For people with mental health problems, detention can be deathly

More than 30 years ago, between 23 November 1981 and 2 December 1982, hundreds of schools, homes and businesses were bombed during a series of so-called “chick bombings” in Oxfordshire by a mentally disturbed man with a gun. In the aftermath of these despicable attacks, a decade later, the new strategy for preventing bombs in rural England was rolled out nationwide.

The paper for this operation contained ideas that helped to shape the ways we respond to major incidents today. And a year ago, following the attack on the Ariana Grande concert, it was again renewed.

We urge leaders to end slow-burning conflict with suicide bombing victims Read more

Police and fire service personnel are some of the frontline members of communities involved in defending our lives. It is that risk that is a key part of why the main prevention strategy for preventing suicide among civilians in the UK is called the Threat and Risk Management (iNTM) strategy.

Chief constables must implement INTM plans (iNTM [ITM], Home Office-approved with local partners) in practice. They should know what planning to prevent suicide is like. They should know what they can do if they witness distress or are called to assist. And the professional response in the criminal justice system, including the magistrates courts, should align with the plan.

In 2012, around 1,060 suicide related deaths were reported. Of those, 443 were the result of an attempt and 42 of successful suicide. To ensure we prevent the majority of those deaths, the main prevention strategy is about change in society. Our national strategy, supported by INTM strategies, must help achieve that.

It makes a positive difference to the outcomes of the criminal justice process for some people who make suicide attempts or suicide attempts due to mental illness or depression. That is why many excellent suicide prevention interventions are developed and implemented in areas and more recently across the country.

But one particular intervention runs counter to the way our justice system works today. It is behaviour recognition (or, at a worst, the lack of it). For those in need of treatment for depression or for any other mental health disorder, abuse or neglect, this could be the difference between life and death.

People seeking help may be told, incorrectly, that help will come for free from a clinic on the NHS. They may be told, mistakenly, that if they do not go to the hospital, they will be charged. Many get stopped by police or the fire service for reasons they suspect are related to their illness or lack of a place to live. They fear they could be detained and held against their will, arrested, charged and have the matter leave the criminal justice system.

According to the National Offender Management Service, a service provider for offenders from all backgrounds, 63% of all adults who were detained had a mental health issue and 46% had a substance misuse disorder.

Five years ago, we launched a review of all detention practices in the UK and we found that response to fears about the mental health status of those stopped and questioned by the police and others should be made as simple as possible to ensure a quick return to health. And we commissioned research and work by the Mental Health Foundation to understand why some people do not receive the help they need.

Since then, there has been greater awareness about the methods of such arrests and more consideration given to improving the way they occur. Legislation was introduced to strengthen terms of support for those affected, such as better information and mental health assessments. Only a small proportion of people who want help to return to health are detained in prison.

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We have clearly not achieved all that we want. Government bodies need to look for ways to prevent people suffering fear, anxiety, distress and frustration as a result of threats of arrest.

But we cannot ignore the obvious. A constant reminder about the serious issues of people with mental health is how precious, but also unspoken, suffering is experienced and talked about by victims of suicide. Awareness is increasingly important for those individuals affected and their families, but it is also an opportunity to prevent a tragedy.

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