AIBU to think mental health crises should not be treated as antisocial behaviour

Ok they are not perfect but they are better than hanging around on a bridge waiting for police to show up surely?
Even calling a 999 ambulance is better than that although still not ideal.
Whats your better suggestion if you don’t like mine?

I mean the larger hospitals. My mother used to be admitted to one of these after her overdoses (antisocial personality disorder). They'd keep her there until she got so fed up she wanted out, then her behaviour would improve and she'd be allowed home.

A&E can't cope - I was there a couple years ago and there was a very distressed young woman there waiting for a mh assessment, iirc she'd already been there for 48 hours, wouldn't stay in a cubicle so was wandering around shouting, occasionally trying to leave. The staff were being incredibly patient with her, guiding her back to her cubicle, talking her into staying when she tried to leave, but it really wasn't the best place for her wellbeing, dignity or privacy, nobody seemed to have any idea how long she'd have to wait and it was taking up a lot of staff time.

Helplines are hit and miss in all honesty, many have limited opening hours and they can't diagnose or offer treatment.

Except that I did NOT say that

I said it’s rare for people on S136 police holding power to be psychotic and I stand by that. They are more commonly drunk or high in my extensive experience of conducting such assessments.

On the other hand it is self evidently very common for people on S2 or S3 to be psychotic and is probably the commonest reason to be placed on one of those sections. Most assessments that result in those detentions are planned ones and not emergency ones and indeed it is a mark of a poor service if there is a high S136 conversion rate as clearly those people should have been recognised and responded to in a planned way sooner.

The lack of meaningful mental health and addiction support sits at the heart of this. Extremely unwell people having to wait far longer than is safe for an assessment. Or left so that they become too ill to engage.

Of course the police shouldn’t always be the backstop, but criminalising people in this way is not a good way to manage this.

They do in a&e

anyway im clearly not explaining what I mean very well so ill give up 😂

Gosh they never stay in ours. They hand over to the S136 suite staff and go back on their way. Unless the person was extremely aggressive I suppose.

I waa about to say the same. Train driver family friend. Very unlucky because jumpers were quite rare where we lived.

Op, Is part of the asbo ban from the area?

Do you mean psychiatric wards? These do still exist, but the priority is for people who are acutely unwell so beds are limited. Do you mean the old style asylums where people stayed for longer periods as they struggled to manage in the community?
We have different legislation these days that means the least restrictive option always has to be considered first so detention isn’t always the go to

I meant the police have to accompany their section 136 to a place of safety and frequently stay with them for the 24 hours until section expires.

unless the place of safety is a police station of course

I wonder if there were fewer incidents like these when the mental hospitals were open. Not that they were great places of course, but you'd usually be detained until you were a bit better, assessed and started on some treatment. I don't remember the police's time being so taken up with people's mental health problems in past decades.

I agree.

The police should be solving crime not running around after the same people

I couldn't agree more with you OP. Whilst I sympathise that the police often pick up casework where there is no mental health support available, criminalising people will simply lead to less engagement and support.

I clarified on the previous page I didn’t mean to imply they had arrived in the ward on a section 136. They had been section 2/3 in a&e following admission under 136. It was in response to the poster who said it was rare for a sectioned person to be in psychosis.

There was a change recently so police are not having to deal with issues that really should be dealt with MH teams

unfortunately there just isn’t enough staff or they are often poorly managed so it falls back onto the police when it isn’t actually a police matter but then it can often become a police matter as the persons reaction towards the police

so I would be more inclined to loon to not where the police have gone wrong but where other teams have not supported your friend

People admitted onto a ward are likely being admitted under a section 2 for up to 28 days, or a section 3 for up to 6 months and it is reasonably likely that could be psychotic.

A Section 136 is for 24 hours and it is a police Power that they can bring somebody to a place of safety if they suspect a mental illness. In a significant proportion of cases these people may be drunk, intoxicated with drugs or very stressed after an argument with a boyfriend etc. It definitely does not mean that they are automatically psychotic or mentally unwell and need admission. Further assessment is needed.

Re the OP, this reflects the dire state of MH services, the lack of support for people in society, inadequate housing, poverty and so much more. It thus falls on the police’s shoulders and this must be an act of desperation on their part. Sad all round.

Then yes it is justified.
Think of how it would impact the person who found them, and anyone else who came upon the scene.
The moment they decided to attempt suicide in a public place it became anti social.

I don't think that would be a section 136. If they are being admitted onto a mental health ward, the likelihood would be section 2 or 3.
136 is specifically for situations where people need to be in a 'place of safety' (which can be a range of locations) for up to 24 (36?) hours to facilitate assessment.

I am not commenting on the specifics of your loved ones case. However, I can tell you from professional experience that there are people who significantly misuse emergency services and then blame a “mental health crisis” when it isn’t actually a mental health crisis at all. I think that is probably what these are aimed at trying to deter, I’m not familiar with these orders, so not sure on what basis they are issued and what criteria have to be met. That said, I would think this is aimed at repeat offenders, those refusing to engage with services appropriately, or those behaving recklessly where a mental health condition is not diagnosed, for instance.

In cases of misuse of emergency services, there is often something else behind it that is not a true “mental health disorder”, but the individual is not seeking help from the right sources (often despite being told to). For example: not uncommonly an underlying social problem; sometimes emotional distress but not an emergency; sometimes related to misuse of alcohol or drugs; not uncommonly personality disorder diagnosis. I do think the under-resourcing of social services, community resources, addiction services etc plays a part in this issue too.

By way of example of what I mean by misusing because of “crisis” which is not actually a crisis, at all- I know of one person who had action taken against them after a prolonged and protracted process (including warning that if behaviour continued there would be action taken against them) during which they misused gp, community mental health, hospital, police and ambulance services to such an extent that there was no choice.

This person had a personality disorder diagnosis, but from personal knowledge these “crises” were very actually true crises- somewhat distressed but not actually suicidal, often furious a request has been declined etc- if they did not a significant enough “reaction” from CMHT, would call GP, then escalate from there. On many occasions having two, three or even four of these services out in a single 24 hour period. On multiple occasions an ambulance out more than once a day. This individual would keep ambulances with them for long periods and in a quite rural area. There were multiple multi-disciplinary meetings including all services- taking up even more time and money. I can’t tell you the processes that were put in place- and money spent- on this individual for very little long-term progress.

At one case review, it was noted that tying up the service with this patient (threatening suicide if they left, refusing to be taken for mental health assessment as they wanted to go to hospital when there was no reason for an acute admission), meant that another ambulance had to be brought from out of area to another (actual) emergency and this patient had a delay in treatment which was catastrophic. It’s one thing if the service is stretched with actual emergencies- that’s a resource issue (and there is one within ambulance services across the country)- but when it is because of time-wasting, it’s an avoidable tragedy. I know this person was an extreme example, but the underlying narrative/behaviour is not uncommon. They just pushed it further than the vast majority, in this person’s case, threats of prosecution and then actually being charged did significantly lesson the abuse of services.

You don’t imagine the police make these decisions lightly, after a one off incident or on their own do you? There are interagency forums where such cases are discussed.

I’m sorry you feel it is not compassionate but I really think there is a lack of nuanced understanding here. It is possible to feel compassion for someone in distress and still to think that them going to a bridge repeatedly is an unhelpful behaviour that merits a deterrent.

Some people who go to a bridge really intend to end their lives but there are others for whom it’s a repeated maladaptive behaviour and they need to be deterred from doing this for their own sake as much as anyone elses because it does not help the person concerned either and there is a risk of them coming to accidental harm that accumulates the more they engage in high risk behaviours.

I would imagine there’s more to this than you know about which is why the measures were taken. I’m sure it wasn’t just a one off incident.