Mental health and the police

An independent report has found that the Metropolitan Police Service (MPS) must improve its response to mental health to reduce the likelihood of deaths or serious injury occurring. The report highlights issues of severe discrimination towards those with mental health issues. Worst still the levels of discrimination increases when the victim is from an ethnic minority background.

The Independent Commission on Mental Health and Policing reviewed 55 cases, involving people with mental health issues, over the past five years. Five cases were deaths in police custody, and 45 deaths were either prior to or following contact with the police. The other five cases resulted in serious injury.

Mental health is a core part of day-to-day MPS business. People with mental health issues interact with the police in many different ways; as witnesses, victims of crime and as suspects. Frontline police officers are the public face of policing and encounter difficult challenges every day. They should be supported in any work that relates to mental health issues through thorough training and guidance.

The Commission has also concluded that the MPS must respect all members of the public, in particular the most vulnerable. It also needs leadership that recognises public safety.

Key findings include:

• Should the recommendations in this report be implemented the events that informed this inquiry, are far less likely to happen in the future.
• In most cases, there were failures in systems, mis-judgments or errors by individuals, resource limitations, poor co-ordination with other services or discriminatory attitudes towards people with mental illness that led eventually to these deaths.
• Studies also suggest that Black people are treated differently within the mental health system. Research from the 1980s shows that Black people were more likely to be detained under section 136 of the Mental Health Act 1983, which allows police to arrest a person and take them to a 'place of safety' if they feel that they may be suffering from a mental health disorder in a public place5. In addition, Black people were also found to stand triple the risk of being sectioned when compared to the White population.
• Black women in particular are treated very differently to their White counterparts when using mental health services, and are 20 per cent more likely to receive a psychosis diagnosis compared to white women (who are likely to be diagnosed with a personality disorder when exhibiting the same symptoms). Furthermore, Black women are less likely than White women to display symptoms of postnatal depression and GPs are less likely to recognise any symptoms or signs of a mental health concern
• In 2011, 38% of all deaths in police custody were people from a BAME background. Finally the IPCC reported in 2012 that having reviewed deaths in custody over a 10 year period that Black people, and those of Mixed ethnicity, formed a greater proportion of those restrained than they did of the entire sample, while the opposite was true of people from White European backgrounds. When the BME groups were combined for analysis, people from BME groups were significantly more likely to be restrained than people from White European backgrounds.
• People with mental health issues complained they were treated like criminals by the police. They also felt individuals with mental health issues were handled with too much force, that the police should engage more with the families, and that police and NHS staff should have more mental health training
   
• Many families said they could not understand why there was not better liaison between agencies. Some professionals made similar points in evidence.
   
• The Commission did have access to MPS files. However paper files and records were incomplete. This is clearly unacceptable for a 21st Century, customer-focused police service.
   
• Care pathways must be recognised and developed and there needs to be greater operational working together, such as inter-agency working within the NHS, clinical commissioning groups and local government.
• The London Ambulance Service (LAS) needs to respond to someone experiencing a clear mental health crisis as an emergency even if the police are present.

Lord Victor Adebowale, speaking at the launch of the report, said:

I would like to offer my sincere thanks to the families of those who have died for their contribution to this report. Whilst a report like this cannot take away their suffering, I hope that those who receive this report, ensure that the recommendations are implemented in the name of the families as citizens who have lost loved ones in terrible circumstances. They deserve the reassurance that other families will not suffer the same loss.".

Lord Adebowale went on to say,

The Commission has sought to provide actionable recommendations, so that there is a real opportunity for the MPS to change their approach significantly to those with mental health issues in their everyday policing."
 

Ashlea Williams