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Boris, here's why we need so much more than 20,000 new cops

KNICKER-TWISTING frets about ‘mental health’ get bandied about to the point that it probably makes people switch off.

But have you ever wondered what mental healthcare in the UK is really like?

You should. Because whether or not you have mental health problems, this affects you.

If you’re one of the millions of UK citizens to have had the misfortune of relying on mental healthcare services then you already know, so can stop reading.

But if you aren’t, and you’re sold on Boris Johnson’s election promise of 20,000 new police officers, then read on.

I work with police officers on a daily basis, because I work in the ambulance service. Before I joined the ambulance service, I had no time for cops. Now, I do.

A typical mental health job goes as follows…

Someone close to the patient, maybe the patient themselves, calls 999 or 111 or a crisis line, saying the patient wants to hurt or kill themselves, or is acting in a way that presents a danger to themselves or others. Maybe they’ve overdosed. Maybe they’re violent.

If they can, the police will try and get the ambulance service to attend, but if there really is a safety risk, which there often is, then both will turn up… eventually... and not at the same time.

Often, one turns up before the other, so can spend a long time - hours, perhaps - managing the scene while waiting for the other service to arrive. Everybody's busy.

And we can’t just kidnap these patients - this is still the Free West after all - so what follows is usually 1-3 hours of negotiation with the patient to try and persuade them that they need to be assessed by a mental health professional at hospital.

Often, the patient doesn’t agree. This is usually because the patient has already experienced the UK’s publicly-funded mental healthcare regime and has, understandably, drawn the conclusion that it is not fit for purpose, ie, they don’t get the therapy, drugs or rehab, etc in anything like the time required, so they’re not interested.

They're also not rational, yet their requirement is immediate. But the appointment is two months away, by which point further crises or suicide may have happened.

So we spend hours on scene - many hours, often - trying to negotiate anyway. That's because the legal framework restricts our options, which is absolutely right and proper. We can’t just cart people off.

Speaking of options, people can be arrested if they commit an offence. Trouble with that is most people with mental health crises aren’t criminals, or at least aren’t in the process of committing an offence. So for the most part, that’s out.

The police can also deprive someone of their liberty in a public place for their own safety under the provisions of section 136 of the Mental Health Act. We call this ‘doing a 136’.

Trouble is, you can’t ‘136’ a patient in a private place. Only on the street. And crises generally happen at home.

To section a patient in their home, where most people are in the middle of the night, you usually need two mental health professionals to come, assess, and sanction. But guess what? In the middle of the night in London, there aren’t any, or at least rarely enough spare to come and help the police and ambulance service with a patient.

And sorting all of this out takes time, maybe more than an hour or two, and many phonecalls.

At then end of that, you usually get told that you're out of luck and there are no mental health professionals available to help.

So then you might resort to the Mental Capacity Act, which is not ideal but, in reality, often happens, and which doesn’t require doctors to attend.

What time is it now? 2am?

Depriving someone of their liberty is a big deal, and under the Mental Capacity Act, there’s a series of stages/tests you have to go through to establish that a patient is so impaired that they do not have the capacity to make decisions on their own behalf, and can therefore be carted off to hospital against their will for their own safety.

It’s a last resort, but the last resort is often where you end up when all the other resorts are hopeless.

Having done the paperwork, established as many contacts as possible with the patient’s loved ones and health providers, checked with your own control/superiors, and done everything possible to persuade the patient that they need help, then and only then, you might consider removing the patient against their own will.

IF that’s the best and least restrictive option for them.

In the absence of alternatives, and in the middle of the night, it often is, yet it takes a very long time - often with multiple emergency services on-scene - to get to this point.

Problem is, the patient still disagrees, because they’re suffering some kind of psychosis/crisis, so additional physical help - vehicles, perhaps - are require to remove them.

The police provide those. Ambulance staff aren't trained in physically detaining people against their will.

And if someone is off their nut on drugs, they may need four+ police officers to be safely detained.

We’ve been on scene for several hours now, maybe three, maybe five. Ambulance crew. Two to four police officers. Maybe more, if the patient is atop a building or bridge and threatening to jump.

So the patient is eventually carted off to the closest A+E.

We’re only halfway through, I’m afraid.

There’s no room at the inn.

There’s a queue for A+E, no secure cubicles and nowhere else to go.

There is also no solution. All that remains is for the police and ambulance crews to wait, making sure the patient doesn't run off or hurt themselves. This can take hours.

And so it goes on.

Recently, I was waiting in an A+E corridor with a patient and counted 10 police officers in the corridor with other similar patients, several of whom had been there for hours.

There were also 17 ambulances parked outside. Waiting, no doubt. I have a photo.

I asked one of the police officers, jokingly, I thought, who would attend a crime in the borough if one was to arise. He told me, with a straight face, no-one.

What’s described above is a normal daily experience for our emergency services.

In fact, I’ve seen worse.

I’ve witnessed a violent patient take an overdoes of opiates, I've remained on scene for four hours, but been told by the higher-ups to leave after all options were exhausted and that there were no police or mental health professionals available to assist.

We had no choice but to leave and I have no idea what happened next.

And that’s normal. Not unusual. Every day.

Or the incredibly vulnerable, injured long-term mental health patient who had been on the ground in sub-zero temperatures for a long time INSIDE the grounds of a 'secure' mental health facility.

I found a phone number for the facility and was told, bluntly, to bring the patient back when I was done. Ho hum.

Or the injured patient (police present) with no money or wallet or orientation found many miles away from their facility at 6am, with old injuries, and whose carers claim to have seen the patient an hour ago. Hmm.

Often, these are patients whose illnesses could be managed with sufficient resources but who are instead left to crisis, at which point the option of last resort - 999 - becomes the only option.

For some reason, tonight’s Prime Ministerial Debate made me think about, and want to write about, all of this. Not sure why. Something to do, I'm sure, with Boris's golden promise of 20,000 new police officers and even more nurses.

I suppose it boils down to this. Mental health care in this country is beyond crisis point.

The main point of all of the above is to illustrate that dealing with Britain's failed mental health care regime occupies a huge amount of police and ambulance time.

More cops might help address crime rates, I suppose, but increasing police numbers is definitely only part of the answer.

The next time you suffer a burglary or other petty crime, and this is the nutshell, ask yourself whether the reason the police can’t attend is because of what I’ve described above - mental health care in collapse - or because all we need is another 20,000 cops.


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