Whose Line Is It Anyway?
I had a fascinating comment added to my blog The Other Way Aroundwhich has prompted me to blog on a question which has been bothering me for months.
In this blog I suggested that Crisis Teams need to be more flexible and responsive and I recounted the story of the suicide intervention from last week which involved about 30 emergency services personnel.
The comment I received was this:
Is this a joke? So a drunk person threatening self harm is an “ill” person requiring medical attention? Not sure which med school you went to.In reality it’s a difficult pers on you don’t know what to do with.Your answer: send a nurse to the house to do what precisely?Apart from putting themselves and the person at more risk. Have a nice chat? Put the kettle on? Remember vast majority are not ill. Precisely what the antipsychiatry movement predicted many years ago. Call it “illness” and medicalise it. Funny thing is though,it’s always people outside frontline psychiatry who do that. Emergency situation=Emergency Service.
To which I replied:
Interesting argument. So if I say it’s not a crime either and the police have no powers to deal with it – where does that leave us?
It a variation of this which has been playing on my mind for a while.
What is a suicide attempt and whose responsibility is it to deal with it?
The author of the comment was perhaps a little harsh. I have never been to Med School and they know it. I am not a clinician, nor a psychologist nor am I a psychiatrist. I have no medical training other than basic first aid.
I am a police officer, with many years of experience, whose “Boss”, the Home Secretary, has told me that my job is to “reduce crime – no more, no less.”
Suicide was decriminalised in the UK in 1961.
Even the term to “commit suicide” is a throw back to the days when it was a crime – in the same way as you commit any offence. It has not been a criminal act for over 50 years but the terminology hasn’t changed.
So if the author is right then it is not a medical problem. If I am right then it isn’t really a police problem – the police certainly have no powers to deal with it.
So whose problem is it – and is it, in fact, a problem?
It is not an offence but what would society think of any organisation which turned around and said “it’s nothing to do with us”?
The law places an obligation on the police to protect life under Article 2 of the Human Rights Act. It is a positive obligation unlike any of the the other articles. This means that if the police are presented with a life threatening situation they MUST do something about it.
A responsibility without powers to back it up.
I am not even going to pretend to understand the complexities surrounding mental health and suicide but to my untrained mind it boils down to one simple thing. Capacity.
Does the person making the threats to kill themselves have the capacity to make that decision?
How can you determine this unless there are professionals present who can use their training, experience and knowledge to make that judgement?
Remember – I am not a psychiatrist and I haven’t been to Med school.
Returning to the lack of powers to intervene – if someone is threatening to harm themselves in their own home then there are absolutely no powers to deal with it. Why would we resort to using archaic Breach of the Peace legislation and arrest the person when the Government of five decades ago decided that what they were doing wasn’t actually a criminal offence?
The government have not seen it necessary to amend that or add to the Police and Criminal Evidence Act or Mental Health Act in all those years.
We end up arresting someone for NOT committing an offence by calling it something else simply to get them help and stop them doing it.
If someone is threatening to commit suicide this does not automatically make them mentally ill. I know that. But it MIGHT mean that they are mentally ill.
Shouldn’t all agencies be involved until we know one way or the other?
The author says “emergency situation – emergency services”. This scares me more than anything else he said.
Why? Because it has reached the point of becoming an “emergency situation.”
There will always be times when, completely out of the blue, someone decides to take this final course of action but in most cases there are signs and signals.
Depression, previous attempts, involvement with a GP, even earlier involvement with mental health workers.
If it reaches the point where someone is stood on a bridge threatening to jump then has this earlier intervention failed?
Why has it reached an “emergency situation?”
What does this person really need right now and is there anyone around who can provide it?
If the person then jumps whose actions usually gets examined most closely? I would put money on it being the police via the IPCC.
If suicide, self harm or attempting suicide are not criminal offences – and they are not medical issues – then who should be dealing with them?
In the meantime – I will continue to do my bit as people would expect me to. I will continue to advocate for increased training and awareness across all the agencies. I will keep campaigning for someone to straighten out the legislation on this and clarify who should be doing what.
I have an obligation – both moral and legal.
Washing my hands of it – “your situation – your problem” – simply isn’t an option.