Incident Log No 1234-011025 @ 0204hrs –
011025 – 0205 – CH14 – Caller reports being suicidal
011025 – 0206 – CD22 – That’s for ambulance
011025 – 0207 – CH14 – States he has mental health problems and intends to take his own life
011025 – 0208 – CH14 – Caller says he intends to kill himself in the park.
011025 – 0208 – XXXX – mapping shows call in the vicinity of Elizabeth Park, Sanford.
011025 – 0208 – CH14 – [address history check]
011025 – 0208 – CH14 – [mobile phone number check]
011025 – 0209 – BWR2 – This is a mental health call for welfare, RCRP says this is for ambulance.
011025 – 0210 – CH14 – near the bandstand in the park
011025 – 0210- CD22 – calling ambo …
Imagine this were the beginning of a police incident log under review by the Independent Office for Police Conduct or by one of His Majesty’s Coroners. Someone has rung 999 at 0204hrs and the call handler writes on the blog “caller reports suicidal” and without any more being known the control room despatcher (the person who asks available police officers to attend a call) writes on the log “That’s for ambulance.”
Now – nothing more is known than someone saying they’re suicidal. We don’t know the context or background, we haven’t done any intelligence checks yet on the person, their phone number to see what else might be known, or any PNC check to see what warning markers they may have (and why). This could include markers for mental health, suicide or self-harm and markers usually contain a one sentence summary of why the marker was added – such as “MH – disclosed depression on arrest, 2023” or “SH – recent self-harm injuries seen, 2023”, etc..
AMBULANCE
I’ve written before about the amount of demand now being deflected to the ambulance service by the police and we do have some data insights in to this. The (then) Chief Executive of the London Ambulance Service gave evidence to the London Assembly in February 2023 and stated they were now receiving an additional 250 calls a day from the Metropolitan Police, most of whom did not need an ambulance. So the first point to make is we know already that deflection to the ambulance service is usually not ensuring the “right care”, it’s just ensuring another inappropriate agency is asked to deal with some one where they’re also ill-equipped to deal.
Now, by all means: take the view that it’s more appropriate for the ambulance service to deal inappropriately with healthcare demands than the police. That’s a point of view, isn’t it? – the ambulance service is a part of the NHS and if the matter is medical or health in nature, it may “doing the wrong thing righter” to have the ambulance service burdened with the responsibility instead of the police. I’m not here to say no-one should think this. But what we also know about much “mental health” demand facing the police is it’s not really mental health demand in any direct, meaningful way. It’s usually not acute mental illness where powers under the Mental Health Act 1983 will be required – it’s often what someone once termed “social distress”.
By way of making a MAHOOSIVE over-generalisation, we know most people who are detained under s136 MHA by the police are not “sectioned” and many are just signposted to self-help resources, perhaps with a courtesy letter to their GP. We know people who have been found intoxicated and threatening to end their own life have been detained MHA in circumstances where it should have been obvious, the alcohol and social distress were driving the presentation. This kind of thing was the example given in one area which caused the NHS MH trust to create the UK’s first “triage” scheme. Cleveland Police‘s mental health trust once presented at an event and talked about the number of drunk students who were detained under s136 whilst miserable after failing exams or splitting up with their partner. I’m not attempting to trivialise things, but it’s not acute mental illness when people have sobered up and the distress ameliorated.
THE RIGHT CARE
So whilst that inevitably sounds like a caricature, Cleveland’s mental health trust was so concerned about the amount of those kinds of incidents, they decided to start spending six-figure sums of money on nurses who could be on duty to “support” police decision-making at incidents – and by “support” I mean “stop the police misusing s136”. If we now think more widely than 136 presentations, we can see the obvious potential for incidents of social distress to give rise to awkward debates through fogs of alcohol about whether something is “mental health” or not.
And how hard would it be to get this right from a telephone call where no-one can see, speak to and smell the person at the centre of the call? Yes, smell is important not least because alcohol generates a smell and that information may be relevant to decision-making – and if we already agree it’s hard – and I hope we do agree – it can only be harder to make that judgement when there is just one line on an incident log where all we know is “caller says he is suicidal”.
Think about that one, because you have to take calls at face value until you have a reason to do otherwise –
- Is there any version of events where someone who is suicidal is going to require a police response first and foremostly?
- Yes there is – the person may require urgent detention under legal powers which only the police have.
- Is there any version of this where the ambulance service will be irrelevant to the call?
- Yes, there is – it may be someone’s location isn’t known and cannot be established or the person will not cooperate.
- So is it a defendable professional decision to be saying “One for Ambulance” so early in a log?
- No, it’s not – there is no objective way to know whether the legal threshold for police involvement is met. It requires more nuanced assessment, after some initial questions, background checks, etc.
KEEP YOURSELF ALIVE
Why am I writing this post? – because a few months ago, I had a decent phone conversation from an officer who was concerned about this kind of thing. The hypothetical incident log at the top is a composite of a couple of real examples she had about her supervisors’ decision-making and after raising it, she’d been somewhat patronised by the supervisors who suggested she hadn’t understood RCRP and the fact that these were “health” calls.
Ironic, right? – even recently, John Thirkettle MBE from Humberside Police was quoted in saying that “RCRP should not be used as an excuse not to do things the police should be doing” and he’s right. The concern I have had running for months, also based on my own experience at the end of my service, is that the kinds of examples above are exactly what we are hearing of most days and no-one seems interested in acknowledging them or discussing how they could very obviously lead to a very difficult day in an inquest or inquiry charged with investigating whether a police non-response was appropriate.
The thing I’d say to the hypothetical call despatcher and sergeant, above, is this – if you really do think you can defend a decision taken so early in the process, without more information, than it’s you that needs to understand more and not about the RCRP process: but about the law. The phrase “real and immediate risk to life” has a meaning and sitting behind that is a requirement to take decisions based on the fullest information, given how much could be at stake. If it turns out your premature decision was fateful and contributes directly to the death of a vulnerable person, don’t think for a moment someone will be running in behind you to say “it’s not their fault – RCRP” because this kind of intervention is not an RCRP compliant thing.
Not for a moment – and you’ll be expected to rationalise it for yourself in light of all this material nobody trained you on.
Awarded the President’s Medal, by
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.
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