Protecting people in mental health crisis

Charlie Waller CEO Clare Stafford looks at the issues.

Reports that the Metropolitan Police will stop responding to 999 calls about mental health incidents are concerning. In a letter to health and social care services, Metropolitan Police Commissioner Sir Mark Rowley has suggested that from September, officers will only attend calls where there is immediate threat to life.

He argues that this will free up officers, after a significant rise in the number of mental health incidents being dealt with by the force in the past five years. However, the move threatens to leave vulnerable people in limbo because health and social care services simply don’t have the resources to replace the work carried out by police officers. If the police don’t attend, it will lead to greater distress and potentially loss of life.

Safety net

The police have become a vital safety net when nothing else is available. The NHS and social care have come under increasing pressure with rising demand and a shrinking workforce.

People are reaching breaking point without getting any support and, too often, the police are the only public service that responds to someone in crisis.

At the same time, the economic crisis has resulted in more serious and complex mental health issues. People are reaching breaking point without getting any support and, too often, the police are the only public service that responds to someone in crisis. They do have a role, but they should not be the default primary responder.

Mental health crisis agreement

The Mental Health Crisis Care Concordat was established in 2014, setting out a national agreement on how services and agencies should work together to make sure people get the help they need when they are having a mental health crisis. Despite those intentions, the provision of local health and social services remains fragmented. For example, an area may have a great crisis house run by a charity but there’s no consistency and systems are not integrated.

Crucially, there is a lack of staff in key roles, such as community psychiatric nurses. A consequence of this lack of immediate support is that it can take far too many hours before a police officer can hand over a patient.

Approaches that work

There are approaches that appear to be working. For example, Humberside Police introduced their Right Care, Right Person strategy in 2020, which deploys officers to only the most essential mental-health related calls and diverts the rest to health services in the call centre.

Emergency call handlers have been given extra training, working alongside experts from Mind, and the clinical commissioning group has funded additional mental health crisis suites and assessment beds.

In some areas, ambulance trusts are also providing crisis services, such as a dedicated ambulance response car with a mental health nurse and a paramedic, who can triage patients to mental health services.

Need for investment

It's important that we look at the data and the evidence, rather than having a kneejerk response to the Commissioner’s statement. However, it’s clear that we need to see greater investment in public health and mental health services, both to prevent crises happening and, when they do, to ensure people get immediate help in a safe place.