The decision last week by the Metropolitan police commissioner, Sir Mark Rowley, that in future his officers will attend emergency calls related to mental health only where a threat to life is feared, was both a wake-up call and a threat. His letter, and deadline of 31 August, have raised the stakes in negotiations with health bosses. The danger is that his combative approach will undermine attempts to find a solution to a problem that no one denies.
Sir Mark is right that people with severe mental illness should be looked after by health workers, not police. The enormous amount of time that his officers spend in A&E departments with mentally ill people waiting to be treated should be reduced. Situations such as the one described last year by the former West Midlands chief Sir David Thompson, in which a child having a mental health crisis lived in a police station for two days because there was nowhere else for her to go, should shame us all.
In Humberside, a scheme called Right Care, Right Person resulted in 1,100 police officer hours a month being clawed back as health practitioners took over tasks that were previously done by them. The scheme attracted plaudits from the police inspectorate. This is the example that Sir Mark aims to follow as part of his plan to put his discredited force back on its feet.
This is a sound idea. Humberside police has been judged the best force in the country, and successful innovations in public service should be copied. But the Met is a special case. At almost 20 times the size of Humberside’s service, with 43,000 officers, it is a huge organisation with responsibility for policing a growing city of almost 9 million people. Its relationships with local health and care services are far more complicated than in a smaller area. In London, there are five integrated care systems (partnership organisations that plan and deliver care). Given how overstretched these services already are, it is alarming to learn of the capital’s police chief announcing a unilateral withdrawal.
Hopefully, the response to his letter will convince Sir Mark to work with, rather than against, local health and care bosses. It should also focus the minds of politicians. It is widely recognised that failings in one public service have knock-on effects on others. The best-known example is the burden placed on hospitals by social care shortages. Sir Mark’s announcement has drawn attention to the impact on police of inadequate mental health provision.
But while it is useful to highlight such pressures, they will not be reduced by ultimatums alone. Referrals to NHS mental health services in England increased by 44% between 2016-17 and 2021-22, and expansion of the workforce has not kept pace. Police and health commissioners should work together on securing the investment that would make a new approach work (separate waiting areas in hospitals, for example).
Sir Mark knows that public confidence in the Met is at a low ebb. His task of rebuilding the organisation will not be made easier by fights with health bosses. Ultimately, the responsibility for the worsening situation lies with a government that has underfunded public services, particularly the kinds of preventive and ongoing support from councils that help people with poor mental health. New tensions between frontline emergency services are a symptom of a crisis that has developed over the past 13 years.
