An eye-popping statistic emerged during the PSNI 15 Years On conference this week. While reflecting on the complex web of causal factors surrounding crime we learnt that ninety percent of the individuals admitted to PSNI custody suites had mental health problems. Ninety percent. Many had self harmed, some were at risk of suicide. This raises the question -is the custody suite the correct place in which to detain these people? Would an acute mental health assessment unit not be a more appropriate placement?
Many of those who end up in the custody suite are under the influence of alcohol and drugs, some are in personal crisis. Mental health crises, whether they are related to drugs, self harm, suicidal thoughts or other mental health problems, are extremely stressful to both the sufferer and carers. Families are often distraught trying to access help while struggling to contain their disturbed son, daughter, parent or sibling. They often feel that they are bounced between the mental health services, social services, PSNI and community support organisations. Concern is expressed by many agencies, but no one seems to take responsibility. Crisis intervention is like a maze with no exit. Families feel powerless as they watch their loved one deteriorate mentally.
What is needed is an assessment unit within the health sector where individuals can be admitted, observed, detoxified, supported and kept safe. Mental health staff can be supported by PSNI officers but the ethos is a health service ethos. As the effects of alcohol and drugs wear off more detailed mental health assessments can be undertaken. The patient can be discharged, urgently referred for further psychological support or addiction counselling, or admitted for immediate treatment. Sometimes the crisis passes and the person regains a sense of wellbeing and control. However it is well recognised that early intervention in psychiatric illness is more likely to be successful. At present the problems are often well established before any help is forthcoming.
Any General Practitioner or Social Worker will tell you that arranging an acute admission to a psychiatric unit is exasperating and extremely difficult because of the scarcity of beds, Little wonder that many in crisis end up in PSNI custody suites.
Belfast Health Trust has been talking for years about setting up a ‘Safe Place’ where patients in crisis and at risk of self harm can be admitted for observation and assessment. So far nothing has materialised and at present there are far too many of these young people ending up in custody suites, entering the criminal justice system rather than the mental health services. Mental health workers are not uncaring; they simply do not have the resources to adequately care for these patients.
The Chief Constable has said that we are asking the PSNI to deal with problems for which they have neither the expertise nor resources. A truly multi-professional approach is necessary. Mental health problems among the young are escalating. The connection with violence is well established. Unless we respond appropriately the situation will only become worse. Creating Safe Places in which to triage, assess and treat would not solve the crisis, but it would be a good start.
John Kyle is a Belfast City councillor and an East Belfast GP