“Criminalising people has somehow become acceptable mental health care. This approach strikes me as the latest evolution of the deserving/undeserving narrative… that is culturally embedded in mainstream services.”

An Anonymous #MadCovidDiaries 21.02.2021

TW: Police, self-harm, suicide

As a mental health charity worker I frequently cross paths with other organisations who support people coming out of prison. The messages are clear – prison often has a devastating effect on people’s physical and mental health and future prospects. Adapting back to life in the community is hugely challenging and the whole process hugely exacerbates pre-existing mental health conditions. It is well known in our sector that rates of self-harm and experiences of abuse and trauma are far higher in prisoners than in most other sections of the population. Simply put – unsurprisingly, prison is not good for your mental health.

So it’s hard to contain my disgust and anger at what I am starting to witness more frequently happening to some of the people we support – people who are clearly very unwell and highly distressed, who are frequently harming themselves or attempting suicide, are not being offered more intense mental health support, but are being criminalised with the support of mental health services, under the banner of it being ‘in their best interests’.

I want to be clear – these are not people who are causing harm to others, these are people who often have a specific mental health diagnosis that is poorly understood, who are in such high levels of distress that they frequently try to take their own lives. This often leads to services they contact or members of the public contacting the police out of concern for that person’s safety and increasingly I am coming across people in this situation who have been served a ‘Community Protection Notice’ that effectively bans them from seeking help if they are suicidal.

In our service this puts us in the paradoxical position of offering a space where we support people who are at high risk of self-harm and suicide, being required by law to have a safeguarding policy where we contact the police if someone tells us about imminent suicidal intent, but then being advised by the police that if this person uses our services appropriately, and then we follow our own policies and contact them, the person we are concerned about will be arrested.

Confused? Me too. You’d be forgiven for thinking this might be a draconian police response uninformed by knowledge of mental health, but I have sat in meetings where it’s been confirmed that this approach is a joint agreement with NHS mental health staff and staff members have stated that ‘sometimes prison is good for people, it gives them the shock they need’. In a world where trauma informed care is bandied about across policies and strategies, I have rarely seen an example of it being so misunderstood and disregarded. The focus in these meetings seem to be how to get people to use fewer resources, not what might be missing from the support they need.

I understand mental health services are stretched, I understand it is very difficult to know how to respond to extreme distress, but it doesn’t mean we shouldn’t try. In one meeting, it became clear that NHS staff thought they needed to reassure the voluntary sector staff about risk and boundaries. My concerns in these cases are not risk and boundaries – we have very solid policies and procedures in place and it is very rare anyone uses our services in an inappropriate and abusive way because we are so clear about what we do. My concerns are the complete lack of compassion shown to people who have had these notices served on them, that criminalising people (and it has to be said often young women) has somehow become acceptable mental health care, and that there is no way for anyone outside statutory services to prevent this from happening.

Our organisation was set up in the 80s, to provide an alternative space for mental health support, which was not punitive, but curious about people’s lives and what had led them to such distress and despair. I’d love to say we’ve moved on, but this approach just strikes me as the latest evolution of the deserving/undeserving narrative running through mental health care, that is culturally embedded in mainstream services and that I despair of ever managing to change.

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