A Drama Out Of A Crisis

A tweet from Surrey’s Chief Constable Lynne Owens really struck me this morning. It said this:

“My officers & staff have been dealing with 3 high risk missing people overnight. The continual increase in these cases is concerning”

 

It got me thinking back to last week when, in my role as incident manager for the force, I felt deluged by the sheer volume of these kinds of calls.

Part of my role (in addition to the firearms element) is to initially review the risk of every single missing person reported to the force. On two shifts last week, by the time I had got to about the twelfth in relatively rapid succession it was becoming  unmanageable.

On one of these days we had no less than 7 cases that I considered to be high risk. This is not a decision I reach lightly or without much consideration.

There are four grades applied to missing people reported to the police:

ABSENT – where someone just isn’t where they are supposed to be (often the caller knows where they are or are likely to be.)

LOW – where someone’s whereabouts cannot be established and there appears to be no danger.

MEDIUM – where someone’s whereabouts cannot be established and there is a likelihood of danger.

HIGH – as above but where that risk is immediate (and therefore likely to be a risk to life – theirs or someone else’s.)

The decision on classification is not fixed and can be reviewed, lowered or escalated as an investigation continues.

Here are some examples for you to consider:

1. A 15 year old girl missing from a care home for the third time in a week. It is perhaps the 25th such report this year. Her whereabouts cannot be established but it is likely that she will be with friends or associates and possibly older boys or men. There is a likelihood that she will be drinking alcohol or even taking drugs and she is she is at risk of sexual exploitation having been sexually active for at least 2-3 years already.

2. An 79 year old dementia sufferer who has not been seen in their residential home for two hours. This has never happened before.

3. A 33 year old male who has just sent a series of text messages to his former girlfriend indicating “I can’t take any more.” “Life isn’t worth living” “Say goodbye to the kids for me.” This follows the break up of their relationship and his failed attempt to reconcile. She is convinced that he is going to harm himself.

What would you grade those as?

All three types of calls are extremely common. Very very common.

I don’t want this to be a political blog but you will no doubt remember that the Home Secretary has said on a number of occasions that she wants the police to be “single minded crime fighters.” That their mission is to “reduce crime – no more – no less” and she has recently rejected evidence from the College of Policing which states that as much as 80% of police work is not crime related.

Now look at those examples again and ask which are crime related.

Example 1 is most likely but look how often it has been reported to the police previously. It is quite likely that several crimes are being committed here including by the missing person themselves but this situation has been going on repeatedly with no positive outcome. The protocol of the care home is to call the police whenever she does it. It is a never ending cycle. The criminals here are those taking advantage of the missing person but the regularity with which it occurs suggests that little is having an effect in protecting her from their actions or dissuading her from placing herself in danger.

Example 2 might have a crime element to it if you consider the possibility that the elderly person may have been taken from their home or may be being criminally exploited by someone. These are possibilities which cannot be discounted but the most likely outcome is that they have wandered off – possibly confused and disorientated. There is no crime in these circumstances.

Example 3 there is no criminality at all. It is not an offence to commit suicide or to attempt to commit suicide if those are indeed his intentions. The only issue at stake here is whether the person intends to kill themselves.

In all three of these examples there is no-one else who will look for these people.

In example 1 it is all too common to hear that staff at the care home cannot / will not go looking and it is their policy to call the police.

In example 2 I have often found that staff will look and help in the search but I have found examples where they haven’t.

In example 3 it is the police. There is no other agency who will respond to this and yet it is the one example where there is no hint of criminality at all.

What Lynne Owens has noticed (and I have also noticed) is that these types of report seem to be increasing. I would need to have proper data to be sure of this and it may just be a sense which is actually not true but from where I sit there does seem to have been a rise in the number of people being reported missing to the police where there is a risk of suicide.

The question is – why?

Is it a societal issue? Have things become worse for people over the last few years where they feel this is a viable option?

Is it a lack of care further upstream and before it reaches crisis point? Have they even sought care? Does it exist? Is it being tried and failing?

There is a problem with the term “crisis”. I would determine the person in the last example is in crisis but that might well not be a view shared by a mental health crisis team. I have been told many times that just because someone is suicidal does not mean they are mentally ill.

If a situation doesn’t meet the specific criteria of the definition of a mental health crisis then the crisis team are unlikely to come out. They certainly won’t look for people. It isn’t their job they say. They deal with them when they are found.

If it isn’t mental health and it isn’t crime then who should deal and why?

This last few weeks has also seen an increase in the number of people calling us (or being reported by witnesses) from high places – buildings and bridges. It simply isn’t true that if someone calls in they are less likely to go through with it. I have seen the opposite happen far too often to believe that.

This then involves suicide intervention. Another skill which most police officers have zero training in. We have access to negotiators but they can’t always get there quickly enough and the person won’t always engage.

Again, there is no crime here and yet it is the police who have the only capability to respond and deal.

If police do not respond in a timely way to any of these calls or get the risk rating right and a death occurs then it is likely to lead to a full blown investigation by the IPCC.

Most high risk cases are usually resolved within a shift or two. This does not mean that they weren’t high risk. The person is usually found and then there is the issue of what to do with them.

In examples 1 and 2 they are likely to be returned to the care homes.

In example 3 it is possible that they may be detained for assessment under the mental health act but it is very rare, in my experience, for someone to be sectioned after such an incident. I’m not saying that this is wrong – just that whatever follow up is arranged instead needs to be swift and preventative.

The issues are these:

If demand on the police is rising in terms of dealing with people in crisis someone needs to be asking why.

What else is available earlier in these situations to prevent things reaching crisis point?

Are we all aware of these, signposting them and talking to each other?

They also need to be asking if it is right that the responsibility falls to the police.

If it does fall to the police then what training are we giving people.

Are the classifications used by police to grade such reports too narrow? What criteria is being applied and how much of it is driven by fear of future IPCC inquiry? How many are being under graded through complacency?
Is there a role for organisations like Samaritans to become involved (at cost) in the intervention process? Do the police HAVE to go to every report of a suicidal person?

I think there are many other questions to be asked as well but one thing is clear – I agree with Lynne Owens in that this is an escalating issue placing increasingly huge demands on police resources. It can take all available officers several hours to bring a situation like this to a conclusion. Whilst doing this they are not available to do anything else.

I just wonder if anyone else from any other organisation is actually asking the same questions.

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3 responses to “A Drama Out Of A Crisis”

  1. J says :

    Strangely enough I responded the other week on local radio to comments made by CC Lynne Owens as I have been a missing person myself. I said and stick to this that several times had I been given the proper help up front from the mental health services then the police probably need not have been involved. I am in agreement that too often the buck stops with the police. Once upon a time if I rang the crisis team and was assessed as at risk they would come out themselves now they don’t even bother to talk with me they just dial 999.

    I will give a similar eg Last friday having been staying in a crisis bed following a visit to A&E the previous weekend despite saying that I still felt suicidal I was discharged home. I live alone. Now that left the weekend to get through when the normal mental health service is shut. I was acutely distressed and I rang mental health services. No help forthcoming. Over the previous 3 weeks the crisis team had been too busy for referral or when referred to too busy to visit. I drove around for many hours in distress & I found out later someone was about to report me missing. I did eventually go home and with serious intent attempted to end my life. I was found the next day by a visiting family member – still alive obviously. Then the farce began. The paramedics arrived I was just about ok enough to refuse to go to hospital and went back to sleep. During the next 5 hours the mh crisis team were too busy to come out, the police were contacted to section me (presumably section 135 as I was in my house) and finally because the ambulance had been off the road for so long a paramedic manager persuaded me to go to A&E. I reluctantly went knowing that despite me having a high risk rating I would probably be discharged. I ended up walking home (5 miles) first thing sunday morning. I slept most of the day. I now get daily visits from the crisis team and from a care agency.

  2. AH says :

    Couldn’t agree more . I have been away from operational for two years . I have now returned and I am utterly convinced high risk missing persons and concern for welfare calls have significantly increased. Managing resources to deal and keeping the show on the road is very difficult

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