90% of the individuals admitted to PSNI custody suites have mental health problems

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

This is a guest slot to give a platform for new writers either as a one off, or a prelude to becoming part of the regular Slugger team.

  • Reader

    John Kyle: 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.
    Will they all be allowed to leave, for instance if they want to get another drink or a knife?
    Does a “safe place” require a bit of muscle and authority; or will it be based on tea, buns and muzak?

  • nilehenri

    that was about as sensitive as a house brick to the face. any other solutions? maybe they should just pray it away dup style.

  • Reader

    nilehenri: that was about as sensitive as a house brick to the face. any other solutions?
    Rephrase the questions if you don’t like the tone. Those questions must be answered before a “Safe Place” can be set up.

  • nilehenri

    a good start would be to ignore the brightly coloured health trust webpagers and posters and instead look at the hard raw facts and the provision of care for these people in the north, which is practically non-existant.
    with all due respect, given the curent pecking order of the north, where exactly do you think mentally ill/at risk individuals are on this scale?

  • Teddybear

    Sorry but Reader has a point

  • Teddybear

    SHouldnt such people be just locked up like they were in the old days? Are we happy with mentally ill people wandering around? They frighten people, lower the tone and cause harm.

  • Granni Trixie

    ‘Lower the tone’!

  • nilehenri

    i’m glad you found it. care to pass it on to the rest of us?

  • SeaanUiNeill

    “Sorry but Reader has a point”, well yes, but what actual human vulnerabilities this point is gouging into is the problem……..

  • Reader

    Seaan, I thought the article was clear about this: “where patients in crisis and at risk of self harm can be admitted for observation and assessment…people ending up in custody suites…”
    So, “Safe Places” are intended to be for dealing with people with the above vulnerabilities.
    My questions dealt with: how are such people to be looked after in a place where the staff, the patients and the public can all be kept safe?
    My suspicion is that inconvenient cases will end up in custody suites anyway. What’s your guess? Alternatively:
    A relative of mine has taught in an establishment for ‘troubled’ youths. She was taught self defence, and was always accompanied in class by a minder trained in restraint techniques. The training came in useful. Is this your image of a ‘safe place’?

  • Reader

    I assume your attempted diversion means that you don’t know how a “safe place” will operate, then?


    This is frightening. Could we actually be voting in mentally ill politicians!

  • Theelk11

    There is a safe place, it is your local friendly A&E .
    This has been agreed by all the health trusts without providing any new space in overstretched A&E’s for these types of presentation.
    It means the perp will sit among your children and granny accompanied by two peelers on a soft shift until the perp deemed fit for assessment. Don’t forget they may have committed an offence and are under arrest. If not the peelers will stay in case they kick off or abscond.
    PSNI will not look after any of these cases any more. All the perp has to say is he is suicidal or has taken an overdose and its straight to the place of safety.
    There has been huge resources put into assessing these sort of presentations in the last few years. It is simply not true to say it is a maze there is a single point of contact in all A&E’s to access all or any services.

    John understandably is straddling a line between looking for help for these people and trying not to alienate his electorate who basically created the problem to begin with.

  • Ciaran McNally

    The comments here betray shocking ignorance, and I’m not surprised to see they’re mostly made under pseudonyms. Being taken into police custody does not necessarily mean you have committed a crime. Being mentally ill or addicted does not mean you forfeit your human rights and can be kept in cells or wards without good reason (the Mental Health Order applies to very strict and specific circumstances). The police have a clear role in helping to protect people in vulnerable and dangerous situations as well as the detection of crime. There are no easy answers to these problems, but wise up and display a bit of compassion and humanity.

  • Theelk11

    Totally agree with you some are perps, a lot are unwell and need help. That help is there.

    The PSNI are now the de facto guardians of the vulnerable, a condition one can confer on oneself to avoid the repercussions of poor decision making which culminated in being asked to empty your pockets in front of the duty sergeant.
    Would it not be preferable if the PSNI were protecting life and property as per job description.

    The place of safety is the accident and emergency department. Increasing amounts of police time is now taken up sitting around looking after people in A&E’s
    There is absolutely no role for mental health orders in addiction or related problems.
    Enormous improvements in care have been put in place, it’s an answer but not a perfect one.
    John Kyle has a brass neck…..

  • AntrimGael

    John, I agree with the vast majority of your thread but sadly wider society is just not sympathetic to most people currently in prison FULL STOP let alone those with mental health issues and I cannot see any change to this in the short term. In fact I would go further and say that society is still very intolerant and dismissive of people outside prison with mental health problems and consequently prisoners with these issues will NEVER come on to the radar of “things to solve”. Northern society, from whatever community, is still very reluctant to admit or accept mental health illness because it is seen as weakness and embarrassment and it will always be denied and swept under the carpet. Mental health in NI in 2016 is like being gay in NI in the 50’s and 60’s and some would say still in the present. It is there and we all know it but to admit to such ‘failings’ is just NO NO.

  • AntrimGael

    In fact I will go further and state that I know there have been several GP’s in the Belfast area who have left their jobs over the past year or so because they just could not deal with the stress of the MASSIVE mental health problems within their ‘constituencies’. One GP, a good friend of my father, stated that if he and his colleagues stopped prescribing anxiety and anti depressants, there would be riots outside their practices every day………and he got out for his health sake. The North with austerity, Brexit, Troubles issues and ongoing mental health problems, is a tinderbox waiting to explode.

  • nilehenri

    yes, you correctly assume that i am not an architect of national mental health programmes. what was it that gave it away?
    i’ve been on the front line on both sides of the mental health game and i know that there is a definite lack in provision on the issue, not least because of the north’s special position due to our history.
    researched effective measures are available to combat the problem, but the initiative so far seems to have been lacking. we’ll wait and see what claire sugden and michelle o’neill can do as regards the matter.