Mental Health (Police Procedures)

Keith Vaz Excerpts

Thursday 28th November 2013 Westminster Hall

[Mrs Madeleine Moon (Bridgend) (Lab)]

I look forward to this debate under your excellent chairmanship, Mr Brady. I thank the Backbench Business Committee for finding the time for this debate on a most important subject and I am pleased to see the interest, that the turnout here today shows.

The poor quality of life and of the services available to people struggling to live with mental ill health has been the subject of previous debates in the House. This debate relates to police involvement with people with mental ill health, particularly during times of mental health crisis. Mental health crisis, as defined by the Royal College of Psychiatrists, is

“when the mind is at melting point”.

It may involve an immediate risk of self-harm or suicide, extreme anxiety, panic attacks or a psychotic episode. How we treat the most vulnerable in society lies at the heart of our values. We made a decision not to hide away the sick and disabled, as we had hidden them away in the past in asylums and institutions, but we still have a long way to go in granting them equal status in society and equal access to justice.

The Mind report “At risk, yet dismissed” shows that those who suffer from mental ill health are three times more likely to be victims of crime. Shockingly, 50% of people with some form of mental ill health have experienced a crime in the past year, and severely ill women with mental ill health are 10 times more likely to have been assaulted. Crimes are less likely to be reported and prosecuted, because people with mental ill health fear being dismissed or disbelieved. Sadly, the evidence shows that more often than not they are. How does the Minister plan to improve police understanding of mental ill health and ensure more accurate recording of such crimes, and will he give a commitment to greater investigation and prosecution for such offences?

Another reason for not reporting is fear of police powers in relation to mental ill health. Too often, between 5 pm and 9 am during the week, at weekends and on bank holidays, police officers are the only first responders available in a mental health crisis, despite the fact that they lack the medical knowledge, skills and training to resolve and manage the crisis. They respond not because there is a real and immediate threat to members of the public, but because mental health services are understaffed, under-resourced and overstretched, and lack facilities.

For example, Miss P, who is 23 and a size 8, is a sweet, loving young girl who has suffered mental ill health for most of her life. She finds it difficult to build relationships and she is lousy at keeping appointments. She does not drink alcohol, except when she is in mental health crisis, and when she does, she turns into a violent and abusive person. Local mental health services concede that she needs a specialist placement, but they cannot find one. In the past five years, police have been called to 130 incidents and attended court to give evidence for 81 offences, resulting in 18 terms of imprisonment. The gaps between her prison sentences are becoming briefer—days, not weeks—and her self-harming and suicide attempts are escalating. The cost to that young girl, her family, the police, the courts, the probation service and the Prison Service is huge. I am told that it approaches £1 million, all for one young girl.

When the Minister sums up, I hope he will address this critical question: how much longer will we expect our police services to process vulnerable people through the criminal justice system due to mental health, underfunding and failures?

[Keith Vaz (Leicester East) (Lab)]

I congratulate my hon. Friend, the hon. Member for Halesowen and Rowley Regis (James Morris) and the right hon. Member for Sutton and Cheam (Paul Burstow) on securing this debate. My hon. Friend will be pleased to know that, as a result of the work done by her and others, the Select Committee on Home Affairs will be looking into this issue, with a possible report next summer.

Will my hon. Friend comment on the study by Nottingham university, published in May this year, which shows that 56% of custody officers suffer from depression and anxiety? It is not just the victims of crime, but the officers themselves. Is it not right that the new College of Policing should carefully consider the issue of training?

[Mrs Moon]

As always, my right hon. Friend makes excellent information available to the House. I am delighted to hear of the study to be made next year by his Committee, which is highly regarded across the House. He is right to focus on mental ill health among police. It is little surprise, given the amount and range of incidents with which we require them to deal. That is why we must ensure that the police are called to attend only incidents that they can deal with and that they have the skills and capability to manage, so they do not go home at the end of their shift feeling guilty and bereft about an incident that they may perceive they dealt with badly. My right hon. Friend made a most helpful intervention, and I thank him.

The Centre for Mental Health states that police are the first point of contact for a person in mental health crisis and that up to 15% of police incidents have a mental health dimension. Other people have told me that mental health interventions occupy up to 30% of police time. The Royal College of Psychiatrists recognises that in some areas police cells are the routine place of safety, under section 136 of the Mental Health Act 1983, when a mental health crisis requires urgent assessment and management. Many of those detained come from socially deprived backgrounds, and some black and minority ethnic groups are over-represented.

The Royal College reports considerable geographic variation in the use of police cells. During 2012-13, five police areas recorded more than 500 uses of police-based section 136 places of safety, while four areas recorded 10 or fewer uses, and one had zero. The difference was that the latter areas had better health-based services and facilities. Will the Minister undertake to talk with the Department of Health about the urgent need for commissioning boards to provide an adequate number of staffed health-based places of safety in every part of the country? At present, 36% of all places of safety under section 136 are thought to involve police custody. In 2011-12, an estimated 8,000 to 11,000 orders were made, with 347 involving under-18s. Will the Minister ensure that accurate figures on how often and in what circumstances police officers are called to deal with mental health crises are available, so that we can get a clear picture of the problem?

People held by police under section 136 are, as I have said, the most acutely vulnerable. One study found that in 81% of cases involving police-based places of safety, the person was self-harming or suicidal. The Independent Police Complaints Commission found that 35% of deaths in police custody involve people with mental ill health. Alarming reports from Inquest show that a number of those deaths are linked to police restraint techniques, and that 65 people took their lives within two days of leaving a police place of safety. Between 20% and 30% of people held on section 136 detentions in police cells were subsequently sectioned.

The impact on time and costs associated with police engagement in mental ill health has never been calculated accurately, but it is clear that, in a variety of ways, health service costs are being passed to the police services. It is common for police officers taking people in mental health crisis to accident and emergency or medical-based places of safety for an assessment to be told, “There’s no bed available”, “The person is too drunk”, “They are under the influence of drugs”, “They are aggressive”, “They are a child”, or, “They have a learning disability”, all of which condemn that person in crisis to a night in police custody. How much longer can we allow these informal exclusion criteria around drugs, alcohol, aggression, children and learning disabilities to continue?