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I know one individual very well who has received one of these & they were very distressed by it & have now become very withdrawn & secretive.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.

If we can easily understand the aggressive nature of suicide threats in that context, surely it is easy to see that a subset of incidents repeated, public, suicidal behaviour are inappropriate attempts to control the police, NHS, social workers, friends and family.

This is exactly it.

I don't have access to reports. I assisted them with the complaints process & the police disclosed the decision making records at the time. Also SAR.

That’s exactly it. People who have been traumatised can learn maladaptive coping strategies. It’s not their fault but it’s not a good thing to be encouraged. People can get addicted to the drama of all the fuss and blue lights. Some people actually find being restrained containing even though it retraumatises them because a punitive response is all they ever knew. It is better for everyone that they are deterred from this pattern of behaviour themselves included.
If they live in supported accommodation wouldn’t staff support inside be better? Or calling a helpline to talk it through/ practice distress tolerance techniques? Or going to A&E and speaking to liaison psych there?
It is true that long term help for such conditions (cPTSD, EUPD, ASD) is hard to come by but that’s largely because such conditions are difficult to treat. Long term 1:1 therapy is very resource intensive which explains why wait lists are long.
It’s not true these days that there are no better options in an immediate crisis than a public suicide attempt. Calling 111 or Samaritans or texting SHOUT or going to A&E are all much better options that would help with the immediate crisis.
Going to a public place and threatening suicide does not result in any accelerated response anyway as you see in this example (they were repeatedly not admitted to hospital as inpatient care has nothing to offer them beyond immediate containment)
Of course a police deterrent action like this is not the best immediate response to a one off episode but on the 4th occasion it seems justified to me and might benefit the person in the long term if it redirects them to safer and more helpful coping strategies

My exh was prone to all sorts of wild behaviour that were attached to a similar profile of mh conditions and self medication leading to escalating dangerous and abusive behaviours. My brave daughter eventually reported him and lo And behold, two years go by while this is processing through court and his behaviour has been impeccable. People with MH problems also need to see there are consequences to actions, particularly when there is harm to others. Who knows what goes on in the subconscious during a crisis but in my limited experience, it makes a difference.

Is this all "cry for help" stuff, or does this person genuinely want to end their life? The police are not mental health services, sadly. There might actually be no help for this person. How sad and bleak, especially if they are a teenager. What help do they actually want or expect?

Agree with this. My dad has psychosis with mania (similar to bi-polar) and repeatedly called 999. He was definitely "wasting resources", as you put it. He was also abusive, physically and verbally, though thankfully the physical side of things was limited due to his age - we suspect his issues were triggered by dementia (he was 80). Did he have a formal diagnosis? No. He had an 'unusual presentation' that meant he died before a diagnosis was made, though we were edging closer to one. Would slapping him with some sort of police order stopped him? Absolutely not. Would it have made things worse, particularly for my mum, who was caring for him? Yes.

I know that seeing people like my dad is frightening and not OK in any way - but honestly, he was off his rocker. Well beyond any kind of reasoning. That is unfortunately the nature of the beast - because if a person wasn't in a crisis, they sure as anything wouldn't be behaving the way they are.

It's very hard, when faced with someone behaving appallingly, as my dad did, to be able to remember that they're not just some vile person. That they're ill. I get that. But the answer is not criminalising mental health. It's better mental health provision.

I am hugely sympathetic to the police and also the ambulance services - the police especially are bearing the brunt of mental health service under-funding - but arresting people for essentially being ill is not the answer.

I think it’s a great idea and should be enforced around the country. People who cause inconvenience and/or harm to people/property due to mental health should be held accountable for that.
There’s been multiple instances of people being hit by trains recently, I guarantee most if not all of those were a suicide attempt. It causes trauma to the driver and passengers, disrupts everyone’s day, takes a public service out of action and the person who’s caused that should be held accountable such as with criminal charges.

Some people with severe and enduring mental.illness ,will not be able to see how their behaviour affects others due to how their illness impacts others
Somone who is in a state of acute psychosis for example may quite literally be outside.of reality .

That’s exactly it. People who have been traumatised can learn maladaptive coping strategies. It’s not their fault but it’s not a good thing to be encouraged. People can get addicted to the drama of all the fuss and blue lights. Some people actually find being restrained containing even though it retraumatises them because a punitive response is all they ever knew. It is better for everyone that they are deterred from this pattern of behaviour themselves included.

This states things so well, and also makes it clear that attempting to set boundaries (by using the anti-social behaviour legislation) doesn't need to be regarded as a harsh/hostile/unempathic response. On the contrary it can be unkind to simply ignore the pattern of behaviour and keep on responding to each incident as if it was a one-off, in ways that reinforce a painful and dysfunctional coping strategy.

Provided all the professionals involved work hard to speak respectfully and without visible anger and frustration to people behaving in this very challenging way, they may well be doing the right thing for them.

It is hard to remain respectful and humane when you can see that a person's distress is causing them to be coercive and manipulative, but provided that the police and other professionals meet that threshold of decent behaviour, then they should be able to feel positive about the solutions that are provided by anti-social behaviour legislation.

?

If my child saw someone jumping off a bridge to kill themselves…. My sympathy would lie with my severely traumatised child and I would see my child as the victim

How long ago did this happen? Is the complaints process ongoing?

In the last two years I've been involved with two situations involving the devolving mental health of two individuals, one my elderly SM and one former friend in middle age. Both were obviously suffering immensely, and I was absolutely gobsmacked by the way the system dealt with them, and those close to them, including myself in terms of waving off obvious risks to both themselves and those close to them.

My SM was routinely found to have capacity, so after a brief section was lifted allowing her to go home to my frail 84 year old Dad, she became physically abusive, he ended up homeless and at the mercy of the LA and in my opinion died prematurely a year later partly due to the stress. However, he was expected to just "get over" the demise of his 40 year relationship, while my SM had every kind of support going. While age related complications were involved, SM had a history of MH issues that read like war and peace, and the over arching sense I got was that they were old and going to die soon anyway, so resources were limited. My own MH is rocky now, but I'm just dealing with it by being reclusive.

I can't post about the other situation, for complex reasons.

But in both cases despite regular appeals for help from those close to them who could see catastrophy looming, professionals claimed that they were constrained by the system and could only act if the crisis was "big enough".

In terms of criminalising the behaviour sometimes associated with acute mental health crisis, I don't know what I think to be honest. My SM seemed to think she was above the law and just didn't care. The former friend just wanted to punish anyone that wouldn't bend to their will. Both these cases show that because their minds are disturbed, the impact of such measures may be limited in terms of helping them navigate their distressing behavioyrs and the consequences.

It's desperately sad and frustrating and also scary for all concerned, and I often wonder what it is about modern life that is contributing to the rapid escalation in mental health deterioration for so many people.

So I stand in solidarity, but no little bewilderment, with anyone dealing with such issues, whether suffering themselves, or observing the suffering. It's incredibly sad, and I wish that some services would pay just a little more attention to people trying to inform them that a crisis is looming, which might prevent some of the scenarios these criminal measures are clunkiky designed to address.

It's a new pilot scheme in the force area. Rolled out at start of last year.

Yes complaints process is ongoing.

SIM was widely criticized & challenged & then abolished I think in 2022 but this scheme is new & I know very little about it.

I'm more interested in the policy itself & interested in what goes on in different areas.

The individual case & details is not my story to tell.

The person dying by suicide is someone's severely traumatized child.

The thing is that as terrible as it sounds, it doesn't mean people should be silent about "passing on the trauma".
Are you suggesting that people just shrug and "be kind" when these things can affect them and their loved ones in quite a significant way?
That's imho not particularly helpful outlook which will help general public being more understanding of MH issues.

If that makes sense.

And?

we can go around in circles here.

But 4x on 6 months - i hate to say it but if they were serious they’d have taken an overdose in their bedroom. Instead of a shit load of drama, inconvenience, police time and expense.

So hopefully this order will stop a 5th attempt in such a way as to result in so many people being inconvenienced and valuable time and money spent

You already have the SAR?

Why should members of the public-possibly children, possibly people struggling themselves, have to witness a suicide attempt? Standing on the tube platform, seeing someone throw themselves in front of a train could mean life long trauma for many people. Seeing someone throw themselves from a high building would have the same effect.

Why should anyone have to suffer any problem at all, like being stuck in traffic for hours while someone has to talk a person down from a motorway bridge. This happened to me, I was taking a friend for radio therapy treatment. The motorway was closed and we had to go all around the houses with masses of cars trying to do the same thing. It caused a lot of angst.

I am sorry for anyone who has reached this point and more help should be available but don't make exiting your life destroy or hamper the lives of others. How does that benefit you or anyone?

I’d feel very little aside from anger if someone chose to choose to end their life so publicly and my young children witnessed it all and it impacted them for life

What is SIM

This poor medical student was paralysed by someone jumping and landing on her. All he got was a leg fracture
https://www.theguardian.com/lifeandstyle/2019/nov/01/experience-i-was-crushed-by-a-falling-man

That is appalling, @PaleAzureofSummer

It was a controversial mental health pilot which was widely criticized by experts & mental health charities. It was based on a lot of judgements & assumptions with very little evidence. It was abolished by NHS England.

Try googling SIM/HIN mental health or serenity integrated monitoring/high intensity network Paul Jennings. You should find links to the NHS England statement etc.

that is a tragedy. Poor girl