Sir Mark Rowley, the Commissioner of Police of the Metropolis, sent a letter to his health and social care partners on 24th May 2023 informing them that after 31st August 2023, police officers will no longer be sent to “health-related calls” linked to “mental health incidents”, unless there is an “immediate threat to life”. This has prompted understandable alarm amongst health and social care professionals and many questions, including:
- Who determines what a ‘’health-related call’’ is?
- How is a ‘’mental health incident’’ defined?
- Who determines when there is an ‘’immediate threat to life’’?
- Is this an immediate policy change or Sir Mark expressing his frustrations with the health and social care system?
- Will Metropolitan Police Officers no longer be attending the execution of warrants under s135 Mental Health Act 1983 (MHA), or using their s136 powers?
- How far-reaching is this policy change likely to be?
Perhaps it also begs the question, that in a society which has changed unrecognisably from when Sir Robert Peel founded the Metropolitan Police in 1829 - what, exactly, is the role of the police force?
The role of the police
In Sir Mark’s letter, he outlined what he perceives is the police’s core responsibilities:
- The prevention and detection of crime.
- Keeping communities safe.
- Supporting victims of crime.
The devil may well be in the detail as it could be argued that police involvement in mental health incidents helps keep the most vulnerable members of communities safe and prevents crime. Many police officers, however, do not agree with what Ken Marsh, of the Metropolitan Police Federation terms ‘’babysitting’’ people, waiting for them to be treated.
Following the letter, The Met released statistics, highlighting that police officers are spending an average of ten hours when called to assist with sectioning someone under the MHA. In London this happens 500 to 600 times a month. In addition, officers regularly point out that they are not trained to deliver mental health care (nor do they wish to be).
The consequences of this, Sir Mark feels is twofold. Firstly, sending police officers rather than qualified health professionals to deal with mental health incidents. And secondly, taking police officers away from their core duties of preventing and detecting crime.
What Sir Mark appears to be trying to do is draw a line in the sand as to what his officers will and will not do in mental health matters. And, as he referenced it, fast track the implementation of “Right Care, Right Person” (RCRP). This is a successful pilot project in Humberside where members of the charity, Mind work in the police control room and deal with mental health calls. The objective is to save police hours and ensure that people in crisis get timely and appropriate care and support. If, when the pilot ends, it is felt to be sufficiently successful, there are plans to roll it out nationwide. But certainly not by 31st August.
The Mental Health Act 1983
Under the MHA, the following powers are reserved only for police officers:
- A Justice of the Peace can issue a warrant authorising any constable to enter, if needs be by force, any premises in which a mentally unwell person is believed to be and, if thought fit, remove them to a place of safety (section 135).
- A constable, following, where practicable, consultation with a doctor, nurse or AMHP, can remove someone to a place of safety when they are in a public place and appear to be suffering from a mental disorder and seem to be in immediate need of care or control (section 136).
The delays that Sir Mark referenced in his letter usually arise when the person and police officer arrive at the place of safety. At this point the person should be handed over to health professionals. The place of safety is often a s136 suite – a specialist unit where the person can be assessed mental health professionals for up to 24 hours. In reality, however, not all s136 suites are staffed full-time and those that are often contain other people awaiting assessment. Therefore, it is not uncommon to find police officers having to wait in their vehicle with the person they have detained.
Periodically, the person who has been detained under s135 or s136 may urgent treatment for their physical health at A&E. At this point they will be handed over to hospital staff, overseen by a security guard. This is, however, entirely dependent on resource. In addition, where the person is aggressive, police officers will be asked to remain.
It is also important to remember that often, what triggers the police to use their s135 and s136 powers is not the individual ‘’bringing it on themselves’’ but failings of the health system. All too frequently, people who are “sectioned” complain that they were unable to access the appropriate support in the community when they need it.
Summary
As we have highlighted above, the system is clearly broken – and certainly cannot be fixed before the 31 August 2023. Yes, the police force is stretched but there is a severe lack of resources in health and social care as well.
Sir Mark’s approach has already been criticised by Zoe Billingham, a former Inspector of Constabulary and the current Chair of the Norfolk and Suffolk NHS Foundation Trust, as “really dangerous” and “brinksmanship”. She is working with Norfolk police to adopt the RCRP policy and has observed that, although she has seen something similar to RCRP work well in other forces “that is after years of negotiations and investment in community mental health services”. In London, “there isn’t another agency to step in and fill the vacuum”.
If this policy change is to take shape, we hope that the proposed deadline of 31 August is revised to allow enough time for the implementation of carefully considered contingency plans. This would ensure that the most vulnerable in society, as well as all those who work tirelessly to care for them, are properly supported and protected.
Author: Max Duddles
This article was first published on 20 June 2023.