If you follow the narratives about police contact deaths (PCDs), you won’t get very far before you see there is a lot of discussion about the need for accountability – whatever that might mean.
This posts is a reflection on all this, because it obviously does mean different things to different people. Before we get in to it, think through a few of the situations in which we see demands for accountability – it’s not just mental health related PCDs, we see it after fatal police shootings and other deaths in custody or suicides after police contact. We also see it in state contact deaths for other organisations, inc prisons, immigration and NHS mental health care.
There is some academese on this if you want to go reading about it and a great place to start is from University of Liverpool lecturer, Dr David Baker and his 2016 book Deaths After Police Contact. If you want to get deeper in to, try the bibliography in Dr Baker’s book as well as the website of the Independent Advisory Panel on Deaths in Custody (IADPC).
JUSTICE CAMPAIGNS
One might be forgiven for thinking that accountability, for some, is nothing less than criminal prosecution and conviction of police officers (or other professionals) for the use of force, or for an omission or misconduct which led to someone’s death. This being the most sensitive business imaginable, we can all understand why those calls are made but we’re not being balanced if we think every time someone dies after police contact, there must have been fault on the part of the professionals involved, sufficient to justify criminal or even gross misconduct proceedings.
Use of force is contentious, always – it’s often a contributory factor to adverse incidents gone awry so of course it should be carefully examined in the context of training and policy, etc. We know use of force is prone to bias – we often hear the claims about disproportionality and various cases in MH-PCD history highlight where force has been found to be excessive. It also highlights that inquests and IOPC investigations operate to different standards because know some inquests’ juries have raised concerns about excessive force, only for the Crown Prosecution Service to decline criminal charges against the officers.
Others might argue accountability sits with the police in this country being subjected to all manner of oversight mechanisms – if you are an officer involved in a police contact death, as I have been twice -you are fully aware that within a few hours, the death you’re still processing will have been reported to your Professional Standards Department who will refer it to the Independent Office for Police Conduct who will undertake a preliminary assessment to ensure evidence is preserved during primary investigation and a decision taken about whether the IOPC will investigate the thing independently or supervise PSD doing it.
POLICE CONDUCT
Assessment will give consideration to whether the officers should be treated as witnesses or treated as criminal or conduct suspects, where there is some potential for shortcoming or wrongdoing. This might mean telling officers it is a conduct investigation – gross misconduct or so-called ‘simple’ misconduct only – or whether it is also considering criminal offences which may have been committed.
This means there may be criminal proceedings, if the CPS authorise the IOPC to charge officers with an offence, as was the case after the fatal police shooting of Chris Kaba in London, for example. A police sergeant stood trial for murder and was acquitted by a jury and has only recently learned there will be no gross misconduct proceedings after the IOPC and the Metropolitan Police spend years exchanging views on it amidst the uncertainty of a Supreme Court case which reframed the law on police use of force. The outcome of all this is he has not been found at fault by a criminal or misconduct process, but has had his life and his family’s life put on hold for four years already whilst detailed investigations in to all aspects of what happened too place – and the inquest process is still to come at an unspecified date in the future which will do it all over again.
In what way is that not accountability? – unless the argument is that because he was not convicted of murder or sacked for gross misconduct, it is clear evidence of the police being unaccountable. Accountability can only be imprisoned or sacked police officers? – there is no possibility that officers using fatal force may have done so honestly, reasonably and lawfully, in incredible difficult circumstances? Don’t waste my time.
MENTAL HEALTH CONTACT DEATHS
These issues affect mental health related cases, too. Following the decision not to criminally prosecute the Leon Briggs officers (in Bedfordshire), the IOPC directed a gross misconduct hearing which began in February 2020. During initial legal arguments at the hearing, the Chief Constable of Bedfordshire offered no evidence and the hearing collapsed, each “side” blaming the other.
There are other examples but these various investigations, inquiries and inquests have different purposes – the IOPC is looking to investigate an incident and determined whether there is individual blame; criminal trials seeking to determine criminal guilt beyond all reasonable doubt; inquests are trying to work out who died, when, where, how and why. The reality of all these mental health events, however, is that they are multi-faceted, multi-layered and often have a partnership dimension which reaches beyond policing.
Think of how many high profile police contact deaths are also NHS contact deaths? –
Sean Rigg: neglect by the South London and Maudsley Trust before anyone rang 999; Seni Lewis / Kingsley Burrell: both detained MHA patients on psychiatric wards before the NHS itself rang 999 for the police – these are just some examples, there are more. How do we construct accountability in those settings? – who are we hoping to hold accountable and for what? If you look at inquest conclusions for those three examples, you see mixed attribution across the organisations and professions. Five things contributed to Seni Lewi’s death, two of which were about the police alone. Neglect by SLAM “more than minimally contributed” to Sean Rigg’s death, prior to the Met’s “more than minimally contributed”. Of course, it could well be that nurses or doctors should face professional proceedings as well as police officers in some cases but accountability cultures differ in policing and “health”.
UNTHINKING SYSTEMS
Generalising outrageously but based on my own experience, the NHS over-typically looks at system failures and we see open resistance to the idea of individual professionals being held accountable – see the Nottingham Inquiry for evidence of that. We also see the police over-typically looking to hold individuals to account for failures which in no small way were affected by way the policing system and culture fails to ensure officers are giving every fighting chance of being able to do the right thing.
So what is accountability? – only criminal or conduct outcomes for individuals or is it still accountability if someone was subjected, for example, to a number of investigations, inquiries and inquests and came out of it with no finding of fault? We can ask this without believing those systems operate perfectly – we know they are far from it.
And why do we not look more at organisational accountability? That may be something for another post on another day, but one thing I can’t help notice is the time it takes for all of these cases to get through the “system”, the senior people responsible for the system aspects are never there when the accountability is due.
What is accountability? – how is it created and manifested in the real world? It has to be about more than whether a nurse, doctor or police officer was sanctioned after a process when so many organisational and other factors play in to the outcome.
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, 2026
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 