I had a meeting this week at a conference about healthcare security and took the opportunity to whilst there to hear an input about Right Care, Right Person – it’s important to stay up to date.
The healthcare security audience were mostly aware of the programme and working alongside police forces who had introduced it, even if only partially so far. The speaker began by giving an example of a job which caused consideration of the need for something like RCRP and it went like this –
The police were called to an address by a family, their teenage child who lived with autism and learning disability was exhibiting some challenging behaviours, endangering the family as well as themselves and the child’s mother had been assaulted. The risk ongoing, they rang 999 and the police despatched officers to the scene.
After arrival, the situation calmed a little and once more settled, they rang the “mental health team” (whatever that means) for support for the child and family – they were told to ring the “LD team” (whatever that is) who told them to ring the “autism team” (whatever that is) who said they should ring the GP who told them to ring an ambulance.
An ambulance crew did turn up after a long delay and checked the child’s vital signs, but beyond that, could offer little for the substantive incident in even the short-term and during the many hours which had been spent so far, the child’s challenging behaviours had gone up and down in terms of further disruption and assaults towards their family.
It was stated the police felt if they left, there would be further assaults and the child endangered.
By this point in the story, I’d suggested to a client sat next to me and said “PPO” – that it should be obvious the teams contacted wouldn’t be able to respond and even if they could have done so, not quickly. Given the openly stated risk of significant harm to the child, the officers should have considered a police protection order (PPO) some hours ago, without waiting nine hours overall to make a decision about how to proceed. It should be noted: the threshold for use of a PPO (“significant harm”) is different than the threshold for Article 3 (immediate risk of serious harm) which we’ll come back to in a moment.
If RCRP is about ensuring the “right care” by the “right person”, how does this anecdote help us? – who is the “right person” to deal in the short-term with assaultative behaviour by a child living at home with their family?
CRIME
The first point in the RCRP threshold for a police response to anything is whether it involves crime “which is happening now or has happened”. Well, in this incident we need to start with the 999 call which made it clear, mum has been assaulted by the child – so there’s your first “in”. Also relevant to point out: being placed at risk of serious harm by another through crime can trigger Article 3 obligations for agencies like the police to protect the victim. We should also remember, the police also various legal obligations which are which are entirely unmentioned in the RCRP threshold.
Now: you and I both know very well, mum is highly unlikely to want criminal prosecution of her own child and even if she did, it is unlikely to happen or to help. One can just imagine, for example, the reaction of a police custody officer to a very vulnerable teenager with autism and LD being arrested for something like this and taken to custody whilst in ongoing crisis and I can imagine what charities and the media would say!
Indeed, arrest might be one of the worst things you could do and the call will have been about securing “help” in a very immediate sense and probably little more than that. But regardless of what we think the best outcome is, the beginning of this is someone who has been assaulted and may be assaulted again in a situation which may get out of hand if it hasn’t already – we need to make it stop before someone is hurt or more seriously hurt and so who you gonna call?!
THRESHOLD ISSUES
We should also remember: the RCRP threshold fails to mention the police duty to maintain the King’s Peace – a breach of the peace occurs where violence is used or threatened, to cause fear of assault (amongst other things) and that legal duty exists, whether or not it’s mentioned in the threshold. Put it another way: imagine not responding and then the assault ends in grievous bodily harm or worse, as we know has happened during other incidents involving people with learning disabilities?
The police do not always respond to crime with arrest and prosecution: they must always consider the necessity to arrest and in terms of youth crime and mental health related crime, must consider the necessity of diversion from justice, of course. It seems quite likely there would be little legal basis for prosecution and I will have to assume mum wouldn’t want this anyway or give a statement of evidence to support it because the conference speaker did not conceptualise the incident as a crime, beyond brief use of the word “assault” at the beginning.
The whole thing was characterised as a healthcare matter, which of course it was as well and I don’t think anyone questions the idea there should be healthcare review of a number of things to ensure the child and family have the right support and that health, social care and support is the main issue in play here. But you can’t do that in an instant or whilst someone is busy being assaultative and as I’ve been at pains to point out in this blog over the thirteen years I’ve written it, there is no “mad” or “bad” dichotomy to be had here – this is not about “health” or “police”, it might need both and everyone has a resources reality check to offer up amidst these various kinds of risk.
So nine hours in, a police protection order (PPO) was used – a power only the police have. Even when social workers from children’s services are looking for urgent intervention in situations of child neglect or abuse, they often ask for officers to accompany them in order to use a PPO because child social workers cannot do anything equivalent without going to court. So I admit I was left wondering – just as I was when I watched the recent episode of Inside the Force, how does it help us understand the argument RCRP is trying to make to take incidents which obviously reach the published threshold for police involvement and use them as examples of where the police are not the right agency?
I will admit: I can’t make this make sense.
HEALTHCARE SECURITY
It being a healthcare security event, I was talking to other attendees over coffee afterwards and their sentiment was similarly confused.
The examples some of them were giving me of non-police attendance in their own workplaces like acute hospital Emergency Departments included a patient smashing up the NHS’s computers, at a cost of thousands = “RCRP” … and yet that is very obviously a “crime happening now”. Inside the Force a few weeks back: a serious of crime incidents including domestic abuse assault, arson and a report of a man with a knife = all them saw police responses, thankfully and quite rightly so. But because background factors to all of those events were mental health concerns, the narrative of the programme and the talking to camera by the response officers involved was about how the police were not the right agency.
So who do we call about these crimes, officer? – there is an irony here to be noted and it does need more discussion:
When I’ve heard any RCRP speakers making the point about supposedly “inappropriate” deployments or where we see social media comment about incidents, it’s often pitched as a deployment which prevents response to victims of crime. That happened at this week’s event with mention of “thousands of incidents of victims of crime” going unattended because of “mental health related demands” and yet the very example used to make this point involved a victim of crime … I’m not the only one confused.
POLICE BUSINESS
Most of the Inside the Force incidents had a victim of crime – only the final one involving supposed possession of a knife that was never found didn’t involved a specific victim, but if the caller’s concern about knife possession had been substantiated, it still amounts to a crime of the kind officers almost always arrest for and it takes police officers with powers of search to determine whether the guy did have a knife.
That’s all police business, isn’t it? – the RCRP threshold states this very clearly.
So if I’m understanding things correctly from what is being said: in order to focus on crime the police are going to pull back from mental health incidents and the best examples they have to explain what they’re doing, why and how this should work in practice is to use mental health incidents which involve actual victims of crime who are as entitled to be protected from criminal actions as any other victim of crime? It’s hard not to think about words like “stigma” and “discrimination”.
Please make it make sense.
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
Mental Health Cop 