Home AffairsWritten evidence submitted by Black Mental Health UK [IPCC 23]

Executive Summary

The purpose of this submission is to highlight the need to ensure that the issue of deaths in custody as it relates to mental health services users and ethnic minorities is included on the agenda of the Home Affairs Select Committee’s (HASC) inquiry into the Independent Police Complaints Commission (IPCC).

People who use mental health services account for 50% of those who lose their lives in police custody, and it is in the area of mental health and policing that many of the most serious causes for complaints against the police occur.

Detention rates under the Mental Health Act continue to be highest for people from the UK’s African Caribbean communities, even though there isn’t a high prevalence of mental illness amongst this group. Black people are currently 50% more likely to referred to mental health services via the police than their white counterparts.

The high profile, deaths in police custody, cases of Kingsley Burell-Brown, Sean Rigg, Olaseni Lewis, Colin Holt, Mikey Powell and Roger Sylvester is further evidence that failures in policing of mental health services users, which is impacting people from Briton’s black communities in greatest numbers.

The unsatisfactory way in which a long line of complaints involving high profile police deaths in custody of people from this community has been dealt with over the years has shattered faith in the belief that the IPCC is an independent body with the ability to investigate complaints made against the police without bias. In light of this, BMH UK is using this submission to highlight the pressing need for a judicial review into how all deaths in custodial settings are handled.

Mental health service users also account for 61% of all deaths of those detained by the state, but currently there is no independent body established for investigating these fatalities.

This submission is also being made to highlight the need for the establishment of an independent agency to investigate preventable death of those detained under the Mental Health Act.

Introduction—About Black Mental Health UK (BMH UK)

Black Mental Health UK (BMH UK) work in the area of public policy with a focus on the over representation of people from the UK’s African Caribbean communities detained in medium and high secure psychiatric settings.

We work towards educating and informing the communities over represented within custodial and detained setting about the latest policy developments and equip those most affected by these issue and other injustices to lobby for positive change. Also an online publisher we use our website, www.blackmentalhealth.org.uk and online magazine, entitled The Solution, to raise awareness and address the stigma of this health condition within the communities most affected but least informed about this issue.

BMH UK’s The Solution Magazine is the only publication of its kind with a focus solely on the African Caribbean experience of mental health and mental health services.

Information BMH UK would like the Committee to Consider

1. Mental health and policing.

2. Prone restraint.

3. Tasers: lack of accountability in the overuse of force.

4. IPCC complaints procedure.

5. Deaths in custody.

6. Police presence on psychiatric wards.

7. Independent scrutiny of mental health service users deaths.

8. Recommendations.

1. Mental Health and policing

1. Police officers often have a significant role to play in mental health services1 and are commonly the first point of contact for a person in a mental health crisis.2 The police have specific powers under the Mental Health Act 1983 to intervene in a case where an individual appears to be in an immediate need of an assessment. Up to 15% of incidents with which police deal are thought to have some kind of mental health dimension.3

2. People with mental ill health rarely commit serious crimes and are at greater risk of becoming victims of crime than the general population.4 The linking of the perception of dangerousness and resulting stigma around mental illness with negative stereotyping to other areas such as race, is particularly damaging and there is no evidence to support this stereotype.5

3. BMH UK have observed that it is in the area of mental health and policing where the most tragic outcomes occur. This is borne out by data from the IPCC which shows that 50% of fatalities which occur in police custody are of mental health service users.6

4. Although responding to situations where people are experiencing acute mental distress is a significant aspect of policing, some police departments do not feel that their general response is a good one.7

5. People from the UK’s African Caribbean communities are 50% more likely to be referred to mental health services via the police than their white counterparts.8

6. In almost all cases mental health service users held detained in police custody under S136 of the Mental Health Act are left feeling vulnerable and distressed.9 This experience increases paranoia and the feeling of being criminalised.

7. Research shows that some people with mental health problems held in police cells as a place of safety have been strip-searched, left naked in a cell, left cold, hungry and thirsty, not given the medication they needed, been restrained by more than one officer and been insulted or patronised.10

8. There is a commonly held view among the UK’s African Caribbean communities that police cells are not a place of safety, in fact they have the opposite effect, with a lot of black men dying in police cells and families never actually have a satisfactory answer as to why.11

9. The recent tragic cases of Sean Rigg, Olaseni Lewis, Colin Holt and Kingsley Burrell-Brown have reinforced this view. This is also borne out by data published by the IPPC which shows that black people account for 20% of those who die in police custody even thought this group are just 2.9% of the national population.12

10. Although police are routinely involved in the detention under the Mental Health Act, officers are not mental health experts and do not have the training or resources to deal care for a vulnerable person in need or urgent mental health care.13

11. The treatment of mental health service users by the police has shattered this community’s confidence in police services and the police complaints system at the IPCC as it viewed as being staffed completely by police.14

12. BMH UK would welcome the HASC including the issue of mental health and policing in their inquiry in order to look at ways public confidence among some of society’s most vulnerable group who come in contact with police services can be improved.

2. Prone restraint

13. There is a growing body of research that has raised particular concern about deaths involving ethnic minority men following police restraint.15 Cases involving Black people and those of mixed ethnicity form a greater proportion of those restrained.16 The UK Parliament’s Joint Committee for Human Rights notes that between 1998 and 2003, 18% of those who died in police custody overall were from ethnic minorities, and restraint was involved in a higher proportion of the deaths of people from ethnic minorities coming into contact with the police (22%) than of White people (12%).17

14. Over one-third of cases in which a black detainee had died occurred in circumstances in which police actions may have been a factor (the proportion raises to almost one-half if the cases of accidental death where the police were present are added); this is compared with only 4% of cases where the detainee was White.18

15. The police continue to use restraint techniques that have been attributed to deaths stretching back nearly two decades. Guidelines do not bar any particular holds but say that the use of force must be lawful, proportionate and necessary.19

16. The numbers of fatalities, particularly involving mental health service users shows that there are “fundamental problems in the effectiveness of police training in restraint. There is an ever present risk of death or serious injury.20

17. This submission is calling for fresh parliamentary scrutiny through this HASC inquiry into the way often distressed mental health service users are restrained by the police.

3. Tasers: lack of accountability in the overuse of force

18. Despite an overall increase in of police contact with those experiencing mental distress, they are not trained to deal with such situations, which they are facing on a daily basis. This could account for the over use of force when dealing with people from the UK’s African Caribbean communities in urgent need of mental health care. There is a growing level of public concern over the disproportionate use of Tasers against people from the UK’s African Caribbean Communities and particularly those who use mental health services.21

19. There have been a series of high profile cases which have raised questions about their use, including case of an Alzheimer’s sufferer who was Tasered in his home when he refused to go into care.22 Another incident involving a 25-year-old graduate with a history of mental illness, who was Tasered in his groin after officers, shot him five times with live bullets.23

20. BMH UK is also aware of a mental health service user who was Tasered while handcuffed and in the caged area at the back of a police van.

21. These cases make the use of Tasers very much a live issue for professionals in the health and social care sector.

22. BMH UK are aware of cases, where because of lack of capacity, mental health services users are unable to make complaints about their treatment or have missed deadlines for appeals during the complaints procedures because of the absence of support.

4. IPCC complaints procedure

23. The practice of referring complaints back to the station where the incident may have occurred raises questions of independence when it comes to investigating complaints against the police.

24. The requirement to attend the police station where the offense may have taken place acts as a prohibiting factor for many people who would like to make a complaint because of fear of coming in contact with police again after what has often been a traumatic experience when in custody, (usually while detained under the Mental Health Act).

25. The added restriction of the time limit for making a report means service users who believe that they have been subject to coercion unjustly often do not have the capacity to respond within the window of time available. This excludes them from any recourse to have their concerns addressed and further reinforces negative perceptions of the force and systems that are established to monitor their performance.

5. Deaths in custody

26. According to the Equality and Human Rights Commission Triennial Review, people who use mental health services are more likely than those without to die during or following police custody.24 This is confirmed by the Joint Committee on Human Rights report into deaths in police custody, which found that just over half of those who died following contact with the police had shown signs of mental health conditions.25

27. In addition, in terms of total deaths in police custody since 2004 in England and Wales, a disproportionate number were of Black people (20% of deaths in 2008–09 who comprise around 2% of the population).26

28. While it is welcomed that suspicious deaths in police custody are automatically referred to the IPCC for investigation, there is widespread mistrust among communities who are disproportionately affected by these fatalities that the IPCC is in any way independent from the police in light of data which indicates that 90% of senior IPCC investigators are ex police.

29. Also data indicating that large number of IPCC staff are also former police employees reinforces that view that independence in investigations are compromised because of the close relationship that employees have with those they are supposed to be investigating.27

30. There is a need for a judicial review into how the issue of deaths in custody is currently handled with a view to establishing an independent body responsible for investigating all preventable deaths which occur within mental health settings.28

6. Police presence on psychiatric wards

31. Police presence, often in riot gear, on psychiatric wards is an issue that is not publicly discussed but has led to a number of high profile death in custody cases that have reinforced distrust of both police and mental health services. (see Annex 1).

32. The final report by the now defunct Mental Health Act Commission entitled “Coercion and Consent: Monitoring the Mental Health Act 2007–09” details the eye witness account of an elderly service user who watched while a squad of 12 heavily equipped police officers with riot armour, CS gas, Taser guns and an Alsatian attack dog went onto a hospital ward to remove just one young man of African Caribbean origin from a hospital, which is a practice that is largely unknown to those outside mental health services.29

33. The use of Police restraint on psychiatric wards is a major area of concern. When such incidents occur, an often unreasonable level of force is used and preventable injuries are sustained by the patients.30

34. There is no consistent mechanism for monitoring deaths which occur after police restraints on psychiatric wards. Only cases where there are high profile fatalities, and the family are vocal about the incident are such matters brought to the public’s attention. BMH UK believe that there is a need for all preventable deaths which occur within mental health settings to be reported to an independent agency outside of the authority of the Health Trust where the death occurred.31

35. With mental health service users making for 61% of all deaths of people detained or held in custody by the state,32 BMH UK are of the opinion that there is a need for such deaths to be subject to the same independent investigation as those which occur in prison or police custody.

36. Mental health patients who do not suffer fatal injuries after being restrained by officers who have been called onto a hospital ward are not in a position to make an official complaint about their treatment to the IPCC because of their status as detained patients under the Mental Health Act, which restricts them from leaving the hospital. The absence of privacy on many secure wards with staff listening to patients telephone calls from the ward33 also prevents this group of service users from seeking redress through the IPCC for their treatment at the hands of the police.

37. While the IPCC is responsible for investigating all preventable deaths in police custody and the Prison and Probation Ombudsman (PPO) has the same duties to those who lose their lives in prison, no equivalent mechanism exists for when someone dies in mental health detention.34 BMH UK believe it is unjust that institutions responsible for the care of those detained often against their will under the Mental Health Act should not be subject to the same level of scrutiny.

7. Independent scrutiny of mental health service users deaths

38. In 2004 the parliamentary committee on human rights recommended that there should be an independent body to investigate the deaths of people detained under the Mental Health Act.35 Earlier this year the Equalities and Human Rights Commission noted that this is a key area that needs improvement.36

39. The case of 23-year-old masters graduate Olasei Lewis, who died after he was restrained by up to seven police officers at the Bethlem Royal Hospital in Beckenham on 31 August 2011 has made once again raised the profile of the issue of black deaths in custody.37

40. The case of 29-year-old father of two, Kingsley Burrell-Brown who died after he was restrained by police officer while detained at the Mary Seacole mental health unit, at Queen Elizabeth Hospital in Birmingham on 30 March 2011, further reinforced the widespread distrust of mental health services and the police. Although this incident occurred over a year ago, his body has not been released to his family because the IPCC are still investigating the case; they have been told that it is likely to take a further six months before they will be able to bury him.38

41. All suspicious deaths need a truly independent agency to monitor them, currently there is no such agency for those who die in mental health care.39 BMH UK are of the view that it is not possible for a mental health trust to be independent when investigating a death, which may have been caused or contributed to by the failures of its own staff and systems.

8. Recommendations

For the HASC to examine issue of mental health and policing in this IPCC inquiry in order to look at ways public confidence among some of society’s most vulnerable group who come in contact with police services can be improved.

For the HASC to examine the over user of Tasers among mental health service users in light of the lack of capacity that this group have to raise complaints after being subject to this use of force.

For the HASC to examine need and the establishment of an independent agency to investigate preventable death of those detained under the Mental Health Act.

For the HASC to examine and recommend a review of the IPCC’s current complaints procedure in light of mental health service users lack of capacity to effectively access the current process.

For HASC inquiry to examine the way often distressed mental health service users are restrained by the police and the use of restraint generally.

For the HASC to examine the pressing need for a judicial review into how all deaths in custodial settings are handled.

For the HASC to examine the role and appropriateness of riot police entering health based settings such as psychiatric wards and restraining patients and establish a system to monitor when such incidents occur with a view to phasing them out.

For the HASC to review current staffing of the IPCC so that it is more reflective of the general public. An emphasis on the inclusion of family members who express an interest in working as an IPCC commissioner should be considered.

Annex 1

CASE HISTORIES: FATALITIES OF MENTAL HEALTH SERVICE USERS FROM UK’S AFRICAN CARIBBEAN COMMUNITIES

July 2012