Officers or Nurses

I know I shouldn’t go to the Daily Mail website. It is a form of morbid curiosity but I saw this article headlined and couldn’t resist

Chief Constable Peter Fahy of Greater Manchester Police says that he needs ‘more mental health nurses as much as officers’ because, and I quote

‘there were so many disturbed patients being let out onto the streets by the NHS that officers were having to ‘pick up the slack’.

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‘Let out by the NHS’ – I wonder if that’s the new term for a hospital discharge. .

I don’t even know where to start with this. Of course, I don’t have the figures to hand and don’t know what the time spent on s135 and s136 is on Greater Manchester’s police force but it’s a valid use of police time.

s135 is the part of the Mental Health Act that allows an AMHP (who would have a warrant) with a police officer to enter a property to remove someone who is mentally unwell to a place of safety for an assessment to take place.

s136 allows the police to remove someone who they believe to have a mental disorder to a place of safety for an assessment to take place.

And the use of s135 and s136 powers is not about ‘apprehending criminals or ensuring no crimes are committed’ but rather an act taken for the safety of the patients and the general public to ensure that an assessment can take place.

Public safety, I thought that was what we were to expect from the police as much as ‘apprehending common criminals’.

I ponder at his comment that

‘We have to train our staff to a professional level of someone like a mental health nurse to enable them to deal with these cases.’

Seriously? He thinks he is training his staff to the level of a mental health nurse? I have to say I am fortunate to work in an area with some really wonderful police officers but it’s a bit like MPs saying they are social workers because they deal with a bit of paperwork every now and then. It denigrates the work that is done by professionals and that it should be acceptable to make an issue of it is a surprise. If it is acceptable.

The article goes on

He said: ‘Officers are very good at being able to detect the burglars, the car thieves, the hoodies, basically your common criminal.

‘But what we are talking about is a particular type of disturbed individual whose irrational behaviour is outside of the norm.’

He told the conference: ‘I really feel for my own staff who are sent to domestic violence or mental health cases, dealing with vulnerable people when that officer is trying to do his best and then a tragedy occurs.

‘Even if they have done their best, the Independent Police Complaints Commission will treat the officer as if they are responsible.’

Mr Fahy also called on magistrates to lock up suspects until proper risk assessments could be carried out.

So much to pull apart in those sentences. Firstly, I think he is underplaying the skill of his own officers. He distinguishes between ‘common criminals’ and somehow manages to put mental disorder as ‘outside of the norm’. I’d love to know what his idea of normal is. .. oh wait, I think it is very clear. The fact that he refers to ‘hoodies’ says it all really.

I wonder how much he is just riding on the crest of Daily Mail readership but there’s some serious problems with what he says. The assumptions that he draws that mental illness = danger. That domestic violence is ‘just a drag’.

The police should be dealing with ‘common criminals’ rather than ‘domestic violence or mental health cases’. Interesting interpretation when he wants to pick and choose what help to give.

I would feel very sorry for any mental health nurses he did want to employ but I think it was just a matter of rabble rousing.

In the meantime it does nothing for the cause of working together and combatting assumptions and stigma against those who suffer from mental illnesses and need the support of services, including the police force, at some of the most difficult moments.

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10 thoughts on “Officers or Nurses

  1. I love your blog! It’s so sane!! But perhaps on this occasion you may have missed the point??

    If only the police did indeed work alongside people who can tell the difference between a ‘criminal’ and someone ‘in crisis’ who could benefit from the kind of support that can be provided by the NHS or social services (tho it begs the question : what if there is nothing to meet the need and suggests even more that we need support workers out on the beat who can intervene and take on case work!!)

    The police force which relies on compassion, being in touch with themselves and connecting via the touchy-feely stuff won’t be doing its job (to enforce the law) which it does through authority and physical presence. If it doesn’t there is a risk of force being left in the hands of the less touchy-feely criminal!

    The police don’t have time to ask questions – they are required to make speedy decisions and get the job done. They learn to physically retrain. A mental health worker has time to communicate, to give time for thinking, for returning to senses.

    Mental health workers can deal with shades of grey. On the other hand, the law, for the police, has to be black and white : it’s the judges and juries who decide the shades of grey.

    I could be mistaken about mental health workers. Too often, it seems, they are as tough (frightened and therefore controlling) and lacking in insight as ‘coppers’. 😉

    Too many ‘common criminals’ are people who are where they are through mental health issues – if only we could take that burden away from the criminal law system and leave the ‘real’ (hardened) criminals to the police. Then, in time, perhaps we may have fewer hardened criminals for the police to pursue!! 🙂

  2. PS Taking the burden away from the criminal law system would mean providing LOTS of good half-way houses for those people who simply can’t cope with our complicated, scattered and heart-less society – whether temporarily or permanently.

    If only…

  3. I’ve not heard it here tha tpolice officers ar eoverburdened by having ot take mental patients to a place of safety, but it is a common complaint here that people aren’t sectioned soon enough, so that the police has to deal with mental patients who should b ein hospital time and again. I can see this point, having been picked up a number of times before I was bad enough even for a crisis team to come out to assess me. Even so, it should be the duty of the police to deal with the public in general, and the public happens to include mental patients.

  4. As a mental health nurse who has trained police officers and the police complaints bids on several occasions I really don’t know where to begin here.

    This is a blatant reduction of the complexity of the real issues and the interface between the police and mental health services. To follow what appears to be his line of thought is to seriously impact upon principles of European and domestic principles of liberty.

    I’d suggest he looks up Winterwerp vs the Netherlands in the European court for an idea about why his suggestions are so superficial.

  5. Hi … like you reading the Daily Mail, I resist commenting on blogs, but I couldn’t in this case: I am a mental health lead for a major UK police force (not GMP) –

    I think Peter FAHY very badly articulated a lot of fairly valid instincts about the amount of police contact with service-users or those with MH / LD problems: estimated to be 1 in 8 of ALL police incidents.

    To answer some issues around mental health rountinly faced by British Police Services, here are a few verifiable facts to get a debate going:

    1. 65% of all people arrested under s136 MHA are removed to police stations as a place of safety, in breach of the statutory guidelines which exist to require provision in health-settings (published UK research).
    2. Of those MH Trusts who ensure PoS provision, most of them apply some form of exclusion criteria, refusing to accept people with dual diagnosis, or who are aggressive (which published medical guidelines indicated may be indicative of medical emergency) or those who are under 18, or are known as an LD service-user (unpublished research by my force across all 43 forces of England / Wales).
    3. Levels of knowledge about s136 MHA are as bad amongst health professionals as they are amongst police officers (published UK research)
    4. Many PoS facilities, have the perverse effect of denying access to healthcare for those arrested, in comparison to health provision in police custody: I can name four different PoS services, which allow the police to ‘let themselves in’, with no nurse triage or early medical assessment, and the police dial a number to get an AMHP / DR for MHA assessment. Routine response time, in excess of 4hrs. Had the person gone to police custody, they’d have at least been triaged by a custody nurse or DR within 90mins (average).
    5. Many PoS facilities are not staffed at all. It is nothing more than a room in which to sit with the person, requiring the police officers to remain in situ with that patient until the whole s136 assessment has concluded. This is in breach of the Code of Practice to the MHA and of the Royal College Standards on s136.
    6. All of this is presented by NHS Trusts as being “an agreement” with the police. Too often, the police have ‘agreed’ by virtue of having NO CHOICE whatsoever to agree to half-provision, because to do otherwise than agree to that pathway, the NHS would shut up shop and close the service. I have seen this happen and have heard managers threaten this where the police have attempted to persuade improvements which take account of police requirements in a PoS.
    7. I know of only one PoS in England / Wales which could be described as meeting all the criteria for a PoS for the assimilated standards and guideliness which exist.

    On the subject of s135 …

    1. There is fairly routine commission of criminal offences and civil torts BY AMHPs in the UK (unpublished survey of fourteen different local LSSAs jointly, by three different large forces) whereby requests are made police support to manage aggression, resistence and risk during MHA assessments, by failing to apply for warrants under s135 MHA where the criteria for application are met and where the existence of a warrant would mitigate risk.
    2. The criteria for obtaining a warrant under s135 are not understood. Many AMHPs labour under the impression that to secure a warrant under s135(1), you need to be able to demonstrate to a Magistrate that access to the property has already been denied or that refused access would be apprehended. This is not true (of warrants under s135(1), although it is true of s135(2)). Frequently it forms the misguided basis for refusals to obtain warrants where the police request them. Powers afforded by warrants are not understood by AMHPs and powers afforded to the police by caselaw whilst executing any warrant are not understood.

    AWOL Patients:

    1. I’m not aware of ANY protocol (required by the CoP MHA) which actually clearly articulates the requirements of the CoP to the NHS. Police Services are not solely responsible for investigations into the location of a AWOL patient. Where the location of the patient is known or becomes known, the police role to that patient’s repatriation is one of support to an MH professional. In my experience and that of all my colleagues, when a patient goes missing, MH ring the police, re-allocate teh bed to the next patient and forget the problem.
    2. Most hospitals – especially where a bed has been re-allocated – have no mechanism to receive patients back once they have been recovered by the police. I have lost count of the number of times hospitals have attempted to have the police illegally detain a patient in the cells, away from any form of medical assessment, purely because they or their managers don’t understand their legal obligations and claim ‘bed management’ problems.
    3. Where a patient absents themselves, the CoP requires that the police be told the date on which the right to detain expires. I am yet to find this answer correctly provided, ever.

    I outline the above, not because I agree with Peter FAHY. I spend my whole professional life trying to make processes better for service users and carers, but unfortunately, this too often involves having to attempt to persuade MH professionals and AMHPs to get somewhere close to complying with the legal frameworks of the United Kingdom. It is with total regret that I have personally threaten criminal sanction on professionals who misunderstand their obligations (dozens of times) and equally of regret that I have had four occasions to have police solicitors threaten to take an MH trust to the High Court, to order the removal of a vulnerable person into a medical setting where they have, in effect, been left to rot in a police cell.

    I know the police are not perfect, (for example, I think our criminal investigation of inpatient offences against psychiatric nurses / doctors is shocking) … but this is not one sided. And finally (thanks for reading this far), everything I have outlined above, has been confirmed to me off the record, over and over again by psychiatric nurses and psychiatrists who I now count as friends.

    I think we’ve all got a lot of work to do.

  6. No argument from me Mental Health Inspector. I agree that provision and awareness re PoS is often sadly lacking within the NHS.

    So I agree there is work to be done but the tone of this article is inflammatory and superficial.

    • Oh, of course. I re-read my comments and whilst starting to type in the spirit of getting a debate going about WHY Peter FAHY may have said what he said, I’m straight onto my high horse.

      I completely agree with you about his tone … he’s very badly waded into something about which he clearly knows nothing.

      I wouldn’t mind quite so much if he was actually the senior UK Police lead on MH matters, but he’s not. I know the man who is and I’m assuming he might be fairly inflammed by these comments. I shall try to find out tomorrow!

  7. Thanks for all the comments. I think I’ve shown up my own knee-jerk response. I suppose it was a reaction because honestly, we have a very good relationship with police officers in our borough – and I have always found them to be enormously helpful and compassionate so I was surprised at the tone of the talk as much as everything.
    I agree, Mental Health Inspector, in so much as we are VERY far from perfect and I am aware that there’s a lot of work to be done by mental health professionals in the field.
    No doubt it is a serious problem that needs to be addressed as far as police time is concerned but I just felt as I read it, that it seemed a bit too focused on the ‘Daily Mail’ demographic.
    I’m very good at trotting along on my high horse as well..

    • I agree completely, but I wonder about the extent to which that was Daily Mail editing rather than Peter FAHY (I still don’t agree he should wade in with this, though).

      Regretable … like you say, police and MH professionals on the ground floor and often squaring circles by the hour, which their managers have filed under ‘too difficult’.

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