Mental Health Units (Use of Force) Bill

James Heappey Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[James Heappey (Wells) (Con)]

May I add my congratulations to the hon. Member for Croydon North (Mr Reed) on bringing forward this Bill? I warmly support it and applaud his willingness to work with people across the House to ensure that the Bill fully meets the concerns of Seni’s parents and family and others who have been in such circumstances—I will share another story with Members on behalf of one of my constituents shortly—and works properly for those who are involved in mental healthcare in our country and who, like our police, will occasionally have cause to restrain those who are mentally ill. Those people work in very challenging circumstances and it is important that the Bill fully reflects that and is workable and fair to them as much as it is fair and transparent for those who are on the receiving end of its provisions.

I wish to discuss three areas, the first of which is the story of my constituent, James Herbert, who died in police custody in 2010. He was mentally ill and had been restrained shortly before his death. Secondly, I wish to look at how this Bill might have helped in that situation and how, in so many ways, it will certainly help to ensure that those sorts of events do not happen again. Thirdly, I will consider what additional training we might offer not only to our police, but to those who work in mental health. We need to make sure that, yes of course, there are safer techniques for restraint, but that there is also a much greater understanding of how we de-escalate those circumstances so that restraint might not be necessary.

James Herbert was known to the Avon and Somerset police, particularly those serving locally in and around Wells, as being mentally ill. Over the course of the day on which he died, there were a number of occasions when the police had had cause to observe his behaviour. On the evening after a hot June day, he was detained by the police. In the process of that detention, he was restrained. He was then put into a police van and driven for 45 minutes to a custody suite where he was stripped naked and put into a police cell. He died later that night of a cardiac arrest. The Independent Police Complaints Commission has looked in full into his death in the seven years since, and its report “Six missed chances” is rightly very critical of what happened that night. It is important to note that the police officers involved—one of whom is still a constituent of mine; the other, very sadly, took his own life a year or two ago—have not been held personally responsible for what happened. The failings that were identified were systemic, institutionalised failings—that sort of misunderstanding of mental health and the way that the processes were handled.

The Bill brings forward a very important aspect of how we deal with those with mental ill health. Sometimes, restraint is unavoidably necessary, but how that is done can have a profound impact on people such as the constituent of the hon. Member for Croydon North and my constituent, James Herbert.

Undoubtedly, the Bill will help. Staff not deliberately restraining people in a way that constrains an airway is clearly a very important and necessary provision, so, too, is restricting the intervention of a restraining technique that causes pain. Similarly, people should always seek to use the least restrictive method of restraint possible. Those are necessary de-escalatory measures, which in themselves could help, not quite to calm the person but at least not aggravate them further, which happens so often. The more that I have spoken to police officers about James Herbert’s case, the more they tell me that their concern to get their job done and retain the person means that they find themselves naturally going up through their levels of force and the application of their physical power. As both sides seemed to rub off of one another, they both got more and more aggravated, and the use of force became all the greater. The police reflected afterwards that they might have approached the situation differently in the first place.

[James Cleverly]

I do not know the ethnicity of the constituent who died in custody, but does my hon. Friend agree that it can be intimidating for police and medical professionals when the person they are dealing with is physically big and robust? As well as the measures in the Bill, they need our support to ensure safety for them and for the people for whom they are caring.

[James Heappey]

My hon. Friend, as ever, makes an excellent point. These are highly challenging, confrontational situations. James Herbert was white, but he was a big guy. As his anger and emotions built, so did the efforts of the police officers who were trying to restrain him for his own safety. My hon. Friend is right to observe that there some people who require restraint are physically very intimidating. The police officers or mental health workers involved in the restraint often fear for their own physical safety, which may lead them to use overly aggressive techniques. They may really be focusing on self-preservation, instead of on de-escalation. A great confidence is required in the techniques that have been taught for restraint, and in understanding how to deal with those who have acute mental health challenges. That confidence is absolutely necessary so that people are able to apply the right skills in the right way to bring about the right outcome, instead of fearing the physical situation in which they find themselves.

I agree very much with some of the other provisions in the Bill. Seclusion should be an absolute last resort. It is an alienating and escalatory measure. Then there is the immediate, confident and sympathetic engagement of other people involved in the care of the mental health patient. When the police were detaining James Herbert, they phoned his mother to talk to her about something very different, rather than to ask her about James’s condition and what she might be able to share with them in order to manage him much more appropriately in the situation.

I agree passionately with the use of body cameras. I have seen the profound impact of James Herbert’s case not only on his own family and friends, but on the careers, lives and mental health of those involved in his detention and, sadly, his death. Body cameras would have made an enormous difference in this case.

[Mrs Sheryll Murray (South East Cornwall) (Con)]

I welcome body-worn cameras. However, when someone is subjected to immediate harm in an emergency case, the absence of a body-worn camera should not prevent someone from coming in to address the situation. Does my hon. Friend agree?

[James Heappey]

I accept that there are situations that require immediate intervention. As a former soldier who was used to working on immediate notice to move at times, I suggest that the solution is that there must always be somebody in a custody suite or a mental health ward who is wearing the right kit and is on immediate notice to move. It should be a requirement, and it should be a simple drill for those managing the facilities. That is not to say that everybody needs to be sat around at all times, wearing their stab vest and their camera. But one person in a custody suite should be required to be wearing the appropriate kit at all times. Perhaps that is something to include in the Bill. The cameras are a great addition to what police officers wear. In fact, they are a de-escalatory measure in themselves. Away from cases of people suffering with mental health issues, I have been told by the local police commander for my part of Somerset that the simple act of turning them on has such an effect. People on the high street who have had a few too many drinks see themselves on the screen and know that their behaviour is being recorded; things immediately start to calm down and responsibility returns.

[Mr Reed]

I am grateful to the hon. Gentleman for raising this important point and I agree with the point made by the hon. Member for South East Cornwall (Mrs Murray). The hon. Gentleman will be interested to know that there is a weight of published academic evidence showing that the mere presence of police wearing body cameras reduces the likelihood of force being used in these circumstances by nearly 50%. That alone is reason enough to require police to wear body cameras.

[James Heappey]

The hon. Gentleman is absolutely right. It is great on days like today when the House is in such violent agreement. The cameras really are a great addition for our police forces. They give transparency for those who want to complain about perceived unfair treatment. But they also give a protection as important as the stab vest, by reassuring police officers that they will have a video record of what they did.

[Will Quince (Colchester) (Con)]

I accept points from both sides of the House on body-worn cameras. The Bill makes it clear that the officer has to turn the device on as soon as practically possible from the point at which they are called. Does my hon. Friend think that it would be more practical to say that that should be at the point they attend the mental health unit, not the point at which they take the call? Is not that a little too onerous for the officers? I am just posing the question.

[James Heappey]

From discussions with local police constables and with the police commander, it seems that police officers have an instinct for when they are going into certain types of situation. One would imagine that if an officer were on the custody desk and heard that something required their intervention, they would obviously flick on their camera as a matter of drill while they were going down to the cell or wherever something was happening. That is assuming what we were just discussing—that it should be standard practice that somebody in those circumstances is always fully kitted out.

[Kevin Foster]

The requirement in the Bill is for officers to wear body-worn cameras when attending a mental health unit. My understanding is that that means that the unit has an issue and has called the police to attend. In many instances, custody suites have cameras, even though they may not be body-worn. The real solution is that response officers—those who are deployed ready to attend 999 calls—should have body-worn cameras. That would help not just in these instances, but in many other circumstances.

[James Heappey]

My hon. Friend is right, but whenever attending a call-out to a mental health unit—just as in attending any other event in the community—the police officer would have deployed in their patrol car wearing their full kit. They would already have been wearing the camera and would have switched on it on as they were entering the situation, if they thought that were necessary. The much more likely scenario, as perhaps would have been the case with James Herbert, is of people being called into a situation when they are not out on the street, but are just nearby and lending a hand. The fixed cameras in the building may be obscured by those doing the detention, so I also see real merit in body-worn cameras being used in those situations.

This is not just about how to ensure that acute, immediate interventions are handled properly. It is also about the additional training that might be offered to police and mental health workers to make sure that these situations do not arise in the first place. Training is key. That goes without saying for mental health workers, who, by vocation, understand this stuff very well indeed, but the police are much less confident in dealing with people with mental health issues than they should be.

Training for the police so that they can spot those signs and intervene appropriately with concern and care would be helpful and would prevent a large number of the instances that we are debating. There are techniques for reassuring people, for de-escalating, and for managing the anxiety that often manifests itself in people with mental illness. Equipping police with those skills would be very welcome indeed.

[James Cleverly]

A number of years ago, when I served on the London Assembly, I visited Feltham young offenders institution. I cannot help but think that there are a number of young men in Feltham who had mental health problems but whose interactions with the police and authority during mental health episodes reached a stage at which they became violent and ultimately found themselves incarcerated, perhaps at least in part because of that lack of understanding and training on the part of the police. It is not a moral criticism but an observation that training could help the police officers and some of those young men, who were ultimately incarcerated in what was not necessarily the most appropriate institution.

[James Heappey]

I very much agree. It is interesting to reflect on conversations I have had with police and community support officers in my constituency. The nature of their job means that they understand or know more intimately the community they serve. Very often they have an insight into the mental health of people they routinely see around town who are on the edges of antisocial behaviour or even breaking the law. They can often deal with them very differently because they understand who they are dealing with. The PCSO job description is such that PCSOs naturally seek to de-escalate and deter, rather than enforce the law. My hon. Friend makes an interesting observation, and I certainly agree that it is possible to avoid these circumstances arising as often as they do.

[Wera Hobhouse]

The hon. Gentleman has pointed out the importance of PCSOs, but many police authorities are having to cut those services. Does he not agree that it is regrettable that police services have been cut and that important PCSO services have been taken away from the community?

[James Heappey]

My near neighbour, with whom I share probably the most beautiful diocese in the country, makes an interesting point, which she and I might jointly take up with the police and crime commissioner for Avon and Somerset. The decisions on how PCSOs are allocated are hers. It is not my experience in my constituency that PCSO numbers have been cut. In fact, I have been impressed by the service that we have received from PCSOs in Somerset during my time as MP for Wells. The Bill is not exclusively about the police—it is about the way in which we deal with people with mental health challenges.

[Kelly Tolhurst (Rochester and Strood) (Con)]

It is really good that my hon. Friend has highlighted the role of PCSOs. In January, we will increase the number of PCSOs who police our communities in Kent, because we recognise that they play a key role in the transition from meeting people with mental health issues on the streets to being able to direct them to the right care at local level, rather than getting police officers directly involved at the first point. Does my hon. Friend agree that that is a good thing, and we must recognise that we are increasing numbers in some places?

[James Heappey]

I very much agree. I have no first-hand experience of policing in Kent, my hon. Friend will be pleased to know, but I certainly agree that PCSOs are important. I do not see them in any way as a poor substitute for police officers. The way in which PCSOs carry out their job is excellent. I am fortunate to have some excellent PCSOs serving towns and villages in my constituency, and they make a big difference by intervening and making sure that crime levels stay low.

We have spoken a lot about the police—inevitably so in my case, because my experience has come about as the result of a death in custody, and I wanted to share that with the House. This is really about a wider way in which we care for people with mental health conditions. Mental health is something I am passionate about, and I learned a great deal about it while serving in both Iraq and Afghanistan. Before doing so, I was very much a member of the club that said that people should just pull themselves together. The reality is that when you see people who are absolute heroes—strong, strong people—who have served in the Army for 20 years, and you see their head break, you stop making the distinction between someone having their leg blown off and someone having their head break because they have witnessed a trauma that was so profound that it did something to them and over which they had no more control that someone who has lost a limb. That led me to look keenly at what mental health provision looks like in my community.

I had quite an epiphany when I realised how important mental healthcare is. Today we are discussing how to deal with people in the moment of most acute crisis. That is a necessary discussion, but it must not distract us from the urgent need to discuss how to stop people getting to crisis point in the first place. Somerset’s mental health provision is quite hollow. We have more than adequate provision of acute mental health beds, and we have reasonable provision of community nursing, but we do not have the stuff in between: the crisis houses—the step-up, step-down facilities—that can help people to find a bit of space to avoid or see off the imminent danger of a critical episode. That could prevent their having to go to an acute facility where things might escalate even further and might stop the horrible situations we have been discussing arising.

We must also look at how we do much more upstream prevention involving mental health charities in particular. Their role is enormously important. In Wells, Heads Up, of which I am a patron, and Charley’s Memory in Burnham-on-Sea—again founded as a result of a real tragedy to do with mental health—do amazing work in our communities. They work voluntarily and charitably, but they do something that should be a really important part of a broad, deep network of mental health provision that helps to manage people through mental illness at the appropriate level and prevent their slipping into crisis as much as possible.

We must push even harder to break the taboo on mental health in our communities. If there were greater acceptance of mental health conditions and people were more willing to be open and to talk about the issue and support people with mental illnesses, fewer people would find themselves in crisis because they had become isolated and their vulnerability had become such a problem that they made a big cry for help or their illness escalated to crisis point. Parity of esteem is not just about money, although in Parliament the debate often focuses on that. It is about attitudes and acceptance too. We need a mental health system that has real depth so that we can make sure that people who are living with mental health conditions can do so with dignity, not being unnecessarily aggravated because they have unreasonable waiting times for mental healthcare, but supported by an understanding and supportive community.

Mental health workers do amazing things, and so do the police who have to work with those who are suffering from mental illness. Nothing that we are discussing today should be seen a criticism of what they do. They should understand that we understand, fully, the extraordinarily challenging circumstances in which they work day in, day out. I thank them for the extraordinary hard work that they do.