Police cutting back on mental health calls shows how badly we need alternatives

Following the Met Commissioner's announcement that officers will no longer attend most mental health call outs, UK campaigners argue that this must come with a more holistic approach to support services.

Last week, Met­ro­pol­i­tan Police Com­mis­sion­er Mark Row­ley announced that, from Sep­tem­ber, offi­cers from the force will no longer respond to calls about men­tal health emer­gen­cies where there is not an imme­di­ate threat to life.” Row­ley claims that the move, which fol­lows a sim­i­lar pol­i­cy imple­ment­ed in Hum­ber­side, will help to free up offi­cers to focus on solv­ing crime,’ while health boss­es have react­ed with alarm, warn­ing that peo­ple expe­ri­enc­ing men­tal health crises will be left in limbo.’

At NSUN and INQUEST, we’re clear that the police should not respond to men­tal health emer­gen­cies and crises. We con­sis­tent­ly wit­ness how the police, when respond­ing to peo­ple in men­tal health crises, rou­tine­ly crim­i­nalise, pun­ish and dehu­man­ise those in need, some­times result­ing in deaths. This is acute­ly expe­ri­enced by Black peo­ple, who are sev­en times more like­ly to die than white peo­ple fol­low­ing the use of of restraint in police cus­tody or con­tact. Clear­ly, the cur­rent sys­tem is not fit for pur­pose. The harm­ful and fatal con­se­quences of police involve­ment in men­tal health emer­gen­cies are symp­to­matic of a deeply cru­el and bro­ken system.

In June last year Olade­ji Omishore, a 41-year-old Black man, was expe­ri­enc­ing a men­tal health cri­sis when two Met­ro­pol­i­tan police offi­cers tasered him mul­ti­ple times, after which he fell in the Thames and drowned. His death is one of many which exem­pli­fies racialised respons­es, with Black peo­ple more like­ly to be per­ceived as risky’ when expe­ri­enc­ing dis­tress in pub­lic spaces. INQUEST’s recent report titled I can’t breathe’ under­scores how the police racial­ly stereo­type Black men expe­ri­enc­ing men­tal health crises as big, Black, and dan­ger­ous,’ which jus­ti­fies inhu­mane, dis­ci­pli­nary and vio­lent treat­ment – and can play a part in their deaths.

Marc Cole, age 30, died after being repeatedly tasered – “nearly continuously” for 43 seconds in May 2017 whilst experiencing a mental health crisis after the death of his father. Read: The deadly rise of Tasers in British Policing

At INQUEST, we have assist­ed count­less bereaved fam­i­lies whose loved ones have died as a con­se­quence of police respond­ing to peo­ple in men­tal health crises. It is our view that polic­ing has become the default response to the long-term dec­i­ma­tion of men­tal health and com­mu­ni­ty ser­vices. In order to stem the tide of deaths, in the long term, INQUEST believes it is imper­a­tive to cen­tre com­mu­ni­ty-based ser­vices and alter­na­tives. Ini­tia­tives run by com­mu­ni­ties for com­mu­ni­ties will be bet­ter placed to address the racialised, classed and gen­dered aspects of men­tal health.

While police inter­ven­tion is clear­ly not the answer, what this dis­cus­sion is miss­ing is that cur­rent health­care pro­vi­sion for peo­ple expe­ri­enc­ing men­tal dis­tress is too often inad­e­quate or vio­lent, and can be just as fatal. This includes the abuse and neglect that takes place in pri­vate com­pa­nies con­tract­ed to run men­tal health facilities. 

There is a work­force cri­sis with­in dan­ger­ous­ly under­fund­ed NHS men­tal health ser­vices, and a lack of com­mu­ni­ty-based alter­na­tives to men­tal health cri­sis response, such as cri­sis sanc­tu­ar­ies. Alter­na­tive offers of cri­sis sup­port by com­mu­ni­ty and mutu­al aid groups have been weak­ened or wiped out by aus­ter­i­ty. At NSUN, as a net­work of peo­ple and grass­roots groups with lived expe­ri­ence of men­tal ill-health, dis­tress and trau­ma, we know that the fail­ures of exist­ing pro­vi­sion already leaves peo­ple expe­ri­enc­ing rejec­tion, exclu­sion and gate­keep­ing from services. 

But we are wary of so-called solu­tions that sim­ply call for the expan­sion of exist­ing men­tal health pro­vi­sion – and there is a risk that, along with the with­draw­al of police from for­mal inter­ven­tion in men­tal health calls, we could see the co-option of men­tal health care by polic­ing through oth­er avenues and the expan­sion of carcer­al pow­ers to men­tal health prac­ti­tion­ers. For exam­ple, Lib­er­ty has high­light­ed the risks of the Seri­ous Vio­lence Duty includ­ed in last year’s Polic­ing Act, which push­es health­care pro­fes­sion­als to breach their con­fi­den­tial­i­ty duties and pass infor­ma­tion on their patients to the police. 

Cur­rent mod­els of men­tal health care already go hand-in-hand with polic­ing and sur­veil­lance. From the Seren­i­ty Inte­grat­ed Men­tor­ing (SIM) mod­el brought in by men­tal health trusts, which gave police access to ser­vice users’ med­ical records, to so-called restric­tive prac­tice’ in men­tal health set­tings, which ranges from 24-hour blan­ket sur­veil­lance to chem­i­cal restraint, all too often the struc­tures of main­stream men­tal health care repli­cate and enable the vio­lence and harms of polic­ing. For exam­ple, Olaseni Lewis, held down and restrained by 11 Met­ro­pol­i­tan police offi­cers whilst a patient in a men­tal health hos­pi­tal, died because staff judged the imag­ined risk’ to them­selves to take prece­dence over the life of some­one in crisis.

"He was a gentle giant. We called him our ‘shining star’." Aji Lewis on her son, Seni.

Instead of sys­tems which often sub­ject those in need of sup­port to bru­tal treat­ment, we need to imag­ine and resource gen­uine alter­na­tives. This will take far longer than the three months the Met has giv­en health and social care ser­vices, and demands far more than the cur­rent bro­ken health sys­tem can provide. 

What do alter­na­tives look like? There are already many organ­is­ers and groups explor­ing how we can do things dif­fer­ent­ly, the ground­work for which has been laid by years of trans­for­ma­tive abo­li­tion­ist work in men­tal health sur­vivor move­ments and beyond. Cri­sis or Sote­ria hous­es, for exam­ple, are a rel­a­tive­ly well-known and some­what for­malised exam­ple of com­mu­ni­ty-based, non-coer­cive’ cri­sis care, where the aim is to cre­ate a place of sanc­tu­ary ground­ed in the idea of stand­ing along­side peo­ple and sup­port­ing their auton­o­my, instead of sub­ject­ing peo­ple to a sys­tem of care in which they have lit­tle voice or choice. Men­tal health user-led com­mu­ni­ty groups organ­is­ing and doing peer sup­port, mutu­al aid, and more exist under the radar’ in a range of con­texts across the UK, meet­ing needs unmet by tra­di­tion­al men­tal health ser­vice (or char­i­ty) pro­vi­sion in ways they know work best for them and their community. 

Beyond com­mu­ni­ty-led care, we also need to think about build­ing sys­tems in soci­ety that cre­ate con­di­tions in peo­ples’ lives where they are less like­ly to reach cri­sis. Suc­ces­sive gov­ern­ments have viewed peo­ple expe­ri­enc­ing men­tal ill-health, dis­tress or trau­ma as a social issue’ to be policed away, rather than respond­ing to the root caus­es such as pover­ty, inequal­i­ty and depri­va­tion. We might think, for exam­ple, about the way that this gov­ern­ment has ramped up pow­ers that crim­i­nalise pover­ty, in the form of anti-beg­ging’ mea­sures, instead of repair­ing the gap­ing holes in the social safe­ty net that have allowed so many peo­ple to fall through the gaps into des­ti­tu­tion. From hous­ing to edu­ca­tion, aus­ter­i­ty in the UK has stripped away the sup­ports that allow peo­ple to live thriv­ing lives, and pushed more and more peo­ple towards cri­sis. Revers­ing these cuts, and rolling back the pow­ers giv­en to the police to clamp down on their effects, must be the first steps towards reimag­in­ing men­tal health care. 

Fun­da­men­tal­ly, what must come after this with­draw­al is an urgent rethink of the way in which we respond to peo­ple in cri­sis – one that cen­tres care, choice and dig­ni­ty, and ensures that the needs of peo­ple in men­tal health cri­sis are met. 

Jes­si­ca Pan­di­an is the Pol­i­cy and Research Offi­cer at INQUEST.

Amy Wells is the Com­mu­ni­ca­tions Man­ag­er at NSUN.

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