Is the Metropolitan Police institutionally corrupt?

[ks.234]

No. It is not the job of police to be a substitute for the NHS or social care when having to deal with a person suffering with an acute mental health crisis, if so apparent. Street triage very capably filled this gap(and continues to do so in Notts), by having a mental health nurse with an officer, to professionally assess capability (MCA) and symptoms in this regard. Officers are not properly equipped to assess in this regard - the nurse is, as is a S12 approved medic. By correctly assessing at incidents, you can clearly reduce inappropriate detentions under S136 MHA eg when a person might be faking MH issues (sadly, it does happen), or the genuine crisis that a service user may be in. I instigated and delivered MCA training on 2015, and officers and staff said it was a real eye-opener. Especially that the appropriately qualified professional is the right person to assess.

If a person is suspected of committing an offence, and MH symptoms are apparent, then a substantive assessment will be required by a so qualified nurse (initially), then a suitably qualified medic. If the medic or nurse is of the professional opinion the suspect is suffering such a crisis, then they can be so detained under S2/3 MHA for treatment. Very rarely happens. Officers in some cases used to bin a job before this assessment was complete, and then had to rescue evidence once the medic confirmed the suspect wasn’t so acute. I/we put that right, so there was more balance and victim focus, as well a service-user focus in individual cases.

In term of stats, they spoke for themselves. Before I left - 80% reduction in inappropriate detention under S136, massive increase in faster referrals for MH crisis care etc etc. But we got the recording right from the start



See above. Apologies for the long response.

https://www.nottinghamshirehealthcare.nhs.uk/street-triage

https://www.england.nhs.uk/mental-health/case-studies/crisis-mental-health-case-studies/notts/

The last link should help those reading who like evidence.

My personal view is the above works very effectively, and continues to do so. To pull the plug completely, without control measures, risks harm to some of the most vulnerable members of society.

I take your point, as someone married to a Care professional I am fully aware of the massive shortcomings in our Care system and the cuts imposed that means that serious mental health issues do not get properly assessed.

However, given we are where we are and that insufficient funding of Care means that people with mental health issues are not managed properly, it seems a neglect of duty for the police not to deal with the issues when they get into the public sphere.

Of the police are trying to highlight the underfunding of care, they should do so directly. Perhaps they should show common cause with the underfunding of public services?

 

[Tony L]

The point is that if somebody is in a public place and being a danger to themselves or others (and in the unlikely event of there being a passing mental health doctor of sufficient standing) then it is the responsibilty of the police to take said person to a safe place i.e. normally hospital, under the mental heath act.

This was certainly the case way back in the very early ‘80s when I was a trainee psych nurse in a large old-school mental hospital. The police would regularly bring in folk they’d identified as needing some help or possibly sectioning. Basically the type of people as a society we now allow to die in shop doorways at night in every town and city. There was a lot to criticise in mental healthcare in this era, but it lacked the visceral cruelty of today. If someone was freezing in a shop doorway the police would bring them in and at the very least they’d get a bath, some clean clothes, food, and a warm bed for a week or so. All on the state, no need for charity.

 

[Andrew C!]

If the police find you in a public place and you appear to have a mental health disorder and are in need of immediate care or control, they can take you to a place of safety (usually a hospital or sometimes the police station) and detain you there under Section 136.

Indeed. You are quite right. You miss a very valid point - the assessment of who is suffering an acute mental health crisis, therefore warranting a S136 detention. Also, once detained, the officers have to stay with the service user until the NHS decide otherwise, therefore removing usually 2 officers from other duties at a time. Street triage negates this in so many ways. Have a read up on this, and you’ll see why.

 

[Andrew C!]

However, given we are where we are and that insufficient funding of Care means that people with mental health issues are not managed properly, it seems a neglect of duty for the police not to deal with the issues when they get into the public sphere.

You need to decide who is responsible for what, really. Train officers correctly, or ensure crisis team nurses are available to correctly assess - this is the option preferred in Notts. The numbers and out comes speak for themselves. Cited as best practice nationally by NHS England.

 

[Sue Pertwee-Tyr]

The police role is to maintain order, protect public safety and detect and prosecute offenders. Maintaining order and protecting public safety should not include dealing with people having a mental health crisis, except in an emergency. There ought to be systems in place to support people before they become a public order issue. That there are not, or they are insufficient, is not on the police. I hope this act by the Met gets wider recognition of this.

 

[Andrew C!]

The police role is to maintain order, protect public safety and detect and prosecute offend era. Maintaining order and protecting public safety should not include dealing with people having a mental health crisis, except in an emergency. There ought to be systems in place to support people before they become a public order issue. That there are not, or they are insufficient, is not on the police. I hope this act by the Met gets wider recognition of this.

The Met did try triage, but binned it. As did several other forces. They did not set their systems and processes up to prove the qualitative and quantitative out comes to preserve their teams. If you understand the main out come is to prevent the inappropriate detention of service users under S136, everything else falls into place. As operational lead, this was my sole objective. Other outcomes were very useful, but my main driver was to ensure the primary objective was met. The sgt in my previous link was a PC when I accepted him onto the unit. He ‘got it’. The subsequent results, and accountability, are evident. One of my best decisions.

 

[Ginger]

A person is detained under those sections of Mental Health Act that allow detention. This will usually be section 2 or section 3 and that will be on the basis of an assessment by a psychiatrist and a specialist mental health practitioner- usually, but not always, a social worker. The police commonly use section 136- removal to a place of safety, or less commonly 135- gaining entry to a residence to remove someone to a place of safety. If you are removed to a place of safety by the police under 135 or 136 then yes, you are effectively “sectioned.”

Disagree. Sec 2 or 3 authorised by a psychiatrist as stated- that's 'sectioning'.

Sec 135 by police: that's with a warrant already gained by MH professionals (not a warrant gained by the police but it's the police who execute the warrant, normally with MH professionals present, who can't execute warrants..)

Sec 136: take to a 'place of safety'. But it isn't sec 2 or 3. The person is not sectioned by a MH professional.

 

[Andrew C!]

Disagree. Sec 2 or 3 authorised by a psychiatrist as stated- that's 'sectioning'.

Sec 135 by police: that's with a warrant already gained by MH professionals (not a warrant gained by the police but it's the police who execute the warrant, normally with MH professionals present, who can't execute warrants..)

Sec 136: take to a 'place of safety'. But it isn't sec 2 or 3. The person is not sectioned by a MH professional.

Correct. Executed numerous S135 warrants. Also reviewed numerous S136 detentions and subsequent S2 detentions for assessment.

https://www.legislation.gov.uk/ukpga/1983/20/section/2

S2 is for assessment. S3 for treatment. Either requires a S12 approved medic (Dr) to sign off.

Now, don’t get me started on S 17 leave…

 

[ks.234]

You need to decide who is responsible for what, really. Train officers correctly, or ensure crisis team nurses are available to correctly assess - this is the option preferred in Notts. The numbers and out comes speak for themselves. Cited as best practice nationally by NHS England.

I worked that out long ago. Government is responsible for government spending. If government is not delivering public fund for public services, we need a different government. If the Police are lacking funding and resources to do the job properly, they should imo show common cause with other’s in the same situation.

Don’t get me wrong, I have sympathy with the underfunding of the Police, but it is part of wider malaise. Do the police want to be recognised as part of that malaise, or separate from it, isolated from it?

 

[Ginger]

https://www.bbc.co.uk/news/uk-politics-59336579

Jeez, look at that. 324 patients died of non-covid causes in NHS MH care in the year to March 2021.

Like I say, I think you're far safer in the hands of the police.

 

[Andrew C!]

Do the police want to be recognised as part of that malaise, or separate from it, isolated from it?

I can’t remember the exact figure, but I reckon I assessed a £800k saving in 12 months in the 1st year of street triage. Bearing in mind that set up annual costs were circa £400k!

That figure was based on staff hours, and other costs. Stark. I recall presenting the stats to PH England. Very interesting.

PS as a disclaimer I’m not saying anything on here that isn’t on the wider public domain.

 

[Sue Pertwee-Tyr]

…If the Police are lacking funding and resources to do the job properly, they should imo show common cause with other’s in the same situation.

Don’t get me wrong, I have sympathy with the underfunding of the Police, but it is part of wider malaise. Do the police want to be recognised as part of that malaise, or separate from it, isolated from it?

If the police want to raise awareness of an issue, and get attention focussed by people who can make a change, something like this is surely one way to achieve it? The police may be making common cause with mental health professionals by saying ‘we are no longer prepared to pick up the pieces. Fund the bodies whose job this is, don’t ask us to paper over the cracks for you.’

 

[Andrew C!]

True, but that doesn’t help the service user in need. However, we don’t operate a fair system of thinking about such cracks, then subsequently problem solving those, and ensuring solutions are in place - either at a national, regional or local level.

That will cost money. It will also, ironically, cause some to question the efficiency of the NHS and their budgets. My experience of that question is we don’t like doing that, for various reasons. If you want to allege the police are inefficient, then IMV that pails into insignificance compared to my experience of the NHS in this regard.

Again, this comment won’t be liked on here.

 

[gavreid]

True, but that doesn’t help the service user in need. However, we don’t operate a fair system of thinking about such cracks, problem solving those, and ensuring solutions are in place - either at a national, regional or local level.

That will cost money. It will also, ironically, cause some to question the efficiency of the NHS and their budgets. My experience of that question is we don’t like doing that, for various reasons. If you want to allege the police are inefficient, then IMV that pails into insignificance compared to my experience of the NHS in this regard.

Again, this comment won’t be liked on here.

It's not for the the police to say that they refuse to accept their statutory responsibility here. I hope the mayor will soon have something to say to Rowley...

 

[Andrew C!]

It's not for the the police to say that they refuse to accept their statutory responsibility here. I hope the mayor will soon have something to say to Rowley...

They won’t. S136 will still be available. It will be interesting to see how the MET close concern for safety jobs where MH is an issue. The litigation consequences alone make this call a tough one.

Actually, it’s not just the police that have a statutory responsibility, here. You ought to at least acknowledge that?

 

[Ginger]

They won’t. S136 will still be available. It will be interesting to see how the MET close concern for safety jobs where MH is an issue. The litigation consequences alone make this call a tough one.

Actually, it’s not just the police that have a statutory responsibility, here. You ought to at least acknowledge that?

I’m not holding my breath

 

[Ginger]

On a more serious note: this stance taken by the Commissioner is interesting, but it tells us nothing about what action he intends to take in respect of the Casey report. Unless I've missed something, he doesn't appear to link this stance with MH issues to the issues raised by Casey. I'd have expected a backlash in this respect: what has he said he's doing about the points raised by Casey?

 

[Andrew C!]

@Ginger which elects of the Casey report are you referring to? It’s a big report.

 

[Finnegan]

Disagree. Sec 2 or 3 authorised by a psychiatrist as stated- that's 'sectioning'.

Sec 135 by police: that's with a warrant already gained by MH professionals (not a warrant gained by the police but it's the police who execute the warrant, normally with MH professionals present, who can't execute warrants..)

Sec 136: take to a 'place of safety'. But it isn't sec 2 or 3. The person is not sectioned by a MH professional.

‘Sectioning’ is ultimately a meaningless term. It has become shorthand for being detained under the MHA. There are well over 100 sections to the MHA. Some of them deal with detention. In addition to to 2 and 3 you can be detained under section 4- emergency section when a 2 or 3 cannot be completed and Section 37- a forensic section that results in detention in a secure facility, and there are more.

Section 136 allows the police to, forcibly if necessary, remove a person from a public place who is presenting with a probable mental disorder and is likely to be a danger to themselves or others. The person is removed to a place of safety (usually a police station or detention suite) and detained there until assessed by a psychiatrist and other MH practitioners, being transferred to hospital if appropriate.

Perhaps I’m being pedantic, but their liberty is suspended under a ‘section’ of the MHA. They are removed and detained under section 136 and are therefore ‘sectioned’ albeit not by MH practitioners and not to hospital under a 2 or 3, but still ‘sectioned’ under the MHA even though a lay person may associate being ‘sectioned’ with being detained in a MH facility.

 

[Andrew C!]

@Finnegan FWIW I instigated a ‘ban’ on the use of the word ‘section’. It’s isn’t helpful. Detention for assessment is more appropriate. Anyone so detained is a service-user - they are not a suspect. They have not been arrested for an offence.

‘Sectioned’ means what happened after an appropriate assessment conducted by a Section 12 approved medic, IMV.