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.
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.
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.