We might not be discussing mental health detention at our Conference, but we are trying to change things

The wonderful Ms Rigg wrote a very detailed piece on how the motions were selected for Spring Conference this week. As a member of the Party’s Federal Conference Committee, she knows all there is to know about such things and it’s great that she shares so much with us.

In her post,  she lamented that a motion on mental health detention, had not made it through.

The mental health detention motion would have highlighted an injustice that is not widely known and would have given us a distinctive policy platform which none of the other parties have – with all due respect to the submitters of the NHS at 70, there’s little in there that is distinctive.

I tend to see her point on this. We do need to show our distinctive perspective on all sorts of pieces so I’m glad that she voted the way she did.

We would have had no shortage of support for such a motion. In fact, we may even have got some parliamentarians speaking in favour. Alistair Carmichael held a debate in Parliament this week on this very issue.  He told the story of a constituent’s son, who’s based in England, and the ordeal he went through. The treatment he received and the failure of the authorities to realise what they had done wrong and apologise for it is pretty disgraceful. Here’s Alistair’s speech:

In recent years, as a community and a society, we have made remarkable progress on our attitudes to mental health. To talk about mental illness is no longer the taboo that it was when I was growing up, and as a consequence we have seen remarkable progress in recent years in relation to the treatment of people, especially in our national health service.

Today, I will focus attention on a slightly different aspect of this issue—one that does not get the same attention as the treatment of people with mental health problems in the NHS. I will talk about the experience of people who come into contact with the criminal justice system—initially, of course, with the police, then with the prosecution services and, possibly, the prison authorities. The purpose of this debate is to make clear to the Minister that within those agencies of the state, we need a change of attitude and culture similar to those we have seen in other aspects of our daily life.

It is surprising that this issue does not get more attention. Many of the people about whom we are speaking often exhibit in public or private what might euphemistically be called “challenging behaviour”, which is a symptom or consequence of their mental illness. It seems to me that at all levels—in the police, the prosecution services, the courts and the prisons—we need a greater level of understanding of their life experience and, as a consequence, better implementation of procedures. In fact, many procedures are pretty good but, as I will come on to explain, they are not followed in a way that is appropriate or that was intended when they were put in place.

I confess that I had rather thought that, within the criminal justice system, we had got beyond that point. Almost a quarter of a century ago, both as a trainee solicitor in Aberdeen and as a prosecutor, I railed against some police officers who, at that stage, still reported people who had attempted suicide, alleging that they had breached the peace. That attitude belonged in the 19th century, not the 20th, and I hope that such things would not happen today. However, it illustrates the underlying attitude that requires exposure.

My interest in this issue was first engaged as a result of a constituent—a lady resident in Orkney—who came to see me because she was concerned about the treatment of her son. This is not an isolated case. From discussions ​that I have had with people in the police, the criminal justice system and social work, I believe that it illustrates pretty well many of the ways in which the criminal justice system fails to meet the needs of people in our community, especially those who suffer from mental health problems.

I will not name these people; my constituent and her son want to retain their privacy, which is perfectly legitimate. However, the Minister should be acquainted with this case; last week, I forwarded him my correspondence file, which is fairly substantial, so that he would be aware of the background.

My constituent’s son is resident in Romford. He has a history of mental illness problems, but prior to the episode that I will discuss he had taken himself off some of the medication that he had been prescribed, because it had side effects that disagreed with him. He was reported missing by his partner on 27 April 2014. She contacted the police because she was concerned that he might kill himself. Eventually, he was traced by two police constables to a shopping centre in Romford. Questioned by the constables on the street, he told them that he was in possession of two kitchen knives, and at that stage he said that he did not intend to harm others; later in an interview, he said that he was considering harming some of those he loved.

The detaining officers—the two police constables on the street—proceeded, quite rightly in my view, to detain my constituent’s son under section 136 of the Mental Health Act 1983. Given the information that his partner had provided the police and what he himself had said to them in the street, that seems to have been an entirely sensible step to take. Afterwards, as a standard procedure, the constables contacted their station sergeant. The sergeant instructed them to take him—let us just call him “M” for the purposes of today—not to a place of safety, that is the hospital, but back to Romford police station, where he would be interviewed under caution. That was done and the interview was conducted. There was no legal representation for M when he was in the police station and there was no appropriate adult present either.

I am almost certain that if the medical condition being experienced by the person in custody was physical rather than mental, that course of action would be routine—simply what was expected. That is what I mean when I talk about a culture change being necessary. We need to treat people with mental illness in exactly the same way as we would treat people with a physical illness.

In fact, M disclosed in the course of his interview under caution, which unfortunately was not tape-recorded, that he was hearing voices and that he had been on medication, but had stopped taking it because of its various side effects. At the conclusion of the interview, he was charged with possession of a bladed article ​under section 139 of the Criminal Justice Act 1988. He was seen by medical professionals at some point in the course of his detention. I eventually had to submit on behalf of my constituent a data subject access request to get the custody records to find out the names of those medical practitioners. I still do not know their qualifications or whether they had, as the hon. Member for Stretford and Urmston (Kate Green) mentioned, access to the records that would have disclosed his full treatment history.

My constituent’s son eventually appeared the next day, 28 April 2014, at Barkingside magistrates court. He pleaded guilty and was remanded in custody until 12 May for psychiatric reports. Those were not available on 12 May or 14 May—a familiar story for anyone who deals with the summary courts—and he eventually appeared on 21 May, when those medical reports were available. Unfortunately, at that point it was apparent that the probation service reports were not available. It was 11 June before his case was finally disposed of. He was admitted to bail on 21 May and sentenced on 11 June. He was placed on a community order for six months on the condition that he remained under the supervision of the police service. In the meantime, he spent something in excess of three weeks in Pentonville prison, on remand and in custody, and 24 hours in police custody over a case that ultimately resulted in a community disposal.

I have enormous regard for those who staff and manage our prisons, but I do not know of any body of work that suggests that people suffering from a mental health problem are ever helped by being locked up in prison. That is essentially the point here. If my constituent’s son had been taken not to the police station, but to a hospital where he could have been treated and stabilised at the earliest possible stage, an inappropriate use of resource would have been avoided and he would have got the treatment he required.

Following the community order, I became involved with my constituent and a lengthy correspondence ensued. Fast-forwarding to 12 February 2015, I eventually received a letter from a deputy assistant commissioner at the directorate of professionalism within the Metropolitan police—she is a fairly senior officer—that concluded that my constituent’s son’s

“welfare and mental health was correctly managed during his time in police detention and that he was assessed as being of sufficient mental capacity to understand his actions on the day in question.”

She concurred that the officers had “acted correctly.” Unsurprisingly, my constituent was disinclined to let matters rest at that point. There was further correspondence, including with somebody with the glorious title of “professional standards champion”. That was not particularly fruitful, and it led eventually to a complaint to the Independent Police Complaints Commission.

On 25 January 2016—this is getting on for two years after the initial incident—the IPCC upheld the complaint. It observed in passing that the constable who had been the original arresting officer had received management action in relation to the Metropolitan police’s mental health policy; I pause here to say in parentheses that the only person in this whole sorry saga who acted correctly was the original arresting officer. At every stage in the process, he seems to be the one who gets the training, the management interventions and the counselling. If this poor constable is sitting somewhere in a police ​station in London sticking pins into an effigy of me, I would not blame him, but he was never the object of our concern. It was the failure of those above him to implement their own procedures properly that has probably brought us to this point today.

Thereafter, the correspondence between the Metropolitan police and me discloses a culture that requires change. The concept of professionalism, a directorate of professionalism and professionalism champions seem to exist for the purpose of protecting police officers, rather than admitting fault, learning from the experience and moving on. Those things exist for the protection of colleagues, rather than the investigation of complaints. To this day, I still do not know the qualifications of the force medical examiner who saw my constituent’s son in custody. I suspect that having made a data subject access request, I will get that information if I go to the Information Commissioner, but the fact that I have to anticipate that tells us everything we need to know about how such complaints are handled.

In many ways, my constituent’s son is fortunate. The episode was not perhaps as acute as it might have been. He is particularly fortunate to have a mother who is an intelligent, strong-willed, determined and articulate woman. She was never going to be fobbed off with excuses or half-answers. Without the support of his mother in Orkney or the support my office has been able to give him through her being my constituent, I am pretty certain that these questions would have gone unanswered. I am pretty sure that the original arresting officer will be inclined in the future simply to do what he has been told by his superiors. In that way, the culture and the mistakes continue.

The Metropolitan Police Service could probably have dealt with this issue in April, May or June 2014 had they simply accepted that they made a mistake and apologised. They did not do so because of the culture that exists. I suspect and have good reason to believe—I speak often to police officers and others within the criminal justice system in London and other parts of the country—that that culture continues to exist. That requires change if we are to give people who suffer mental health illnesses and who come into contact with the criminal justice system the treatment and respect they deserve.

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8 Comments

  • Helen Dudden 4th Feb '18 - 7:22pm

    How upsetting it is for the family. Not forgetting the son totally out of his depth, and confused. It seems in some cases it has to get this desperate, before someone listens to his mother who obviously cares so much.
    There is nothing more frightening than another human being that longs to die, they have no future they feel, emotionally drained and seeing no reason. Those with experience of this with family members will understand how lost we feel, we have no control over what these members of our families wish to do.

  • Lorenzo Cherin 5th Feb '18 - 1:03pm

    What a shambles our public sector has often and for ages at times, been in.

    We have always had diminished responsibility, decided by experts, judges , and juries to an extent, we need to see the transparency far more, and accountability, in justice, for it to be worthy of the name or description. You would presume we had robust and humane procedures and treatments in tandem, but apparently no such thing , often.

    We must not lose sight , in our compassion and understanding, of the victims of crimes, often violent ones, committed by those who are mentally ill. Where this is so, that diminished responsibility must not be abused, anymore than the patients, whether criminal or not, should be.

    We do not have fully accountable public services, whether delivered directly or by companies. We eulogise too many too much. Those professionals who do a remarkable job with scarce support, are remarkable. My experience is there are a significant minority at all levels who are not.

  • Sue Sutherland 5th Feb '18 - 2:45pm

    I enjoyed Jennie’s account of the FPC meeting but failed to comment on it because I don’t understand the technology, so I’m asking here. Does this mean there will be no debate on the William Wallace paper the Left Behind? I’m about to frighten the dog by shouting rather loudly so please forgive me for being slightly (?) off topic.

  • Oh dear, Lorenzo, As the late Frank Carson might have said, ‘It’s the way you tell ’em’.

    “What a shambles our public sector has often and for ages at times, been in.”

    Well, how about …

    “What a shambles our private sector has often and for ages at times, been in.” ……. Evidence from a Pension Trustee to a Select Committee today, ‘Carillion borrowed billions from the banks to pay big dividends whilst they were failing to fund their employees’ pension fund.’

    “What a shambles our government has often and for ages at times, been in.” …..
    even when the Lib Dems were in there singing the virtues of austerity…. which might just have had something to do with the state of social care in England

    – the imminent financial collapse of Northamptonshire Council ; and the consequential state of the NHS ? …..

    – all those financially challenged academy schools – Carpetright shares anyone ?…..

    – the imminent closure of more private care homes (remember Southern Cross ?) and the record number of UK care homes declared insolvent. The failures mean that in total 421 care home businesses have collapsed since 2010.’ The Guardian, 5 May 2017 :

  • Lorenzo Cherin 5th Feb '18 - 8:44pm

    David

    As you speak, you worry me, surely a Liberal is less ideologue and more idealist. Where you feel the need to say what you say in response to my piece, baffles me, and , so does your view, which is completely one sided.

    I say

    “We do not have fully accountable public services , whether delivered directly or by companies. ”

    I never utilise the tired expression, which bit of that sentence do you not understand… but then again!

    If you can only think criticism of a service quality is not possible because it is against the public sector and for the private, you are not calling out, as they say today, power that is dominant , wherever it is.

    There is unaccountability throughout our services, whoever delivers them, at times.

    You only ever target the private companies. Mid Staffordshire was worse than anything we have seen, it was before the Tories, the coalition, and in the public owned and run NHS.

    I praise what is good and criticise what’s not. Any time any place anywhere…

  • Helen Dudden 6th Feb '18 - 6:48am

    We have Virgin Health services here, I live near Bath. Not the greatest start for them.
    Could I add, that mental ill health needs to have a constructive basis that prevents suicides and further issues for those with psychosis conditions. As written, it’s often difficult to get treatment. Of course, this produces situations becoming worse, often extremely worrying for all those concerned.
    Family members only wish the best for those with mental health, I speak that most of us, find the situation so difficult.

  • Helen Dudden 6th Feb '18 - 8:02am

    Can I add a further local article written on the online Bath Chronicle. It concerns a father of 47 years of age who very recently died. Again, this flags up the problems with depression.
    I have added my sympathy to his partner and family.
    The system is failing badly.

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