Attempted Suicides (Police Responsibilities)
(10 years, 5 months ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
Mrs Madeleine Moon (Bridgend) (Lab)
Let me take this opportunity to welcome the Minister for Policing, Criminal Justice and Victims to his new role and congratulate him on his promotion. If ever there was a Minister who will understand the issues I want to raise, it will be this Minister, who in his previous role as a firefighter will have come across the very issues that I hope he is eager to support me in addressing.
Let me set the background for the Minister. For the past few months, in my role as chair of the all-party group on suicide and self-harm prevention, I have been leading an inquiry into how suicide prevention strategies have changed since the passing of the Health and Social Care Act 2012, two years ago. Unfortunately, one of the many aspects of that Bill was the change to suicide prevention strategies in England. At the time, the all-party group recommended that local suicide prevention strategies be placed at the heart of the national suicide prevention plan. When led by committed local champions and given sufficient resources, local suicide prevention plans are seen as by far the most effective way of preventing suicide.
The new national suicide strategy, however, included no statutory requirement for local suicide prevention plans. The Samaritans reported that the lack of a statutory requirement created a “major barrier” to the survival of local prevention plans. The report from the all-party group is due this autumn, but from our conversations with the directors of Public Health England, health care professionals, experts in suicide prevention from the devolved Administrations and representatives from the police, it has already become clear that the lack of clarity about responsibility for suicide intervention, post-intervention and prevention is creating problems that must be resolved.
Three weeks ago I attended one day of the five-day course by the hostage negotiation trainers at the Hendon police college. The course is intensive and difficult, and I was impressed by the calibre of the officers attending from around the country. There is thankfully not a great call for hostage negotiations, but officers are frequently called out to deal with people contemplating suicide who need to be talked down from a roof, a bridge or the top of a car park. The frustration of those officers is great when, having spent hours talking someone down and taking them to A and E, they are told that there is no help because the person does not have an identifiable mental illness, but is depressed or anxious, or has a personality disorder or a learning disability.
Jim Shannon (Strangford) (DUP)
In Northern Ireland last year we had 303 suicides and numerous attempted suicides. Does the hon. Lady feel, as I do, that community and beat police officers should receive more help from the staff of suicide prevention charities? That valuable support and expertise could help police officers at a critical time when they are trying to save lives.
Mrs Moon
That is the whole tenet of my speech—the hon. Gentleman has stolen some of my best lines. He is correct: there is the lack of the support that police officers, who take on the most difficult job of saving a life, should have—and that the person who has attempted to take their own life should have—in order to ensure that they are not back in the same situation within 24 hours, trying to save a life.
This is not the first time I have raised the issue. On 26 June, I asked the Leader of the House for a debate on
“the responsibility gap faced by British Transport and Home Office police when they find an individual in emotional and mental crisis attempting suicide”.—[Official Report, 26 June 2014; Vol. 583, c. 480.]
Police officers are estimated to spend 40% of their time dealing with mental health problems, including suicide. In their research, Murphy et al acknowledged that 80% of police time is devoted to social services issues rather than to crime prevention.
I am told that considerable work is being done to look at the interaction between police services and the NHS, particularly in sensitive areas relating to mental health. What is clear from the evidence that I have heard is that there is new money and new engagement in mental health; that is happening. Sadly, however, someone giving evidence to the inquiry said, “If I call a meeting to discuss mental health, the room is full. If it’s suicide, nobody wants to know. It’s too difficult.”
Dr Julian Lewis (New Forest East) (Con)
Will the hon. Lady tell the House whether her research has revealed any increase in the problem since some health service foundation trusts, such as the one that serves Hampshire, closed up to 35% of their acute mental health in-patient beds? With the closure of some units—such as the state-of-the-art Woodhaven unit in my constituency—we have also lost the special facilities that were available to the police to house those who were found in mental distress.
Mrs Moon
I can say that the police increasingly have difficulty finding beds for people who need help and support. Although I cannot comment on the specific situation in Hampshire, the inquiry will reveal whether a suicide prevention action plan is in place and whether there is active engagement with the police in relation to that plan. I hope that that will assist the hon. Gentleman in assessing his local problems and issues.
The role of the police in dealing with mental health issues, mental health crises and suicide is growing. The figures from British Transport police on mental health incidents and suicide are shocking. I appreciate that the Minister will tell me that he has no responsibility for British Transport police, but they have been able to give me the most illuminating breakdown that shows the depth of the problem that we face. For every sexual offence dealt with on the railways, there are 15 mental health incidents, four of which are related to suicide. For every offence of robbery, there are 39 mental health incidents, 10 of which will relate to suicide. For every non-sexual assault, there are two mental health incidents. Last year, there were more calls to British Transport police relating to mental health incidents than there were reports of robbery and assault combined. In fact, British Transport police currently prevent more people from taking their own life every year than there are robberies every year. Those statistics show the size of the problem that we have drifted into.
The British Transport police are not alone in dealing with mental health issues. The Metropolitan police are reporting large increases in the number of people in mental health crisis committing offences deliberately for the purpose of getting into prison, because they believe that they will be safer in a cell than on the streets. At least in prison, they will have access to mental health support. Police say that they are told by local authorities that they are using section 136 powers too regularly, but they do not have any viable alternative to the place of safety that a police cell represents.
The British Journal of Psychiatry reports that in the north-east of England, a total of 205 cases of suicide were identified, 41 of which had a documented contact with the police within three months prior to the suicide while an additional seven cases had impending court appearances. In almost a quarter of suicide cases, the person had been in direct contact with the criminal justice system within the previous three months. Figures taken from the national confidential inquiry into suicides showed that in 24% of suicide cases, the person had been in contact with mental health services within 12 months of their death, compared with 70% who had been in contact with the police.
In my previous Westminster Hall debate on the subject, the former policing Minister told me:
“It is obvious that the police have, and will continue to have, a key role in dealing with mental health issues as they arise.”
That is undoubtedly the case, but is it right for the police always to be the point of engagement for those who are at risk of suicide? Those with mental health issues are three times more likely to be the victim of crime, and half of those with some form of mental ill health experienced a crime in the last year alone. The former policing Minister told me that the police
“are not and cannot replace health professionals. Both types of professionals should be left to do the job that they are best at doing and trained to do”.—[Official Report, 28 November 2013; Vol. 571, c. 161WH.]
Unintentionally, the Minister described what is wrong with the current situation. The police are increasingly replacing mental health professionals.
I am worried by the fact that when a police officer comes into contact with an individual whom they suspect is experiencing a mental health crisis, if that person goes on to take their own life, the officer will be investigated. They are often requested by social services to call on someone who is seen to be at risk, but it is the police officer and not someone from social services who is subject to an internal investigation. Police officers feel particularly aggrieved that they, who have no specialist training in identifying mental ill health, are expected to be accountable should someone with a mental health problem ultimately take their own life.
In my Westminster Hall debate, the former policing Minister spoke positively of the benefits of joint working. Many directors of public health and other suicide prevention professionals have said that the only really successful approach to the issue is multi-agency working. They see police and health professionals working together in a well-defined manner. Will the Minister tell the House what progress the Government are making on such an approach? In particular, what efforts are being made to log incidents of suspected and attempted suicide and to provide that information, in agreement with the coroner, as timely, current examples of the problems and risks faced locally, rather than prevention services having to wait three years for the national statistics to be released?
The Minister will be aware of MARACs—multi-agency risk assessment conferences—in relation to domestic violence. They have been piloted in some Metropolitan police areas to highlight the suicide risk of individuals and to provide a supportive package. I was told a wonderful story from a MARAC involving a lady with dementia who had been burgled 30 years earlier and was ringing the police several times a day to report a burglary. The initial response was that she should be given an antisocial behaviour order, but the MARAC pointed out that that was not the best way of dealing with her and a support package was put in place. Police time was saved and an elderly lady was saved huge distress. Will the Minister examine how MARACs are working and whether they can be rolled out as an exemplar across the UK?
We all agree that the police play an important role in dealing with mental health issues, but post-attempted suicide support should not be a police responsibility. British Transport and Home Office police recognise that their primary responsibility is to those whose life is at risk, but that responsibility is not placed on other statutory agencies, which are able to walk away when the police cannot. It is imperative that health, voluntary sector and local government agencies, as mentioned by the hon. Member for Strangford (Jim Shannon), work together to establish a joined-up strategy, with a primary responsibility to those whose life is at risk, that both prevents suicide and deals appropriately with those who have survived a suicide attempt, ensuring in the best way possible that they do not go on to make a further attempt.
Police officers are there to deal with crises, risk to life and crime. Sadly, too much of the Minister’s budget and officer time is taken up filling gaps that health, local government and appropriate funding of the voluntary sector should be filling. I look forward to hearing how the Minister plans to free police time and responsibility for those attempting or contemplating suicide once the immediate crisis has been resolved.
The Minister for Policing, Criminal Justice and Victims (Mike Penning)
When I woke this morning, I did not expect to be responding to such an excellent Adjournment debate on such an important subject as the Minister responsible for policing in the United Kingdom and with responsibilities in the Ministry of Justice for child protection—among other things, I believe, which we will see once the final list comes out.
I congratulate the hon. Member for Bridgend (Mrs Moon); may I call her my hon. Friend? We have dealt with many things together in the past and this is an appropriate opening debate for me, not least because of my previous ministerial duties at the Department for Work and Pensions as the Minister responsible for disabled people and, as she mentioned, my time on one blue-light facility as a fireman in the Essex county fire and rescue service. I was also a paramedic, when I was in the military, and a battlefield medic. When we are not on operations, the military look after the communities where they are and, sadly, I remember responding to all too many suicide attempts when I was in both the military and the fire service.
Sadly, as the police are on the front line, they often bear the brunt of what is going on, emotionally as well as in terms of their physical time. It is right and proper that as this is my first speech in this role, I should pay tribute to the work that all police do in this country. The hon. Lady has mentioned the British Transport police and the police in the devolved Administrations. I worked closely with the police in Northern Ireland when I was a Northern Ireland Minister, and there are also myriad other police services, such as the ports police, and the nature of ports means that they often sadly see a lot of suicides and attempted suicides.
When I was the Minister responsible for disabled people, one thing I did with the permission of the Prime Minister was start a joint ministerial forum for Ministers from all Departments. I nearly said that they were required to attend, but actually I cajoled them into doing so. For the first time in 40 years, since we first had a Minister responsible for disabled people, Ministers from all Departments came together not to pat ourselves on the back for what we had done for the disabled community but to see how we could improve things in the short and long term. It is spooky that one thing we were talking about at that forum was the whole question of mental health. The previous policing Minister, my right hon. Friend the Member for Ashford (Damian Green), discussed this very subject with me. We started to work very closely with the Health Minister with responsibilities in this particular area, who has been enormously helpful.
One thing we discussed extensively was not just what to do at the time of the incident, but how we could prevent people from getting to that position in the first place. My hon. Friend the Member for New Forest East (Dr Lewis) alluded to mental health issues in his constituency and I hope that we have all been to mental health facilities in our constituencies to see the excellent work they do. One of the biggest problems we have is ensuring that when someone is presenting, not to a police officer but to a health professional, the knowledge and skills are there to recognise that there is a mental health issue, not least at accident and emergency. I know from my own experience that people were presenting at A and E or being presented by the police, but there were not staff on hand with the skills to diagnose and understand those people’s conditions, which would involve either mental health or learning difficulties—another issue that often comes into play.
Dr Julian Lewis
In my intervention, I did not make it clear enough that what happened in Hampshire appears to be happening in other parts of the country as well. We are going through one of those fashionable phases in which there has been a swing away from in-patient acute mental health beds, which is having an effect as the facilities are not available for the people in acute distress whom the police are discovering or with whom they have to deal.
Mike Penning
My hon. Friend raises an important point. That may well be a useful Adjournment debate for us to have, with Mr Speaker’s permission. Even in our front-line acute accident and emergency departments, it is crucial to have staff with the skills to diagnose exactly what is going on.
I could not agree more with the hon. Member for Bridgend that, while the police will always be the front line—always be the people who are there for us—at the end of the day, even though there is mandatory training, their response is not what we really need to happen. We need to prevent as many suicide attempts as possible. I have myriad figures before me, which the Department has kindly provided, including from the British Transport police. The nature of their job means that they come across people who really intend to commit suicide rather than make a cry for help—although sometimes a cry for help can go too far. Suicides are unbelievably distressing to the police and the British Transport police as well as drivers, the excellent facilitators of our transport system. I have been with drivers of trains and buses that people have jumped in front of, and I know it causes them untold stress because they feel responsible, although clearly they are not.
We need to do more. In the short time that I have had this portfolio, I have had the chance quickly to look at the multi-agency risk assessment conference—MARAC—scheme, which is being piloted. I will look at it in detail. The Select Committee is pursuing its own investigations, and I look forward to assisting the Committee in that work. The hon. Lady touched on other areas where the police may well be involved. The prevalence of people with mental health issues or learning difficulties in our prison system across this great country of ours is very sad, and often the police are called to incidents within prisons. Tomorrow at 9.30, I am meeting the Metropolitan Police Commissioner—on my second day in, he is coming through my door. I will be talking to him about this issue.
Jim Shannon
The Minister will be aware from his position as Minister of State for Northern Ireland of the close co-ordination between the Police Service of Northern Ireland and the local health authorities. The two work together whenever people with suicidal tendencies and mental health conditions are presented. There is a system in place which I know that the Minister will be aware of, and which reacts quickly. Does he feel that that system could address the issues that the hon. Member for Bridgend (Mrs Moon) has raised tonight?
Mike Penning
In Northern Ireland I worked closely with the Chief Constable, Matt Baggott, who has retired now—I wish him well, and I wish the new Chief Constable well, too, in a difficult time. Only the other night, we said how pleased we were about how quiet the marching season was.
I want to look at the MARAC scheme to make sure that it is evidence-based. The crucial thing is that, with the limited funding available, agencies must work more closely together so that we not only intervene earlier but, once we have intervened, make sure that we get the decisions right. As the hon. Member for Bridgend said, we get people to what we think is the right place, then release them and sadly the situation recurs. I do not have this written down in front of me—it is anecdotal evidence—but people who commit suicide tend to have tried before. It is sad that as a society we have not managed to pick up on that. If I am wrong about that, I apologise to the House, but it seems to me from my time in the emergency services that that is what happens, and I will look for evidence that I am correct.
The police do a fantastic job no matter where they are in this great nation of ours, and the various police forces all carry out their roles in an exemplary way. It is important that we use their resources correctly. The police will always, rightly, be on the front line. They may sometimes be the first to arrive and in certain circumstances they will be the only people to arrive. It is important that paramedics are trained in understanding health issues and learning difficulties, which are often linked—something that is sometimes not fully understood. We must use our police and their resources correctly. They should not be the first resort but the last resort when it comes to looking after people with these sorts of conditions and those attempting suicide, so that we can improve matters. It is getting better, but I will not drown the House with data. One life lost is one too many, and I hope to work closely with the hon. Lady because I want police arresting criminals and for criminals to be convicted, and wherever possible, not to be put in a difficult position, as is often the case in this particular arena.
Question put and agreed to.