‘The impact of mental health bed pressures goes beyond the NHS’: a police officer’s story

A police officer who blogs under the pseudonym Nathan Constable shares his experience of mental health emergencies

The toll that problems with mental health bed availability are taking on patients and mental health professionals is clear from the examples gathered by this week’s investigation by Community Care and BBC News. As a police officer I can also attest that the issue has a profound and daily effect on our work, and our emergency services colleagues.

I am aware of a recent case where a person in crisis was detained by police three times in a week only to be allowed to go home each time because there were no beds, or alternatives, available to send them to. With each 999 call the situation had become more desperate. The last call was because the person had attempted to take their own life and ended up in A&E.

We also know from this week’s investigation that the pressure on beds means people who do get hospital care are being discharged too early only to relapse and need re-admission shortly afterwards. When this happens it’s highly likely that the police and ambulance services will have been involved in the ensuing crises.

Children are impacted too, and not only in the fact they are being admitted to adult wards as Community Care found. I know of several cases where children as young as 12 have been held in police custody for mental health assessments because there was simply nowhere else to send them.

I am one of the increasing chorus of people who believes that a police cell is the very last place a person in mental health crisis should be taken. My objection doubles if this person is a child or elderly person.

Yet, at the moment we seem to be locked in a terrible cycle which is entirely the fault of the system:

    • A person is in crisis and needs treatment.
    • There is no space for them or their treatment is curtailed.
    • They return to their homes without being properly treated.
    • The police, ambulance and crisis/home treatment teams are involved in the next crisis.
    • And so on ad infinitum.

This kind of situation can happen to one person several times in a matter of days. I am not medically qualified in any way shape or form but it feels like bed space is now largely reserved for people at the peak of crisis. There is no slack in the system for those who might benefit from a temporary – even voluntary – period in a ward.

In recent months I have dealt with two suicidal people who have gone missing after they have attempted to self-admit to a psychiatric hospital. They felt that their illness merited hospital care, they were desperate for help, but the system would not allow it and so they felt there was no other way out. One person took their own life.

We have a system that is rife with what we call ‘failure demand’ – treating the same issue over and over again because there is no adequate first time solution. One has to ask who is actually benefiting from a service that works like this? The NHS and emergency services aren’t and the patient certainly isn’t.

For frontline police officers this has a daily impact. Whether it be through call-outs to situations where people are in crisis, people in crisis AGAIN, suicidal people, missing people, detaining adults in cells, detaining children in cells, the police have become a vital part in holding things together. If feels like we’re propping up a crisis service that cannot cope with demand.

The cost of all of this must be truly staggering. Think about all the money spent on out-of-area placements and the cost of all the other agencies – the police, the ambulance and more – that are being called to firefight the repeated crises people find themselves in when NHS beds aren’t available. It feels that, not only is this system poorly serving patients in crisis, but it must also cost more than if proper provision was available in the first place.

The answer is simple. Invest more money in ensuring that mental health provision is adequate and allow those who can treat it best – mental health professionals – the resources they need to do so.

The volume of work generated for all professional agencies involved is massive. Most of it is spent treating the same issue over and over again because there is no adequate first time solution.

Frontline policing has a role to play in mental health but we are not geared up to deal with people in acute mental illness who need urgent, emergency care. The problem is – at the moment – the NHS’s mental health services aren’t either.

Follow Nathan Constable on Twitter and his blog on policing and mental health.

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One Response to ‘The impact of mental health bed pressures goes beyond the NHS’: a police officer’s story

  1. Alan October 23, 2013 at 6:41 am #

    He is spot on. I know of one who called the crisis team and was advised to go to A&E, they are not equiped to deal with this sort of emergency. The person concerned waited over five hours to see an appropriate person and was told to come back to their next outpatients appointment in a weeks time. Nothing else was offered. I also witnessed a 15yr old being assessed by a pychologist at CAMHS who insisted there was nothing wrong with this person despite them self harming whilst being assessed. As a carer for 27 years and as a Counsellor for the last three years I have yet to see any evidence that mental health care changes has actually improved anything for those who are in need.