On the 29th May 2023, the Met Police said they would no longer take calls from mental health crises from September. This caused anger, confusion and concern from me and after doing a lot of research I continue to have my concerns. Therefore, in this forensic psychology podcast episode, we explore this fascinating topic of how the police overlap with mental health professionals. If you enjoy mental health, forensic psychology and police psychology then you’ll love today’s episode.
Today’s episode has been sponsored by Police Psychology: The Forensic Psychology Guide To Police Behaviour. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also, you can buy the eBook directly from me at https://www.payhip.com/connorwhiteley
Background Information On Police Answering Mental Health Crisis Calls
So, just to give you a bit of background in information though, the Metropolitan Police, which serves the London area in England, the United Kingdom, has decided that from September, so the 1st of September 2023, the Met Police will no longer respond to 999 calls about mental health incidences.
At first, I think that sounds logical because they're the police, they're not healthcare. But then when you start thinking about the state of the National Health Service in the UK and how police are so much better equipped than psychologists to deal with this stuff when there's a mental health crisis, this is extremely concerning, I think. And this is quite dangerous because let's face it though, let's say you've got a suicidal person who's gonna kill themselves, and what number would someone call? 999 is the only one you could possibly think of. No one would call the NHS because they're doctors and they wouldn't be able to respond quickly. You wouldn't do the fire brigade and an ambulance call.
The NHS is in such a disarray in the UK, an ambulance would never get done. And again, it's not a medical emergency yet. You need someone to talk that person who's about to kill themselves from jumping off a cliff. So, again, if you are a family member, you could call their psychologist because the suicidal person might have given you their number. But again though, if I'm a psychologist in bed, I've just been woken up and I have to jump into my car. Okay. So, that's fine, fair enough. One, you've got London traffic, two, as far as I know, not everyone has a car in London. So, if my client is about to jump off, let's say a bridge 20 miles away, I'm not sure if that's right, how I, as a psychologist, going to travel 20 miles in London on the Tube. And for the American audience, just imagine trying to travel 20 miles in New York traffic. Okay. I think that's quite a good example. A psychologist cannot do it, but the police can because they have police sirens. So, unless the police are gonna give psychologists sirens to get to mental health crises, then that's not gonna work.
Now, I know we're in Tier 4 CAMH services, and I've covered this on the podcast before, that there can be suicide, not so much suicide pacts, that's the wrong word, but an agreement between the psychologist and the client that if they're gonna be suicidal, you have to call them just so they can talk you out of it. But again, if you're a member of the public and you see someone looking like they're about to jump, you just do not know any other number to call. So, that's why I'm concerned because 999 is the only number you would honestly call in that situation.
However, though, I do have to admit that this is a quote from the letter that the Met Police commissioner did say. "Where there is an immediate threat to life, officers will continue to respond." So, that, I think, is great. I think that is brilliant because, of course, if there's a suicidal person, it means that they will likely still be responded to by police.
However, immediate threat to life, that's subjective. And as we saw in a few episodes ago when I was talking about the Child and Adolescent Mental Health Services crisis in the UK and how some services require a child to have two believable suicide attempts before they get psychological treatment, it comes back to that believable question. What is a believable question, and also what is an immediate threat to life?
If someone's on a bridge but hanging on, is that immediate? Because immediate to me would be like they're gonna climb up, jump straight away. That would be immediate. And it also depends on how will a person on the phone watching this relay it to the 999 operator, and then it'd be the 999 operator's job to say if it's immediate or not. How would they know if it's immediate or not? So, just, that sort of subjective stuff I'm quite concerned about and questioning.
So, well, something else that the Met Police said was, "In the interests of patients and the public, we need to urgently readdress the imbalance of responsibility where police officers are left delivering health responsibilities. Health services must take primacy for caring for the mentally ill," I hate that word, "allowing officers to focus on their core responsibilities of preventing and detecting crime, and keep communities safe and support victims." And I do just, I want to go on to, like, something else here quickly.
So, this is another extract that I got from the Sky News Report. Met spokesperson told the BBC that officers spend an average of 10 hours with a patient when they are sectioned under the Mental Health Act. "In London alone, 500 to 600 times a month, officers are waiting for this length of time to hand over to patients, and it cannot continue," said a statement. And then another quote was, "Police are not trained to deliver mental healthcare."
Unpacking The Information
First of all, I completely agree, it is not the police's job to do mental healthcare. I know they are not trained for it and I know they basically are clueless in this responsibility. I completely get that, I really do. So, I do understand that it's unfair on them because these are not trained mental health professionals.
However, because of the reasons I said earlier, when there is a mental health crisis like if someone's having a breakdown, if someone's suicidal, if someone's having a psychotic break, or hallucinating, and they cause a risk to others, police are able to respond quicker than psychologists. And again though, the NHS just is not structured for a psychologist who's not on call, for example, to actually respond quickly.
And if any psychologists have actually worked in Improving Access to Psychological Therapies services which is also known as IAPT in the UK, then a psychologist that might be working eight hours a day, and as I understand it, they have eight back-to-back therapy sessions. So, if you get a call during that time, that one of your other clients is suicidal, then you are actually in a massive problem because you cannot just quit a therapy session. You can't say to your client, "Right, I'm really sorry but I have to go to save another client," as much as you might want to.
If you are just making progress with that client, then the last thing you want to do is break the session, answer your phone, and just dash off because that client might not want to open up again. It might have taken so much courage for them to actually want to talk to you and for you about to tell them that if you just dash off when they're about to tell you, they might go, "Well, what's the point of therapy? It took me so long to trust you and commit and actually want to tell you this stuff that happened to me, and you just go and dash off. That's outrageous. I'm not coming anymore." And that would be really damaging to clients, I think. So, again, police are better suited for this to deal with mental health crises.
But again, though, I think this just goes to show that the NHS does need a lot more money. It needs complete restructuring because as every psychologist tells you, at least in my experience, 50% of the workforce does not need to be backroom staff and managers. Like, you do not need as many managers.
And 10 hours, I do understand why that's annoying because, of course, 10 hours with a patient in an accident and an emergency department is unacceptable. So, in an ideal world, well, the police would just be able to come into a mental health hospital or a ward, pass over to healthcare professionals and then just go on, like, their way. But of course, because of NHS cards done by, like, government over the years, we don't have mental health hospitals.
Of course, I think that's a good thing because, of course, the psychiatry stuff and how they just used to, like, drug up people. But again, mental health services are basically dead and on their knees. This is not helping matters for the police.
So, something else I actually wanted to talk about is this. "We are failing them first by sending police officers, not medical professionals to those in mental health crises and expecting them to do their best in circumstances where they are not the right people to be dealing with the patient. We are failing Londoners a second time by taking large amounts of officers' times away from preventing and serving crimes, as well as dealing properly with victims in order to fill gaps for others. The extent to which we are collectively failing Londoners and inappropriately placing demand on policing is very stark."
Again, I do agree. This is a massive, massive problem for the police, and this just goes to show that the mental health services just aren't... They are fit for purpose, but they need more money, they need more resources to deal with the challenges they face. And again though, I think that you need something to replace this with, which I really hope I've actually mentioned this in the introduction, which is why something like that and other police forces has actually brought in, but Met Police are not doing this, which is really dangerous.
And another bit of data, which I find quite interesting. And again, all of this is from the Met Police commissioner. "He added the Met had received a record number of 999 calls on the 28th to 29th of April, but only 30% were crime-related." Again, that's really bad that 70% were down to mental health. So, we clearly have a mental health crisis in the UK, but again, mental health services just are not fit to handle this many people. So, the police have to pick up the slack, sadly.
What Is The Right Care, Right Person Scheme?
So, onto this other scheme. So, what this scheme is is that Humberside Police, what they did was that they created this scheme called Right Care, Right Person. And it is designed to be implemented nationally, but the Met commissioner has lost patience because the way how this is meant to work is that a UK police force is meant to stop taking 999 calls for mental health crises when this thing is actually introduced. The Met Police is not doing this, so London will not benefit from the scheme, I'm about to tell you. Of course, something might change by the time September happens. But this is right now as of 1st of June, 2023.
So, Humberside Police identified that before the introduction of Right Care, Right Person, the force was deploying to an average of 1,566 incidences per month relating to issues such as concerns for welfare, mental health incidences, and missing persons. Oh, yes, and I should also say that this information is coming from a website which you can find on the blog post called college.police.org. I think, like, that's, like, the references are better. This is an official police college website.
RCRP is a program of work that has been carried out over a three-year period involving partners in ambulances, mental health, key hospitals, and social services. These partnerships ensure RCRP can achieve its aims to provide the best care to the public by ensuring the most appropriate free response to calls for service. This reduces stress on the police and health agencies responding to these requests.
So, again, that is brilliant. I have no problem with this, but you need the partnerships there. Like, the Met Police can't just decide to stop these calls expecting nothing bad to happen without these partnerships because it's these partnerships that actually make this scheme work. So, the fact they're not doing it is stupid, I think.
"Early internal evaluation of the initiative in Humberside Police has shown a more collaborative, informed, and appropriate response to RCRP incidences. It has also shown a large reduction in the deployment of police resources to these between January 2019 and October 2022. This has allowed the force to relocate safe resources to specialist teams such as missing persons."
So, again, that is brilliant that the police are actually getting more resources too, but these really specialized teams though, just so they can actually find missing persons.
Types Of Mental Health Callouts The Police Currently Answer
However, what I do want to focus on on the type of calls that the police normally respond to because yes, I've been focusing on suicidal people, but there're actually a lot of other ones and a lot more common ones.
So, one of the first type of calls is actually concern for welfare. And this includes when mental health services report to the police so that an individual hasn't attended any sessions, so the mental health services are actually concerned about them. So, they call the police to go and check on them. Again though, if the Met Police just scrap this, which they are, then mental health services will have absolutely no idea what's actually happened to this client which has not shown up for any sessions.
Voluntary mental health services, and I actually do wanna read the thing from the website. "Voluntary patients taken by police to emergency departments of an acute hospital and a free ambulance. Police were asked to remain as the individual was assessed. Walk out of healthcare facilities." Now, this one I think is really important because an example of this is when an emergency department calls the police because a man or woman has actually, like, walked out with the hospital equipment, like, is still in them. Because if someone has a cannula in their hand, then they're clearly not well, but they've just walked out of the hospital.
Again, are you really going to get nurses and doctors to actually go out searching for that person? No, but you're gonna call the police because the police have access to all the security cameras. And it means that the nurses and doctors can actually get back to treating people. So, and I have an example of where the police were actually called out is after the Mental Health Act, Section 136. And this is actually used by the police to detain people. And the police have to stay with the person if there are no clinicians free to accept them. And on average, this meant the police had to remain with the person that they detained.
I just wanna point that out, that the police themselves have detained this person for 12 hours, which is bad and the police shouldn't have to stay with someone for 12 hours.
But again, there's basically a national crisis, though, of that, for the demand of mental health services, we have not got the supply of mental health professionals.
It's absent without leave. So, this is when sectioned patients have actually gone AWOL after a... Section 17, escorted leave with a staff. So, like, if this person has actually, like, "escaped," then the police have to go and find them, which again the police are the best people suited to actually go and find them. The police have to take this call. So, the fact that the Met isn't, I think is really bad.
And finally, the police are asked to convoy patients from acute hospitals to mental health services.
The Threshold For Police Involvement Under RCRP
Something else I actually want to talk about is threshold tests for police intervention. So, under this Right Care, Right Person plan, though, for the police to be able to get involved, there have to be this, like, threshold test, meaning that it basically has to be serious enough, which I think always gets rather interesting.
So, the first one is, is it a medical emergency?
Which I think is quite weird because surely the whole idea of this is that if it's a medical emergency, then the ambulance or another service or partnership has to get involved. But again, when we're focusing on mental health, if someone's self-harmed, then that is a medical emergency and the police are best to respond to that, so I guess.
Is a child at risk of significant harm?
Good. The police absolutely have to deal with that because again, that's more of a threat to others. Like, if a parent is hallucinating or something and having a really bad violent hallucination, again really rare, but again though, it still happens.
Is there a real and immediate risk to life or serious harm to the identified person?
Again, it's too subjective. It's too subjective about immediate risk. Especially if you are just a member of the public, you don't know the person. They might be hanging on the bridge. But you cannot say to the police if you don't know them that, "Yes, I know for a fact that this person will jump in a matter of minutes." You just can't say that.
So, an operator might, not twist it because that is the flat-out wrong word, but again though, they might convey it to the police as, right, "This is not an immediate thing," especially when we have this meaning like a burglary is going on.
Is the person suspected to have a mental health problem?
Difficulties in language. Use more positive language. Like, these people aren't criminals. They're people that are suffering and need help.
But again though, if you are a public...if you are a person in the street and if you see someone or if someone's having a mental health crisis and a family member isn't about, you are not gonna know that information.
Has a crime been committed?
No. Chances are those people with mental health conditions don't really. It's a massive myth.
Is this a missing person report? So, I guess that means if someone with a mental health condition has actually, like, gone missing, right, and they've been found so that the police get involved just so they can close that case.
Again, it's not perfect. I think there are situations where the police just should automatically get involved. And I think that the Met just should not get rid of this because I just think it's too risky, just honestly too risky.
The Data On The Results Of RCRP
However, because psychology is a science, and in clinical psychology, you've got the scientist-practitioner model, let me just say about the data from this pilot.
"Internal evaluation has highlighted the following positive outcomes for police and partners. An average of 508 fewer deployments per month,
1,132 officer hours saved on average per month, 32,828 officer hours saved between June 2020 and October 2022. Reduction in the proportion of RCRP incidences deployed from 78% in January 2019 to 31% in October 2022."
Forensic Psychology Conclusion
Though I have to say overall, I think this does work. I think this scheme is the best thing we are gonna have because I completely agree and I do understand why the police are annoyed at this because they're not mental health professionals. They're there to solve crime. So, they should be solving crime, they shouldn't be dealing with mental health. But again, though, the NHS in the UK, I'm sure my UK listeners can back me up here, its mental health services are definitely really struggling. And to be honest, it does break my heart every time when I have to report on this, comment on this, and it's why I wanted to today's episode.
I wanted to explore my own thoughts on this because, to be honest now, I'm not at university a lot. I can't really have these, like, debates with different people though. So, thank you, podcast listeners, for actually giving me a place here to actually talk about this. So, there just aren't enough space in mental health services to actually deal with this, so it does fall to the police.
I understand that the police are annoyed and yes, something's got to be done. But I think it's more the case that instead of it being police blaming mental health services, which I'm not saying they're doing, they actually aren't, to be honest. It's more that the government needs to sort out mental health services. They basically need to get a massive scalpel, cut off all the fat over the NHS, including the bosses, the manager, put their salaries actually where they need to be, actually back into the services themself.
And we would actually be a lot better off because again, I say this every single time, but requiring children and adolescents to have suicide attempts before children get mental health is disgusting. Actually, that goes for anyone though, because tons of people have mental health difficulties, but the threshold for mental health services is they basically have to be suicidal. That's disgusting, it's wrong. And of course, we need to be helping people before they ever get to that point where they want...where they think suicide is the only way out. It's not right, it's not fair.
So, overall, my final conclusion is that the Met Police, I fully agree, they should stop taking 999 calls for mental health crises, but not without something to replace it. If they decide to stop taking these calls without something to replace it, people will die, people will suffer, and the Met Police will completely fail in their duty to protect the innocent Londoners they're meant to serve.
I really hope you enjoyed today’s forensic psychology podcast episode.
If you want to learn more, please check out:
Police Psychology: The Forensic Psychology Guide To Police Behaviour. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also, you can buy the eBook directly from me at https://www.payhip.com/connorwhiteley
Have a great day.
Forensic Psychology References
https://www.college.police.uk/support-forces/practices/smarter-practice/right-care-right-person-humberside-police
https://news.sky.com/story/metropolitan-police-to-stop-attending-999-calls-linked-to-mental-health-incidents-12892351
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