Imagine this (hypothetical) situation –
Someone is picked up by the police under s136 Mental Health Act 1983 (MHA) and removed to a Place of Safety (PoS) for assessment. After arrival, the police leave and once they are safely out of sight, the man attacks NHS staff. This involves a window being smashed and he proceeds to hold slivers of broken glass towards staff as a weapon, threatening them. They (quite rightly!) retreat for their own safety, locking a door so he’s contained in a damaged Place of Safety room and he proceeds to smash the place up completely. The word “destroy” was used, not just “damage”.
Upon first ringing 999, the police refuse to attend but eventually state an inspector is coming down on their own to “assess the situation”. This is the point where I’m asked for advice and of course, any is given on the basis of the inevitably partial situation described, always fully aware it’s a summary and there will be things missing from the description, not least things like the man’s background, whether or not an MHA had happened yet, what his police background is, etc. My first instinct, though, is none of that massively changes the situation – he’s caused potentially thousands of pounds worth of damage, armed himself with an improvised weapons and threatened staff safety, so it makes me wonder what was going on in the head of the call handler when declining to attend.
My own reaction was, “there’s no way this isn’t a police situation!” and RCRP makes no difference whatsoever to the assessment of it: there is a crime in progress here, there is “an immediate risk to life” or “risk of serious harm”. It triggers all three parts of the RCRP program’s threshold so why not attend?
SKIPPING TO THE END
Eventually in our imaginings, let’s assume a supervisor’s assessment suggests police attendance is required and the man was arrested for criminal damage. After receiving an MHA assessment in police custody, it was determined he was not suffering from a mental disorder so he was charged with criminal damage. Meanwhile at the hospital, the s136 suite is out of commission for the foreseeable future so all those subsequently detained will have to be taken to an Emergency Department until the environment is made safe. That will mean more police time spent sitting there than would be the case in a MH-PoS because the police cannot leave people in ED.
There are a few issues within our hypothetical situation which are worth unpicking –
- Is the decision to leave the PoS sound? – we know the police are keen to get out of a PoS once they have deposited their detained person there, but is it appropriate. The reality is there is a limit to the capacity and capability of the NHS to take over responsibility and we can criticise that as much as we like – it won’t change the fact. There needs to be a proper process to determine handovers in a PoS and yes: ideally within an hour. But not always.
- The decision not to return – I admit I’d be fascinated to learn why that was the first reaction. What is it about “man with pieces of glass threatening staff and smashing up the PoS” that is not something triggering a police response? We do know of other decisions not to attend events triggering the RCRP threshold (I’ve experienced them personally) but perhaps the argument will be an inspector attended this and put the wheel back on.
This is just one anecdote of several where an NHS professional has asked my view about something they felt was going awry.
At the risk of catastrophising this kind of thing: what would happen if non-attendance had then seen a member of NHS staff stabbed with glass and seriously injured or worse? One reason I’ve chosen to blog about these ideas, with the obvious response to me that it is (yet again) taking a negative view, is that it’s not really hypothetical. This particular incident is, but within my own service I heard senior officers questioning why the police were attending mental health units to weapons-based risks to NHS staff and it’s nothing short of terrifying. I know of two incidents this century where NHS staff have been literally murdered on mental health wards and countless more where people have suffered traumatising, life-or-career altering violence at the grievous bodily harm standard.
WHAT’S GOING ON
So I’m left unsure what to say, except to say I’m really nervous about what healthcare staff are now consistently saying. I recently presented at the National Association of Psychiatric Intensive Care Units legal seminar on workplace violence and that’s what prompts this post – staff who have been injured at work finding it even more difficult than it was before, to have the violence they suffer in the course of their work taken seriously.
As some of you now know, I’m doing research of mental health related police contact deaths (PCD) and I have spent much of this summer pulling together a spreadsheet of incidents from this century – as many of them as I can find. I’m well aware many will not be evidenced in publicly available data sources, not least because no-one is counting them – not even the Independent Office for Police Conduct who publish an annual report on police contact deaths and have a section in each report about mental health. But having so far only interrogated some obvious sources, I now have a databased of well over 250-deaths where there is detailed coverage in public sources, Preventing Future Death reports and so on. No doubt that number will go up as I keep digging.
I’m conscious of my own experience as I do this work: for every situation where there was a MH-PCD, there were many with significant similarity which led to non-fatal outcome, mostly because of luck rather than judgment. This ensured little-to-no scrutiny of the way in which police decision-making contributed to a “near-miss”. So decisions not to attend something where there is obvious potential for serious injury is something we should be concerned about and trying to understand how widespread things like this are, whether because of how RCRP is being interpreted in practice or for any other reason.
And so the question to reflect on at the end, is this: if the police had remained at the PoS in support for just a few hours, might they have saved dozens or even hundreds of police hours spent investigating the offence (and / or any complaint or NHS-requested review) which resulted from the officers leaving and the countless hours then spent waiting in an Emergency Department with future 136 detentions which was only became necessary in the first place because damage to the PoS wasn’t prevented and it was placed out of commission?
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
Mental Health Cop 