The latest Preventing Future Death report to mention the Right Care, Right Person programme was published at the end of May 2025, following the tragic death of Dean Bradley in the Cleveland Police area. It involved what were referred to as “missed opportunities” by the police to safeguard Mr Bradley amidst a lack of appropriate services for him. The PFD is not “an RCRP PFD” because the 2021 case precedes the national roll-out of the programme but a Detective Chief Inspector from Cleveland Police made reference to the RCRP in evidence to the Coroner, by way of ensuring them around correct processes for the police.
Mr Bradley presented twice to the police: on 15th October 2021, officers found him at 0300hrs wandering on a dual carriageway and having established no concerns for his mental health, they arranged some urgent overnight accommodation at a hostel. Having been taken there, Mr Bradley subsequently left the hostel and was encountered by a member of the public at 0450hrs on a bridge, stating he wanted to kill himself. The concerned man rang 999 to report Mr Bradley in need of urgent help and officers attending, securing him back over the bridge and noting he may have mental health problems. He was then assisted back to the hostel and left there by officers who had considered contacting the mental health crisis team, but decided against it because they feared there would be no response due to Mr Bradley’s level of intoxication.
Shortly after 1015, hostel staff entered Mr Bradley’s room and found him deceased.
SECTION 136
First things first: I read all of this and wondered why s136 MHA wasn’t considered after the incident on the bridge. He had expressed suicidal ideas, had managed to get himself extremely proximate to lethal means by which to carry it out, had moved as if to jump in front of a train whilst the member of the public waited for the police and officers noted their concerns for his mental health. The grounds for doing so were obviously met and the officers admitted they thought about contacting the crisis team. I was left wondering: why not invoke s136?
It would have allowed the officers to remove Mr Bradley to a healthcare location and for him to be held there until he could be properly assessed. I do realise, of course, this might mean an extended period of officers remaining committed to staying with him, until sober enough to be assessed by an Approved Mental Health Professional (AMHP). That would at least have meant he wasn’t at liberty to end his own life later that morning and that would have precluded over-consumption of prescription medication (unless taken before being detained, but knowledge of that could have meant treatment for it in an Emergency Department).
Now – there may well be a very good reason why they didn’t do this. We always have to remember: we weren’t there, we don’t know the full facts, a PFD notice is not even a full summary of the evidence, never mind something which gives exhaustive detail. The officers involved here may have had very good reasons for not detaining Mr Bradley and we must give them the benefit of the doubt. The reason for openly wondering is not to criticise, but to try and understand why it wasn’t done because it may have been a solution to the various problems which then lead to allegations of “missed opportunities” and other areas and other officers could learn from that.
RIGHT CARE RIGHT PERSON
Nothing in this report was telling me much about RCRP – my first read of this made me think of other cases where officers have assisted someone to location for supposed safeguarding and where things then went awry after the person changed their mind about remaining there. But the PFD notice itself mentions a DCI bringing up the topic. Unfortunately, it doesn’t say how they brought it up or why – it doesn’t tell us whether it was to reassure His Majesty’s Coroner the missed opportunities would not be missed again or whether it was raised for some other reason, perhaps just as a general update about policing and mental health, rather than to address a particular point of relevance? We will have to speculate until more is made known about it.
But it did make me wonder: is the existence of RCRP now being used to reassure the Courts about the future? – what would be the purpose of mentioning it at all, if not that?
I ask because in this particular context, it seems a strange one: RCRP wasn’t relevant to the death so can only be relevant to considerations in the future. The issues in this case are those listed in the Coroner’s PFD notice, which includes a lack of MH services for those who are intoxicated and at greater risk until sober; as well as the missed opportunities by the police and their lack of good quality communication with the hostel staff (see PFD for details of that). But the PFD is not sent to Cleveland Police for a response, it is merely copied to them for information and of course the Coroner either hasn’t questioned the non-use of s136 in a situation where it seems appropriate and hasn’t raised it as a “matter of concern” in the PFD.
But RCRP as a programme is about pushing for less police involvement in mental health related matters and we know there is debate going on about phase four of RCRP (the one hour handover issue). I have been told since leaving the police there is encouragement in some force areas to leave locations to which people may have been voluntarily assisted and not remain there, so I’m left wondering whether that sort of thing is now more common than it was before RCRP? If it were more common, it would be a strange reassurance to give a Coroner after inappropriately leaving someone at a hostel and failing to inform staff there of relevant risk.
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, 2025
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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