Met police withdraw: a radical restructuring of mental health provision

Recently, news has emerged that will have a profound impact on healthcare providers (and their insurers) across the capital. The Guardian reported that the Metropolitan Police Commissioner, Sir Mark Rowley, is set to ban officers from attending calls relating to mental health incidents.

From 31 August 2023, Metropolitan police officers will be banned from attending any mental health incidents unless a threat to life is feared. In circumstances where the Met's own research indicates that 40% of its work has a mental health element, this is a significant change to the status quo; one that will impact a broad spectrum of healthcare services across the capital. Those entities (and their insurers) need to begin planning how to plug this gap or risk an increase in incidents which could lead to litigation and inquests.

Ambulance services, out of hours services, walk-in centres and (to a lesser extent) GPs should be prepared for an increase in requests for mental health related assistance. Organisations should take steps now to ensure staff are appropriately trained to deal with any incidents and aware of: (1) what assistance they can provide; and (2) when (and where) to refer patients. Policies should also be put in place to assist with determining when an incident represents a threat to life and the police should therefore be contacted. Thorough training and robust policies will ensure staff are better equipped to deal with the likely influx, and able to make informed and defensible decisions. This will assist with defending any claims arising out of such assistance or, in a worst-case scenario, explaining actions at an inquest.

Insurers of the above services will probably want to consider whether the current policy provision is sufficient to cover the likely surge in mental health related interactions and attendances by their insureds. The Met estimates that almost a million hours are spent by officers waiting in hospitals for mental health patients to be assessed. This is just one element of assistance the Met currently provides, so the actual total is likely to be in the several millions. From 31 August 2023 onwards, these millions of hours will need to be provided elsewhere and the burden will, most likely, fall on ambulance, out of hours and walk-in services. Insurers of such services will therefore want to consider whether an increased insurance capacity is required.

The impact will not, however, be limited to out of hours services, walk-in centres and GPs as a variety of organisations rely on police assistance. For instance, it is common practice for mental health providers to ask the police to undertake a welfare check if a patient misses a mental health appointment. Such entities therefore need to consider how this service will be provided once Met involvement ceases. Unfortunately, it will likely be the organisation that faces possible criticism (and/or is subject to litigation) if a welfare check has not been completed and an injury or death occurs.

Each healthcare organisation should therefore consider undertaking a review of what assistance the Met currently provides and ensure that appropriate replacement provisions are in place from 31 August 2023 onwards. Failure to do so may result in a comparable surge in litigation and difficult questions at inquests.