Hosted by the Mental Health Foundation, Mental Health Awareness Week 2019 takes place from Monday 13 to Sunday 19 May 2019.
We often associate the word ‘bedlam’ with raving madness and chaos, whilst forgetting that it derives from the name of a hospital, Bethlem, which was established in 1247 in London.
Now called the Bethlem Royal Hospital, it is a well-regarded psychiatric hospital providing a wide range of clinical services for people with mental health and / or substance misuse problems. Its history is, however, very colourful and is perhaps a microcosm of how mental illness has been viewed, and treated, over the centuries.
As far back as the middle of the sixteenth century, friends and relatives were allowed to visit the ‘inmates’, not least to bring food and other essentials for their survival. Public and casual visitors with no connection to the inmates were also routinely allowed in. It would be easy to think that there was entertainment to be had in viewing the extraordinary behaviours of the mentally ill, but the original rationale behind allowing the public access was rooted in financial considerations.
The governors of the hospital aimed to encourage ‘people of note and quallitie’ to visit and be moved by moral benevolence to make generous donations to aid the running of the hospital. They succeeded in this aim, but it soon became obvious that visitors came mostly for the entertainment value. What drew the visitors was, “the frisson of the freakshow” where Bethlem was “a rare Diversion” to cheer and amuse. It became one of a series of destinations on the London tourist trail which included such sights as the Tower, the Zoo, Bartholemew Fair, London Bridge and Whitehall.
Attitudes to mental illness have shifted somewhat since those dark days, and in generally the right direction. But within the police service it seems there may still be a mountain to climb.
A recent study of almost 17,000 police across the UK found that 95% of officers had been exposed to traumatic events, almost all of which were work-related. Civilian staff too were affected, with 67% of operational police staff reporting they had experienced trauma.
The study showed that 20% of the respondents reported symptoms which were typically experienced by sufferers of PTSD or complex PTSD.
Disturbingly, some 66% of respondents were unaware they might be suffering from PTSD or other anxiety related illness.
The study appears to indicate a widespread lack of awareness by senior managers of the presence of mental health problems among officers and staff.
Gill Scott-Moore, chief executive of Police Care UK, the charity which funded the research, has said,
The service has real challenges around recognising and responding to the signs and symptoms of trauma exposure and is heavily reliant upon generic NHS provision that isn’t equipped for the specialist treatment needed.
View the study here
Meanwhile, in April a national police wellbeing service was launched. Branded as ‘Oscar Kilo’ (OK) it is funded by a £7.5 million investment from the Government through the Department of Health. Chief Constable Andy Rhodes of Lancashire Constabulary heads up the new initiative. He announces on the Oscar Kilo web site that it
. . . was created and designed to host the Blue Light Wellbeing Framework and bring together those who are responsible for wellbeing. It is a place to share learning and best practice from across emergency and blue light services so organisations can invest the very best into the wellbeing of their staff.
Find the Blue Light Wellbeing Framework here
Elsewhere, between 2015 and 2019 MIND, the mental health charity, had thousands of volunteers across the emergency services actively challenging stigma, and learning more about mental health. The charity says they made positive changes for themselves and colleagues and the charity learned how organisations can improve mental health support, tackle stigma and increase workplace wellbeing.
Back in January 2017, Police Oracle, the online publication which covers policing matters, launched its ‘Blueprint Campaign’. Under that banner Police Oracle says it,
. . . accuses the government of failing to meet its obligation of protecting our officers both in the job and particularly, when they have been forced out of the service because of physical injuries or mental trauma.
Read the announcement here
It’s of some significance to note that only the Police Oracle initiative makes any mention of the thousands of former officers who were ‘forced out of the job’ as a result of disabling injury whilst on duty. Once out, their forces have generally done nothing to assist them in overcoming their disabilities. In some forces, quite the opposite. Some forces have instead chosen to hound and harass disabled former officers by a misplaced enthusiasm for conducting ‘reviews’ of their degree of disablement – an enthusiasm driven entirely by a callous desire and foolhardy expectation of easing the pressure on force budgets.
IODPA’s constantly growing membership includes serving officers who are on the cusp of retirement due to injury on duty. Their accounts reveal just how inadequate are the levels of training and awareness of mental health among line managers and more senior officers, as well as civilian staff. The accounts of pensioners are also extremely harrowing, and lay bare the true state of affairs, which is that in some forces no regard or concern is shown for the impact on them of reviews and of the financial uncertainty and anxiety engendered by the prospect of repeated reviews continuing over their lifetimes.
All of IODPA’s members have suffered, and continue to suffer, with a diversity of injuries incurred in the course of performing their ordinary duties. Many of those injuries are of the mind. Notably, depression and PTSD feature highly on the list, but the entire spectrum of anxiety disorders are represented.
In some cases, mental injury is the sole recorded ‘duty injury’ but members who have only physical injuries recorded as ‘duty injury’ also experience resulting mental damage. Hence, it is unusual to find anyone who has been retired with an injury pension who has not suffered some form of mental illness, at some level.
IODPA is pleased to see a greater emphasis on safeguarding the mental health of officers and staff, but is disappointed to see no official government-led initiatives to improve the situation of former officers with psychiatric damage who are retired on an injury pension.
We suggest this shortcoming urgently needs to be addressed. There is a need to start at the top, with the senior managers of forces. Chief Constables have the office of Police Pension Authority (‘PPA’) and are responsible for making all the decisions concerning the injury award scheme. Some of them, thankfully currently only a handful, are actively harming disabled former officers through abuses of the injury pension regulations.
We could fill many pages here with examples of truly appalling behaviour by individuals who clearly have absolutely no comprehension of the need to apply care and compassion to any dealings with disabled former officers with psychiatric damage. We know, from a study of force management of ill health retirements, injury on duty awards and police medical appeal boards overseen by Chief Constable Morgan and sponsored by the College of Policing, that,
Many forces are struggling due to the lack of expertise within their organisations.’ and, ‘The structure of some force HR facilities do not support the management of the process… and …issues are compounded by a lack of dedicated subject matter experts across the service and training opportunities.
What concerns our members is that whilst the inadequacies highlighted by Mr Morgan can be addressed, unless positive and impactful action is taken to significantly change attitudes towards mental illness and injury, then disabled former officers, and officers about to retire due to mental illness or injury, will continue to suffer at the hands of the likes of Mr Morgan. For it is Mr Morgan, in our opinion, who is spectacularly failing in his duty of care for his disabled former officers.
Mr Morgan is not alone in his unawareness, but it is Mr Morgan who has given us the most glaring example of how bad things can be when senior managers fail to understand how to engage with people who are suffering mental health damage. We have reported elsewhere, in earlier blogs, on the situation in Staffordshire, where Mr Morgan is Chief Constable and Police Pension Authority. He wished to conduct mass reviews of the degree of disablement of injury on duty pensioners. When deficiencies and alleged unlawful procedures in the process, as applied by Mr Morgan’s staff, were brought to his attention he reacted in a way which could only possibly be the result of deep ignorance of mental health issues.
He ‘invited’ a number of those pensioners under review to a meeting in summer of 2018. He could have arranged a neutral disabled-friendly environment to meet, listen and discuss issues with those who had raised concerns about the way review process was being conducted. Instead he announced he would be holding the said meeting, at police headquarters,
to which pensioners – all disabled in some way or another, – were invited. His invitation reads
more like a summons.
Here are the original blogs –
Mr Morgan described the proposed meeting thus: ‘The meeting is to explain the next stage of the process.’ There could not have been a clearer indication that the meeting would never be about clearing the air through informed discussion.
When pensioners asked if their legal representatives could attend, and were met with a refusal, the pensioners all decided there would be no point in attending if Mr Morgan wished to use the meeting only to ‘explain’ what he intended to do. Pensioners felt they would be exposed to pressure in the anxiety-inducing environment of police headquarters.
In our opinion, Mr Morgan’s actions seem to be those of a man who is by instinct adversarial and dogmatic. They appear to be the actions of a man who cares more about defending a flawed process into which he has inserted allegedly unlawful demands, rather than caring for the health and wellbeing of disabled former officers. They seem to be the actions of a man who wishes to hear no other views than his own.
His force is now facing a legal challenge to his decision to reduce the pensions of the seventeen pensioners who questioned his review process. It may cost the force many tens of thousands of pounds and will do nothing to foster good relationships with injury on duty pensioners.
Just as Bethlem became bedlam and a meme for historically inappropriate mental health care, so too has the ‘review’ provision within the police injury benefit scheme regulations become, in the hands of the likes of Mr Morgan and a few others, a meme for the entrenched institutional insensitivity and disregard for disabled former officer’s mental health.
Bethlem reformed itself over the years and became a shining example of modern healthcare. We have to hope that the police service and the government will do more than announce initiatives and studies and will take positive and far-reaching action to eradicate the negative attitudes exemplified by Mr Morgan and others who we have identified and named in these blogs.