The news of the death of Pete Seeger has reminded me again of his old song ‘Where have all the flowers gone?’ The line ‘oh when will they ever learn?’ has been running through my head since I saw an item on the local news about police officers and mental health professionals working together to prevent people with mental health problems ending up in police cells for want of the right support. ‘Good stuff!’ you might think. Indeed it is - but it is also profoundly depressing to hear such a venture being reported as ‘new’.
In 1993 I led a multi-agency, multi-disciplinary team, which diverted people with mental health problems and learning disabilities from custody. The team included all the right skills and necessary statutory powers – a specialist social worker, two community psychiatric nurses, a senior probation officer and a police inspector. We had the backing of all the chief officers and the team went wherever they were needed, the police station, the bridewell below the magistrates court and the remand and hospital wings of the local prison.
The approach was simple but effective. By bringing the right skills into the system at the right time, we were often able to help get the right decisions and find the right services. Within a year, the prison hospital wing was no longer full of prisoners with mental illness and learning disabilities. This was a time when the local mental hospital was being run down for closure, so it was no small feat. Of course, some of our clients were very disturbed and a small number were dangerous, or had committed very serious offences so they had to stay in prison or be moved to a secure hospital but at least we knew who they were and where they were. We advocated for them. They were not dumped and forgotten.
We shared our learning and even wrote a book about our approach which was replicated and adapted all over the country. It was cheap and effective because it made better collective use of existing individual professional skills, capacity and powers and partner agencies’ budgets. It was about reducing demand, reducing costs and reducing re-offending – but most of all it was about reducing risk and suffering.
‘What’s not to like?’ you might ask and you’d be right but, somehow or other, twenty years later, police officers and mental health nurses are re-embarking on the same journey. Is it because mental health services are still the “Cinderella’ – and their budgets have been cut even when the rest of the NHS has had increases in funding? Is it because we are still so ignorant and fearful about mental illness? Or is it because innovation is generated by enthusiasts on short-term funding so it doesn’t get mainstreamed or embedded? Perhaps it is all of the above.
Whatever the reason, our collective inability to use the available evidence to guide our thinking and to take shared professional and organizational responsibility for public policy challenges means we are doomed to keep making the same mistakes.
When will we ever learn?
Catherine Staite is the Director of INLOGOV. She provides consultancy and facilitation to local authorities and their partners, on a wide range of issues including on improving outcomes, efficiency, partnership working, strategic planning and organisational development, including integration of services and functions.