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

[Serencwtch]

TW: Some references to suicide.

In my local area Police have started a new initiative to reduce the demands & costs involved in attending to 'concern for welfare'/mental health crisis type calls.

They have issued a number of formal enforcement notices and warnings using Antisocial Behaviour legislation to people who have caused inconvenience through mental health crisis/suicide attempts in public places. These enforcements are community protection warning (CPW), Community Protection Notice (CPN) & Criminal Behaviour Orders (CBO).

I know one individual very well who has received one of these & they were very distressed by it & have now become very withdrawn & secretive. It's also difficult as a loved one as if I was concerned this person may be at risk I would be hesitant to involve emergency services as even a call to ambulance would likely result in police attendance & therefore have criminal implications for them. I also can see that it has increased their risk but in a more secretive & less public way. No doubt police consider this a success as they have not been called out to them.

I fully understand the pressures on police, I have friends & family that have served as officers & police staff. The funding cuts are every bit as bad as NHS or social care but with less public awareness.

This doesn't sit right with me at all. I think it's misuse of legislation designed to tackle antisocial behaviour & that a mental health crisis/someone attempting to take their life should not be labelled as antisocial behaviour.

The police will have care plans in place for many people in the local neighbourhood teams, this may include those with serious mental illness who are relapsing, and those with mental health issues that regularly present in crisis, for example due to trauma, and/or personality disorders. There are often multiagency decisions made on how to respond to those who regularly make threats to end their life or publicly self harm, taking into account the safety of the individual and wider public.

Taking a person to A&E to see a mental health nurse when they threaten suicide and call the police etc can only go on for so long, emergency services are not a finite service.

There is a lack of timely help and support for people. Mental health services are in crisis, even if someone has insight into their condition and begs for help there's often nothing that can be offered to them.

It isn't me, No.

I'm a middle aged woman with grown up kids, this is a teenager.

It is similar to my experiences when I was their age but these enforcements didn't exist at the time I was going through it.

There has been a significant increase in the number of people throwing themselves in front of trains in my area recently.

the general consensus is they are selfish bastards who inconvenience honest working people who just want to get home.

there but for the grace of god

On first read this seems an unacceptable approach from the police, hopefully it will be legally challenged.

The long years of funding cuts are resulting in some very retrograde steps from our public services, this is reminiscent of Victorian approaches to vulnerable people.

Well thst would be depend on their mental stare at the time of the incident ,somone who is currently stable would be accountable for their actions ,somebody who is a hypomnic state maybe less as their illness might be impacting them do much they maybe not be able to think or act with any clarity .

Have you ever been held up for 4 hours after a long day at work, knowing your child is stuck at nursery alone? Due to a suicide on a train track?

The person in question has no diagnosis of any mental health condition.

I wss responding to your earlier post

I've seen these issues ordered, been part of the process. It is much, much more complex than you are suggesting.

These patients have really tight care plans about where and when to access appropriate support, but instead call police, I had a patient who was causing up to 30 incidents a week, both by calling 999 and standing on bridges etc, it had been going on for years and wasn't sustainable

If someone is in a genuine crisis of course they should contact police, but it's vital that police are free to attend and not caught up with high impact users.

Yes. More than once. I’ve had to stay an extra night in a foreign country because someone chose to take their own life.

but here I am, still alive, not pushed to the point where I take an action that I know will end my life and therefore grateful

The person was detained under section 136 by officers a total of 4 times in the space of a year.

So they are repeatedly engaging in this behaviour? Taking up ambulance and police time? Absolutely they should be getting proper care after these episodes, and it seems that they are not. That is the injustice - not the attempt to regulate their anti-social behaviour.

There are many very desperately unhappy people who don't repeatedly draw the emergency services to themselves in this way. It does make sense to try and disincentivise an anti-social behaviour that might well have become a dysfunctional coping strategy,one which isn't really helping the person and may be preventing ambulances etc from going to other calls..

Someone else's child had died by suicide.

It's awful when it happens, traumatic for the drivers.

Try not to lose your humanity, it could be someone you care about one day who loses their child and in those awful times a little compassion goes a long way.

A friend trained as a police officer 20 years ago. Their probation beat included a well known suicide hotspot. One day they were called out, talked a person into the car and took them to hospital. Next shift the very next day, back to the same spot, and what do you know, it’s the same person again. Talk them into car, back to hospital, asked what happened: ‘oh it’s a cry for help, they don’t mean it, so not a danger so no section’. I imagine the situation has got much worse since then.

The police have suffered cuts like all public services have. They are the responders of last resort. They are regularly criticised for not doing their job, but they are having to pick up where other services are failing.

Perhaps this action is being taken to try to force the issue back to the services that should be the ones properly tackling mental health. Speaking out about it hasn’t helped - the police have done that before. so what else can they do?

This is the unfortunate place all our public services are and if I had the solution, believe me, I’d share it.

Okay, so what is the alternative? As you have said resources are stretched and wait times are long. I would imagine that that is why they have put these enforcements is place - as a deterrent. The only other thing that can be done is..well, nothing. That won’t change the wait times or increase resources in the short term. It may, however, be enough of a deterrent in some cases to avoid exposing others to violence or trauma that they had no say in being confronted with.

Not having a diagnosis doesn't mean someone doesn't have a MH condition.

The response to a one off crisis is rather different to the response to a habitual behaviour. I doubt a one off attempt would be treated as a criminal offence but a repeated pattern of behaviour might be.

There are a number of people in every area who repeatedly go to train stations/ bridges/ riverbanks when distressed and threaten to jump. This is not a good way to cope with distressing feelings and different ways need to be learnt eg calling a crisis line or going to A&E.

There needs to be a deterrent to this behaviour for everyone’s sake: it is a waste of police resources to respond to these calls and clogs up 999 lines when multiple people call in the same incident, it causes disruption to other people eg roads or train tracks being closed, it causes accidents when drivers are distracted and worst of all there is a risk of death by misadventure when clambering around a bridge and the more you do that the greater the risk will accumulate. In the long term it is a kindness and a risk reduction intervention to deter people from repeated public suicide threats.

The person has a history of trauma and is autistic.

In my experience with a severely anxious autistic child who struggled to leave the house at all and was constantly talking of suicide and self harm - and I mean that was their only topic of conversation for months -, who had harmed themselves and who had disclosed to a HCP that they had a plan for suicide... CAMHS did nothing.

Mental health services are notorious for pinning everything on the autism diagnosis and washing their hands of the person.

Is it not very possible that the two things (mental health crises and antisocial behaviour) aren’t mutually exclusive?

I was talking to a recently retired police officer last week. He said that when he started 25yrs ago, it was 20% mental health and 80% crime. By the time he retired it had flipped the other way and they were almost social workers.

The shite implementation of "care" in the community and removal of NHS mental health care (except 6 weeks crap CBT) seems to have fallen on the police.

My fear is that it would do the opposite. It may reduce resources on the surface but I think it could increase the risks of suicide & actually discourage someone from engaging with help for fear of police enforcement.

It could also make that person feel a sense of shame or as a burden on society. These are both strong factors in people who die by suicide.

It's also how we feel as a society about labelling distress as 'antisocial behaviour'

Yes.

But really…. Anyone could say that couldn’t they?

If someone persistently causes alarm or distress to others in public or does things that could harm themselves or others in public then something does need to be done about it.

If it is due the MH then you'd hope they could be signposted somewhere for help or fast tracked to seeing a psychiatrist but instead they just fine and criminalise them. Sad really.

I wish I knew how we could help people like that in a meaningful way.

I'm sure that the anti-social behaviour order won't have been made to save members of the public from train delays and similar inconveniences. It will have been made in an attempt to reduce the extreme pressure on emergency services, for example to reduce the likelihood of someone lying on the floor for ten hours because no ambulance can get to them.