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Positive police responses to people in crisis
Posted Thursday 10 February 2011
As part of our Another assault campaign for equal access to justice, we have been calling on the police to improve the way they respond to people who experience mental distress.
Here Karen Wright and Ivan McGlen of the University of Central Lancashire share their work with police on responding to people in crisis.
The Office of National Statistics found that one in four people will experience mental distress during their lifetime and many of these will have contact with the police as a victim, witness or offender.
One of the most common forms of contact, probably in times of crisis, is under section 136 of the Mental Health Act. This is where the police may detain someone if they are presenting a risk to themselves or others in a public place and they are in need of immediate care or control.
We’ve found 1 that police officers are often correct in their use of the power and that the person is in need of some form of mental health intervention, but the question we wanted to ask for this work was: “What decision making process do the Police use when deciding if someone has a mental disorder and how is that then communicated to mental health professionals?”.
Ultimately we wanted to make sure police officers have the right tools so they can get the best result for the person in crisis.
Together with Lancashire Police, we interviewed and surveyed police officers to find out how they make decisions and what the key factors were. As a result we developed a tool for police officers to use when assessing immediate needs of potentially high risk people in public places.
The Public Psychiatric Emergency Assessment Tool (PPEAT) is, in effect, an aide memoire to officers based on the ABC tool commonly used in First Aid. It is printed on credit card sized cards for officers to have with them at all times.
We also developed a training pack for new recruits so they can start to put some evidence behind how they make their decisions and also to help them communicate with mental health professionals in a structured and meaningful way.
Clearly, as police officers are not mental health professionals the challenge is to provide training which helps officers to make clear and accurate observations to health professionals, without any further training in mental health!
However, police officers have very well-tuned powers of observation, so we realised that we could harness these existing skills to provide a comprehensive account of a situation, thus enabling a good mental health assessment when the person is received into a place of safety.
Our ABC method uses information gained through the accurate record of a range of observations (situational awareness) and harnesses the skills of an observant workforce to speak confidently and professionally.
- A: Appearance and atmosphere: what you see first including physical problems such as bleeding.
- B: Behaviour: what individuals in distress are doing, and if this is in keeping with the situation.
- C: Communication: what individuals in distress say and how they say it.
- D: Danger: whether individuals in distress are in danger and whether their actions put other people in danger.
- E: Environment: where they are situated, and whether anyone else is there.
This method has since been by custody visitors, paramedics and first aiders, to make sure that the right sort of information is given and appropriate and sensitive interventions happen for the person experiencing mental distress.
Insp Dave Croll of Lancashire Police told us why the tool is so vital:
As police officers we have powers under the Mental Health Act to detain people and what we can never hope to do is turn police officers into mental health professionals, but what we can achieve is a structured and professional approach to our use of those powers, which ultimately must be beneficial to the person with whom we are dealing with at that time.
Karen Wright and Ivan McGlen, University of Central Lancashire
6 Comments
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This is very encouraging, and I am impressed. However, the fact remains that there are no academic qualifications needed to become a policeman (in Essex at least) and to be honest I am not convinced that some of our new recruits are capable of taking such an excellent presentation in or are sufficiently sympathetic to make it their own. But MIND has does a tremendous job here. The situation of course will not be helped by the huge cuts in police budgets (I wonder what sort of impact this will make on training such as this.)
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Chris, thanks for your comments. I think that the issue of academic qualifications may be addressed by the introduction of foundation degrees for would-be police officers. We have a Foundation degree here at UCLan and this tool is presented by Ivan and I on their course. Initially, we devised a training manual, with Insp. Dave Croll for use with Lancs constabulary. We did a 'train the trainer' sessions with senior officers keen to disseminate this training and then we handed it over to them. They had such a genuine interest and passion for getting this process right, that we were incredibly proud of the impact it made. However, since there are no new recruits at the moment, we have been delivering the training here at UCLan.
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I initiated a very similar campaign of my own in May 2010, following an incident where a police station reception officer responded in the most unhelpful way to my friend and I when we were seeking assistance as she was having a severe panic attack. My website which has links and details is: www.mentalhealthawareness.co.uk.
I think it's brilliant that Mind are running their Another Assault campaign. I have written to Mind with regards to my campaign and received a response from Richard Pacitti, a chief executive, back in June 2010.
I am going to look into the PPEAT too, which I only became aware of through this article, and hopefully with my campaign and that of Mind's and other organisations on this issue, something will be implemented and a positive change will be made which will benefit those who have mental health difficulties and who come into contact with police, in any capacity.
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Hi Nicola, I am going to pass on your details to our campaigns team - have you considering joining us as a campaigner? http://www.mind.org.uk/get_involved/take_action/be_a_mind_campaigner
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Hi Nicola, I am really sorry that your friend didn't receive the right sort of response when she had a panic attack. I think that there is a real lack of understanding about mental health problems, but things are changing, slowly. For example, it is really common for people to misinterpret anxiety as hostility.. Your friend is very lucky to have you, I am sure that your work will make a difference.
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About 2 years ago I found a woman in great distress in a shopping centre, crying and saying that her dogs had wandered off. On her request I rang the RSPCA but only got an answerphone message. At this she became more distressed, so I offered to phone one of her family or a friend. She said no, just kept on about wanting her dogs back, and I became very concerned for her welfare, so I phoned 999 for the police. All they did was ask me if the woman was carrying any weapons or making threats, which she wasn't. They told me they were unable to help, suggested I find out if the woman had a social worker, then they ended my call. So I phoned for an ambulance, which came, but they were not very helpful either. This assessment tool for the police would've been very useful on that occasion.
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