Patients treated in mental health units are vulnerable individuals and deploying police officers to handle them is not the kind of care that patients and their families are expecting. It has on occasions resulted in deaths, often of young black men, such as that of Sean Rigg and Olaseni Lewis. So what is the Metropolitan Police Service's policy for such deployment of their officers?
In their press lines, dated 2014-01-28, the Metropolitan Police Service (MPS) describe their lack of policy about armed police deployments at mental health units:
Q2: Does the Met have a policy on the deployment of armed police to incidents that take place in mental health units?
= The MPS does not have a specific policy in relation to the deployment of firearms officers to mental health units.
Firearms officers are deployed to incidents where firearms or weapons are involved. Decisions to deploy firearms officers will include consideration around the type of premises and the persons concerned.
(Note that firearms officers include not only those in armed response vehicles but also Territorial Support Group (TSG) officers and the forty or so officers per borough trained in the use of Tasers.)
The investigation report into the incident at mental secure unit River House includes mentions of some patients 'making threats' but does not make any mention of either 'firearms' or 'weapons' having been in the possession of the patients. Forty-eight police officers were deployed, including armed response units, and four Tasers were drawn.
Commander Christine Jones, lead on mental health for both the Metropolitan Police Service and the Association of Chief Police Officers (ACPO), expressed a more cautious approach at London Assembly's Police and Crime Committee on 2013-11-21 (pdf) and insisted that all calls for MPS deployment to mental health settings will have to be approved by her team:
Christine Jones (Commander, Metropolitan Police Service): [...] There is also an appetite to take people down to Grays End to show them the Taser training so that we can have the critical third eye from the lens of the community around when it is used and why it is used.
Again, my sense is that on many occasions police have been in that place because there is nothing else and that is the issue we are working through now. Actually, if you need to restrain in a mental health environment, why would that fall to police? If you woke up in hospital after a triple heart bypass and became violent with staff, there is no question that the police would be called. Of course they would not. In a mental health environment, if the right commissioned services do not exist, there has been a reliance on police attending to support staff. I can absolutely understand that, but we need to move on from that and that is the work we are doing. [...]
Christine Jones (Commander, Metropolitan Police Service): [...] I do not think police should be going into mental health institutions to restrain and I have put a stop to it. What I have said is --
Jenny Jones (Deputy Chair): You have stopped the TSG being sent?
Christine Jones (Commander, Metropolitan Police Service): I have stopped police responding to mental health institutions for the purposes of restraint unless there are very, very good reasons why. Claire [Murdoch] and I are busy working through a protocol for London because there are certain areas of London that we get very few calls to and other areas of London that we get lots of calls to. For me, the only time that police should ever go into that health setting, frankly, because you are talking about somebody who is ill, is if there is real danger to life. That is a different issue.
Jenny Jones (Deputy Chair): It is bad for the police as well, of course.
Christine Jones (Commander, Metropolitan Police Service): Of course it is bad for the police, but imagine what it is like for the person. I cannot think of anything more terrifying. We have an escalation process in place at the moment for the Metropolitan Police Service which basically means that if a mental health institution calls on police, it goes into my mental health team to assess the circumstances before we respond. It is as simple as that. We have that level of commitment that we are all on call virtually 24 hours a day to make sure that if we have to respond we have the right people doing it and for the right reason.
Jenny Jones (Deputy Chair): Do you know if this has actually reduced the number of times the police are going to --
Christine Jones (Commander, Metropolitan Police Service): Hugely. Absolutely massively.
The press lines detail some new training for firearm officers and front line officers hopefully resulting in respectful encounters with vulnerable individuals and fewer uses of Tasers:
Q3. Do you recognise the concerns from campaigners about the use of armed police in mental health incidents?
= The MPS takes onboard concerns raised around the use of armed officers to mental health incidents and always places the safety of the public paramount.
Met firearms officers attend special training days where they work with mental health workers and patients to assist them in understanding and responding to people who suffer from mental health issues. We have introduced information sharing protocols to obtain fast time intelligence about any person who may be considered EMD (Emotionally or Mentally Distressed) or suffering behavioural disorders. Training around mental health issues is also included as part of officers on going training as well as forming part of the NPFTC (National Police Firearms Training Curriculum) instruction courses for firearms officers.
In September 2012, the Commissioner requested an independent commission to look at the MPS response to mental health. It was also asked to examine the interface between the MPS, mental health services and other partners.
Since the report by Lord Adebowale was published in May 2013, the MPS has fundamentally looked again at how we work as an organisation, and with partner agencies, to improve services, share information and better understand the needs of people with mental ill health with the aim of delivering a service that can be best adapted to fit individual needs.
The 28 Recommendations within the Independent Commission report on Mental Health and Policing (2013) are being progressed and embedded in the direction of travel for policing, both locally and nationally.
We continue to work locally across London and nationally with partners across the health spectrum and we have also contributed to the forthcoming Department of Health Crisis Care Concordat [(pdf)]. This is where a number of national organisations have committed to work together to support local systems to achieve systematic and continuous improvements for crisis care for people with Mental Health issues.
The MPS are also in the process of rolling out the Community Risk MARAC group (Multi Agency Risk Assessment Conference) and a pilot is currently underway in all NW London Boroughs. This is a local partnership forum, where high risk and developing cases can be discussed and problem solved.
The MPS are also in the process of training all front line officers in the Vulnerability Assessment Framework (VAF). The VAF is a simple investigative approach to assessing vulnerability, in all interactions the police have with the public.
The MPS is committed to delivering a quality of service and care for all those who come into contact with the MPS - especially those who are at their most vulnerable through mental ill health or crisis.
The training of front line officers should have been completed by now and other police staff will be trained by the end of the year:
Christine Jones (Commander, Metropolitan Police Service): Our training plan starts in January for all frontline officers and goes through to March [2014]. For the frontline uniformed response, so emergency response officers, all of those who work at borough level, they will receive vulnerability assessment training, as will our core staff. By the end of the year, every single member of the Metropolitan Police Service will have received that training, so that is how we will embed it at every stage. Regardless of what department you work in or at what point you engage with a member of the public, everybody was applied the same approach, so that is point number one. [...]
Absolutely, and that is the point, I do not think we have invested enough in teaching our officers to understand vulnerability. What we have said is, “You need to be trained in this, you need to be trained in this, you need to understand this risk assessment, you need to know ...” No, actually, our officers need to know this, that is the primary issue for us, we need to understand the legal framework in which we operate and then the issue is how we understand the vulnerabilities and diverse needs of our communities and that is my issue. I do not think we have trained our officers effectively in recognising vulnerability. We have done lots and lots around race, we have done lots and lots around professionalising investigation, but actually the human piece around this is how we deal with people on a daily basis, how we recognise their different needs by understanding where they may be vulnerable, and to be perfectly honest the feedback that we have had from the communities in London around satisfaction has regularly told us, “The officer failed to recognise my vulnerability”. We have the evidence there; we are now using it to fundamentally change that frontline training and, as I say, every single officer in London will have had that training by the end of next year and every single encounter we have with a member of the public they must apply that framework.
If you have an interest in policing and mental health it is well worth reading the transcript of this Police and Crime Committee session (pdf) in its entirety. One learns that some improvements have already been implemented. Last year I made a series of Freedom of Information requests to the MPS and London's NHS Trusts to get some data on the use of section 136 of the Mental Health Act and was frustrated by the police keeping their data in paper form at borough level:
Christine Jones (Commander, Metropolitan Police Service): I absolutely reflect that unhappiness. When you have disparate systems, disparate information technology (IT) and technology that does not talk to itself, you are immediately into a difficult arena. Until I took over the lead for mental health back in September last year, we had no way of knowing by pressing a button how many people across London we had encountered with vulnerability leading to mental health issues. We had no way of looking up how many Section 136 interventions we had or Section 135.
We changed that in January this year and in April that rolled out across the Metropolitan Police Service, so we now use the Merlin system to highlight vulnerable adults coming to notice.
[...] Good metrics now under Section 136. We have good metrics now.
Some changes have happened while others are going through the organisation. At the Police and Crime Committee, Commander Christine Jones said she 'took over the lead for mental health back in September last year', i.e., September 2012, a month at most before the deployment of 48 police officers at River House. Police involvement at this incident was covered up by the South London and Maudsley (SLaM) NHS Foundation Trust and the Metropolitan Police Service. I have two complaints currently with the Information Commissioner's Office, one for each of these organisations about how they are still attempting to avoid publication of information related to this incident. To reassure Londoners that policing of vulnerable individuals with mental health issues is improving, the Metropolitan Police Service will have to improve on their transparency as well as their performance.