Londoners can no longer rely on the police to handle mental-health emergencies

A burst of acronyms came over the police car radio, galvanising Nick Beasley into action. Beasley, who is in his early 30s and has been a police officer for nine years, keeps the peace in Ealing, a borough in west London. It was 4pm on a bright Friday afternoon in October and I was accompanying him and his colleague Malachi Randell, a lanky trainee detective in his 20s, on the evening shift. Beasley flicked on the sirens and the cars in front curved away, as if pushed aside by a centripetal force. We spun around a few corners, and came to a stop outside a terraced house on a quiet, tree-lined street. Three women, wearing Crocs and headscarves, were standing in a garden full of purple and apricot African daisies. “She’s gone in the living room and smashed up the TV,” said one of them matter-of-factly.

The woman in question had previously been treated in hospital for psychosis. This was the family’s third visit from the police in three days. An ambulance had been called an hour ago but hadn’t turned up. Earlier that day a National Health Service (NHS) mental-health team had come to perform an assessment, but apparently felt threatened and left. Randell phoned the team to ask if they could come back. The mental-health worker he spoke to said they couldn’t – they needed to pick up their kids.

The Met, as London’s Metropolitan Police Service is known, has never been busier. In April the force received almost 9,300 emergency calls in a single day – a new record. Mark Rowley, the Met commissioner, pointed out that only a minority of them were related to crime. One of a police officer’s main duties has become responding to people suffering from mental-health crises, who are unable to get sufficient support from the NHS. But the Met is pushing back. From November 1st it hopes to reduce the number of such call-outs its officers respond to by around a third. The Met says this will free up time to deal with criminals: a damning report in March found the force currently solves only 8% of reported crimes.

At the house, a figure appeared in an upstairs window, shouting: “Why have you called the police?” The police have emergency powers to detain people for up to 36 hours under section 136 of the Mental Health Act if they judge it necessary for the person’s safety or the safety of other people: some 7,000 people are sectioned by the Met every year. In this instance, Beasley explained, he had no powers to section the woman because she was in her own home and appeared to have mental capacity. With the family’s permission Beasley escorted her out and she walked away from the house calmly. Leaning against the garden wall, he typed up his report on his laptop before we all got back in the car.

We didn’t get very far before a call came in to say that the woman had returned and was threatening her family. This gave the police grounds for arrest. Beasley and Randell returned and handcuffed her on the street outside the house. She lay down on the pavement in a silent protest, her clogs protruding from between the officers’ spread legs. A police van arrived, and two officers jumped out, donning blue latex gloves before they touched the woman. They tried to pull her up by her coat sleeves, but she went limp, passively resisting. It took four of them, one holding each limb, to carry her into the cage in the back of the van. (Strictly speaking, ambulances are meant to transport people suffering from mental-health crises to hospital, but the ambulance service is overstretched and often passes the buck to the police.)

Beasley came back to the car to get his laptop. Between his police cap and bushy auburn beard his face had turned pink. During the arrest, the woman declared she would kill herself as soon as she left the police station, so the police decided to section her. Her family, perhaps exhausted, seemed indifferent to her fate, re-emerging from the house only to sweep broken glass into the bin.

The police’s power to section people is controversial. It criminalises mental illness and black people are almost five times more likely to be sectioned than white people. But the police often believe they have no choice. “If I don’t section someone and something happens to them, then it’s my fault,” said Beasley.

Once someone is sectioned, police officers are obliged to take them to a place of safety, usually the accident and emergency (A&E) department of the nearest hospital, and stay with them until their mental health can be assessed. With the NHS at breaking point, this can take a while – officers spend 14.2 hours on average waiting in A&E with a sectioned patient before care is transferred. Across England, this adds up to just under 1m hours of police time a year. “There’s times at which a hospital looks like a police yard,” said Beasley.

The police are now being called out for general medical emergencies, he said. “We’ve been sent to people having seizures and strokes...we’ve had minimal training.” Recently, he said, he was asked to take a bleeding pregnant lady to hospital. He refused because “it’s the job of the ambulance service. They wouldn’t have passed it to the fire brigade, so why us?” Beasley supports the Met’s decision to reduce the number of mental-health call-outs it responds to. “We’re fighting back now to say, we’re the police,” he said.

We followed the van carrying the sectioned woman through the early-evening drizzle to the hospital, where a man in scrubs was waiting to whisk her off to be monitored. Calmer now, she stepped out of the van voluntarily. A bed had been found for her in just 15 minutes. “This is miraculous,” said Randell, marvelling at the ease of the handover.

From November 1st fewer of these handovers will be happening. The Met will respond to incidents only if a crime has been committed or if there is an immediate threat to life (a judgment that the call handler will make). The force will be stricter in enforcing existing guidelines, for instance, relying on ambulances rather than police vans to take people to hospital. A dedicated helpline, run by the police and the NHS, will offer advice to officers in London about when to section someone. Next spring the NHS will launch another helpline for members of the public, designed to be a single point of call for anyone struggling with a mental-health crisis.

The Met is confident that these changes will free up more of their officers’ time, although Beasley is sceptical. “I don’t think it will have a drastic effect, but the call load will drop,” he said. When Humberside police in the north of England took a similar approach in 2019, total calls dropped by 8% and mental-health call-outs by a third. Within two years crime rates had fallen, bucking the national trend.

In the current system, “Londoners are being failed twice,” said Alastair Vanner, the detective superintendent responsible for how the Met deals with mental health. People having a mental-health crisis are treated like criminals, he said, but victims of crime also suffer. Currently, the police, struggling with demands on their time, no longer respond to most reports of shoplifting. On average the Met takes two hours to respond to burglaries and muggings, twice as long as it did in 2018.

It is not certain what will happen to Londoners suffering from mental-health crises when the Met stops going out to deal with them. There will be no additional funding for the NHS to cope with the extra workload. Mental-health teams, whose workers are often burnt out, are already unable to meet demand from the anxious, depressed and suicidal. Ambulances take twice as long as the target time to reach patients suffering from heart attacks or strokes. Ideally the police should not be the first responders to medical emergencies, but without them, people in distress may suffer worse fates than otherwise.

Back in the patrol car, there was a brief interlude in the mental-health call-outs when Beasley and Randell were informed about some teenagers setting fire to things in a park. Squelching through puddles in the dark, they found two 14-year-olds in hoodies, and no flames to speak of. They would have had a better chance of pulling off an arson attack at a pool party than in this rain. “How are you so tall?” they asked Randell, who is 6’5”. “Eat your vegetables,” he said.

We returned to the police station with takeaway burgers and chips, which were discarded when a call came in notifying Beasley and Randell that another young woman was having a psychotic episode. An NHS crisis team had told her to take her meds, then “buggered off”, the officers said. The family called for an ambulance, but the ambulance service passed the job on to the police.

Another patrol car had arrived before us. The woman sat on the stairs of her house in a duffel coat, handcuffed to stop her banging her head against the wall. After an hour, Beasley and Randell persuaded her to go to the hospital. As she was being helped into the front of a police van, an ambulance arrived. Rather than move her again, the police van ended up taking her after all. It struck me that the dispatchers who handle 999 calls are like puppet masters, deploying different emergency services to incidents like characters to scenes in a show. But all too often the puppets’ strings get tangled. It is unclear how limiting the responsibilities of the police will improve the evident lack of communication between the emergency services.

In the car, the calls continued to crackle in. A blue-light dash to find a high-risk missing person who had been posting suicide notes on social media was called off after another police unit reached him first. Around 9.30pm, Beasley, who dreams of working in the Met’s dog unit, determined that a friendly seeming XL Bully called Candy did not meet the threshold for being a dangerous dog (following a string of attacks, the breed is about to be banned in Britain). The officers ignored another call, from a woman, known to the police, who swore she was going to cut herself with razors. “We’ve been many times, but genuinely, she’s just lonely, bless her,” said Beasley.

There was time for one final call. We pulled into a side street to see a man sitting shivering in a blanket, a bloodied towel held to his face. In a seemingly random attack, he had been bitten on the lip by a stranger and then whacked over the head with a brick by the attacker’s girlfriend. As police unfurled their blue-and-white tape, there was a kerfuffle in a van when one of the alleged culprits spat at Beasley. His shift finished an hour late, but he still stayed behind to take multiple witness statements. This, it seems, is what the police yearn for: more time apprehending actual criminals. ■

Georgia Banjo is a Britain correspondent at The Economist

Photographs: ZED NELSON