Policing, Mental Healthand Restraint Reduction

Inspector Michael BrownAuthor – MentalHealthCop blog

mentalhealthcop.wordpress.com

Policing and Mental Health

• Estimates: 20% or more of all police demand• Amongst the most sensitive• Amongst the most controversial • Responding to vulnerable people with

complex, often unmet needs.• Reputational impact from the use of force.• Deaths in custody or following contact.

Workshop Outline

• Police responses to mental health emergencies

• Police responses to criminal suspects who are in mental distress.

Mental Health Emergencies

• 22,500 uses of s136 Mental Health Act 1983

• Rising thresholds to access secondary care?• Non-integrated urgent mental health care?

• Identifying clinically relevant pathways –• Triage / Assessment / Care.

Restraint

• Restraint prevention >>> De-escalation!

• Restraint reduction.

• Safer restraint.

• Recognising clinical implications of restraint.

Mental Health Emergencies

• What are the relevant clinical considerations for the police officers in this incident?

• After each feed, you get 30 seconds in your group to make a decision.

• Answers must be limited to just five words!

Scenario 1 – feed one

• You are with another officer, called to the High Street:

• “999 call, my son is in the road, shouting at traffic and he’s punched the window of a bus.”

• En route: caller is the mother, worried about his mental health and he’s taken drugs today.

Scenario 1 – feed two

• You arrive to find traffic moving slowly, a man is in the road, shouting at the traffic.

• He has a hand injury, bleeding injuries around his knuckles.

• He sees the police arrive and shouts, “I’ll tell you now, come near me and you’ll die.”

• Assessment / Decision – what do you do?

Scenario 1 – first decision

?

Scenario 1 – feed three

• Communication has failed, he remains in the road.

• Cars are sounding their horns, some are slowly manoeuvring around him.

• PNC checks reveals he is ‘known’: markers for violence, drugs, and mental health.

• Assessment / decision – what do you do?

Scenario 1 – second decision

?

Scenario 1 – feed four

• You decide to detain / arrest the man –

• He resists violently, punching your colleague to the face, seriously hurting him.

• Other officers arrive, he is restrained and handcuffed to the rear.

• Assessment / decision – where are you going?

Scenario 1 – third decision

?

Scenario 1 – feed five

• Ongoing restraint remains necessary, as he is attempting to bang his head on the floor.

• Accident & Emergency?• Mental Health Place of Safety?• Police station?• Anywhere else temporarily willing to receive

the person.

Scenario 1 – fourth decision

?!

mentalhealthcop.wordpress.com

twitter – twitter.com/mentalhealthcopfacebook – facebook.com/mentalhealthcop