrough, their all-access ‘crisis’ line is to ring 111, option 2. In case you’re not aware, this is a national approach where anyone in need of mental health support in crisis can reach for option 2. Crisis Teams, properly understood, tend to be specialist services for secondary care patients already referred to a mental health trust.
Of course, perhaps this man is such a patient but nothing is said to suggest that. The officer is seen on the phone for a considerable amount of time, during which the man makes it clear “I don’t want to be here” and he’s seeking to leave. This is denied by the officers who say they can’t let him walk off because of what they fear might happen, explaining they have a duty of care. But the man is no longer under arrest and I’m not the only one who wondered what legal power was being used to detain him when he’d stated clearly he wants to leave.
We see footage of him sitting on the rear step of the police van, just waiting and eventually, efforts to secure crisis team support are abandoned and officers drop the man to a friend’s house because he is sofa-surfing, giving him a phone number for the crisis team as they leave. We then see the officer in the vehicle driving away, talking to the camera and reflecting on the incident.
PHONE ASSESSMENT
The specific issue which made me think I need to post about this, was the officer telling the man whilst he sat on the van step, “We want you to get a mental health assessment over the phone”. No, no, no – this is a bigger problem than many realise.
You cannot do a mental health assessment by telephone – ever. The first step in any thorough mental health assessment is a visual / physical assessment which simply can’t be done by phone and it’s not as if we haven’t been here before: in 2017, Mr Greg Hutchings died after contact with the police where officers arranged for him to speak by telephone to a mental health nurse from the local triage team. In the Coroner’s Court after Mr Hutchings’s death, there was considerable debate about what the phone call amounted to – was it a mental health assessment on which officers could then rely, or not?
Well, the officers involved were keen to stress they had left Mr Hutchings at home because he’d had a mental health assessment but the nurse involved specifically denied this is what it amounted to and the Coroner became very interested in what, precisely it was instead – what was its purpose or its standing, in terms of how it might then inform or affect police decision making?
You can’t do mental health assessment by phone – so save yourself a difficult day in a Coroner’s Court facing the family of someone who died by pretending you can. Time to learn the hard earned lessons so the phrase “learning the lessons” isn’t seen as a hackneyed cliche.
POLICE POWERS
And a final point about police powers: as the officers drive away from the man who’s sofa-surfing, one of them says something I was absolutely astounded by –
“We don’t have any powers for mental health unless people are actively trying to kill themselves.”
This is just flatly wrong – you absolutely do but the comment helps me understand why the man was potentially subject to an hour’s false imprisonment on the van step. The power is called s136 MHA and if anyone thinks it’s only about active suicidal ideation, they need to re-read the legislation, I’m afraid. I can easily imagine a PSD situation where they might wonder why s136 wasn’t used when it was potentially or even obviously available and he’s been subject to one-hour of powerless detention against his will. Indeed, I’m aware of an officer not too far from Middlesbrough who was in fact investigated by PSD for doing exactly this. I’m also aware of Coroners expressing astonishment that s136 MHA powers were not used for various reasons – just browse the PFD page of resources on this website for various examples and be aware: I put them on here so people can see them and learn from them.
Section 136 can obviously be about situations where someone is actively seeking to end their life or seriously injure themselves – the “immediate need of control”, stuff. But the definition of s136 is wider than that – the “immediate need of care” stuff is also important and easily engaged where people are encountered in depressive conditions, self-injury or suicidal ideation.
“Every job we go to usually has some kind of mental health issue attributed to it.”
Actually, I doubt this but if that’s your view … what we can say is to the extent that’s true for this programme, each and every example involved one or more things from a list including crime, disorder, weapons, serious risks.
Mental health is core police business, as Lord Adebowale once said – it has always been the case and always will be, if you understand his comment correctly.
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 am not a police officer.
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
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