‘These people are vulnerable, they aren’t criminals’: Mental health, the use of force and deaths after police contact in England
| Author | Claire Pillinger,David Baker |
| Published date | 01 March 2020 |
| Date | 01 March 2020 |
| DOI | http://doi.org/10.1177/0032258X19839275 |
| Subject Matter | Articles |
Article
‘These people are
vulnerable, they aren’t
criminals’: Mental health,
the use of force and deaths
after police contact
in England
David Baker
School of Psychological and Behavioural Sciences, Coventry University,
Coventry, UK
Claire Pillinger
Centre for Advances in Behavioural Sciences, Coventry University,
Coventry, UK
Abstract
This paper considers deaths after police contact
1
in England of people experiencing
mental health issues. It uses rich qualitative data from interviews with the families of nine
people who died after police contact to examine how they died. The paper aims to assess
the police role in providing a de facto service for people undergoing mental health crises
and how the use of force might affect the outcomes of such encounters. The paper aims
to examine the manifest tensions when an enforcement agency is tasked with providing a
duty of care to vulnerable people in society. Key findings are that force is dis-
proportionately more likely to be used on people with mental health issues, and also
disproportionately more likely to be used on people from Black and Minority Ethnic
communities. Further findings provide insight on the use of mechanical restraint and the
way in which inappropriate transportation can exacerbate the effects of restraint.
Keywords
Deaths after police contact, mental health issues, police accountability, street triage, use
of force
Corresponding author:
David Baker, School of Psychological and Behavioural Sciences, Coventry University, 1 Priory St, Coventry,
West Midlands, UK, CV1 5RW.
Email: d.baker@coventry.ac.uk
The Police Journal:
Theory, Practice and Principles
2020, Vol. 93(1) 65–81
ªThe Author(s) 2019
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/0032258X19839275
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Introduction
The number of deaths after police contact (DAPC) in England and Wales is at the highest
level in a decade, rising from 241 in 2016/17 to 283 in 2017/18
2
(Independent Office for
Police Conduct, 2018). More than half of those who died in or following police custody
had mental health issues (IOPC, 2018). This paper aims to examine how people with
mental health issues (PMHI) die after police contact, in particular by focusing on how
force is used on them. A further aim is to consider how this relates to the police role in
providing a duty of care for vulnerable groups in society. It represents the first known
piece of academic research to explore this issue by using rich qualitative data gathered
from the loved ones of those who died after police contact in England. It aims to examine
this data within the context of existing academic literature on policing, mental health and
the use of force. Further consideration will be given to policy reports on these issues in
relation to their findings and recommendations, to determine whether lessons can be
learned to improve practice and reduce the number of people who die after police contact
in England and Wales.
DAPC highlight a number of issues that encapsulate concerns about policing in the
21st century (Savage, 2008). Deaths disproportionately affect those from marginalised
groups in society: if you are from a Black and Minority Ethnic (BAME) group, are a
PMHI, or have dependency issues, then you are disproportionately more likely to die
after police contact than other groups in society (Angiolini, 2017; Baker 2016a). Due to
precedents driven largely by article 2 (the right to life) of the European Convention on
Human Rights, police are required to provide a duty of care to those they encounter and
have a procedural obligation to demonstrate that each individual’s right to life has been
enabled in encounters with police (Angiolini, 2017; Baker, 2016b; Her Majesty’s Inspec-
torate of Constabulary (HMIC), 2015). Research consistently states that restraint is more
likely to be used on PMHIs, or those from BAME groups than any other group in society
(see, for example College of Policing, 2017; IPCC, 2016; Leigh et al., 1998). Given these
findings, police use of force is increasingly scrutinised as it brings into question their
commitment to providing a duty of care to marginalised groups in society, and to
respecting their right to life (Adebowale, 2013; Angiolini 2017).
Cases of DAPC, then, occur at the intersection of a number of charged issues in
policing: the tensions involved in police being both an enforcement agency and an
agency of care; the use of force; and the disproportionate number of deaths of people
from marginalised groups within society. These issues are exacerbated by the apparent
inability of police and regulators to learn lessons that preve nt future deaths (Baker,
2016a; Casale et al., 2013; Coles and Shaw, 2012). This paper investigates the factors
influencing these fatal outcomes, it begins by examining how police have effectively
become a de facto provision for PMHIs.
Policing and the provision of mental health care
The lack of mental health care provision stems largely from the move to a community-
based model of care from the 1960s onwards which was seen to be under-resourced from
the outset (Perkins et al., 1999; Ruiz and Miller , 2004). In England and Wales, the
66 The Police Journal: Theory, Practice and Principles 93(1)
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