• Police are preparing to pull back on heavy involvement in mental health-related callouts, saying it will enable officers to focus on core policing
• The Police Association and Police Minister have hailed the move as positive, noting officers are not the right people to be helping those in mental distress

• Health workers say they are being injured as a result of the change, which they believe is already happening in some areas

Emergency department and hospital staff are already being hurt as police prepare to make sweeping changes to how they respond to mental health calls, a nurse says.

The police changes include officers not attending some 111 calls if there is no immediate risk to safety, plans to transfer some of these 111 calls to the non-emergency 105 line, and a direction to officers to spend a maximum of 60 minutes waiting in emergency departments with mental health patients.

The goal will ultimately be to have officers leave hospital within 15 minutes of dropping them off.

An email sent between health staff and seen by the Herald also detailed a raft of changes in at least the Wellington region, including:

• - Police will only do welfare checks requested by health staff if specific police powers and expertise was required, such as forced entry.
• - If health staff made a missing persons report, police will do an initial investigation, but if the matter does not meet Police or Health policy the case will be closed. If police find or come across the missing person, it will be Mental Health, Addiction and Intellectual Disability Service’s (MHAIDS) responsibility to transport them.
• - Police will not assist with health requests to transport patients between medical facilities unless there is an immediate risk to life.
• - Police will not respond to requests from Duly Authorised Officers (DAO) - qualified health staff with special responsibilities under the Mental Health Act - to attend callouts unless the matter meets a police threshold. For example, if the person in distress is assaultive. These are referred to as section 41 requests under the Act.

According to a proactively-released Cabinet paper, recent police data shows demand from people in lower-level mental distress is growing at a significantly faster rate than demand from those presenting with a high level of risk.

Calls coded “mental distress” have increased by 152% from 2013 to 2023, and calls coded “threaten/attempt suicide” by 92%.

“Police is not equipped or funded to provide a response to those experiencing mental distress, where there is not a threat to life or safety,” said the paper, a report of the Cabinet Social Outcomes Committee.

“Police is seeking to reduce time spent on calls it does attend to enable staff to go back to core policing. For example, police officers are required to take a person who they are concerned may have a mental health condition to a place of assessment and arrange for that assessment. This can lead to two officers remaining in an emergency department for 4-6 hours awaiting a mental health assessment, losing the equivalent of one officer’s whole shift,” said the paper.

“Police is preparing to direct its staff to remain for a maximum of 60 minutes waiting time in emergency departments [unless behaviour or risk requires them to stay longer].

“Over time, police intends to move towards expecting its staff to return to duty within 15 minutes. Police will work with health agencies to manage the impact of this on emergency departments.”

Police Minister Mark Mitchell said he has been clear in his expectation police focus on tasks only they can do. File photo / Marty Melville

The paper provides a report back on work to develop a five-year transition plan to shift from a police-led response to a multi-agency response to 111 calls for people in mental distress.

Police made trade-offs in deployment decisions every day to prioritise high-risk events that cause the most harm in communities, it said.

“It is expected that greater capacity for police to respond to criminal and safety incidents reduces the risk of harm to a much greater extent than police not responding to mental health incidents increases the risk of harm.”

Other changes proposed for the five-year transition include improving the responsiveness of the national telehealth service, Whakarongorau, promoting alternatives to calling 111, trialling peer support in EDs, and considering a fourth 111 option beyond police, fire and ambulance.

Health staff suffering injuries as police pull back, nurse says

Mental health nurse and New Zealand Nurses Organisation spokesman Grant Brookes said police in the Wellington region had already started leaving emergency departments within 60 minutes or less in some cases, and declining to respond to requests to attend some mental health jobs.

“As Government policies are translated into practice . . . at each stage of that process police become less and less responsive to mental health crises.”

Brookes was aware of incidents this month in the wider Wellington area where nurses, other frontline health staff, and other ED patients had been injured, “which occurred as a direct result of police refusing a section 41 request”.

He said a section 41 request might be when the person in distress was armed and high on meth, for example.

Brookes said health staff in his area had started noticing a difference in police practices about three months ago - including in reducing their time spent in EDs.

Mental Health nurse Grant Brookes at an earlier protest for more health funding.

“Police are dropping off unwell, agitated, and potentially violent people in EDs and leaving.

“One doctor I’ve spoken to . . . has said mental health clinicians are literally taking their lives in their hands in responding to mental health crises now.

“People experiencing mental distress are much more likely to harm themselves than other people, but if they are harming other people in a health context then it’s us that are injured.”

Other injuries had occurred when police declined to help with patient transports between facilities, he said.

For example, if a person needed to be transported from Wairarapa to the Hutt or Wellington, that meant two out of the three crisis clinicians staffing Wairarapa were taken out of action for at least four hours, and were potentially in danger while driving an “agitated and distressed” person across the Remutaka hill, he said.

Police ‘not the right people’ to help those in mental distress

Meanwhile, Police Association president Chris Cahill said police officers were not the right people to offer appropriate care to people suffering mental distress.

“Police have by default taken over the emergency response to mental distress and it’s meant they are unavailable for core policing priorities,” he said.

Cahill referred to the “Humberside model”, a “right care, right person” approach taken in the UK where police had pulled back from being the default first responders to mental health jobs.

“To the best of our knowledge there has been no significant increased risk to those suffering mental distress; in fact the opposite, as they are getting the right help from the right people and that’s beneficial to them,” Cahill said.

Police Association president Chris Cahill said the health system should have made changes in preparation for the move years ago. File photo / Mark Mitchell

“We acknowledge that this will require some changes to the Health response but these are changes that should have been implemented years ago.”

In a speech at last year’s Police Association conference, Cahill said officers responded on average to 77,000 events a year involving someone in mental distress.

“That’s an increase of 55% in the past five years,” he said.

“Another way of looking at that statistic is police respond to 200 mental health episodes every 24 hours and most of them have no criminal element requiring police attention.”

Police Minister Mark Mitchell said he had been clear in his expectation that police focus time and resources “on those things that only police can do”.

“This shift will not only alleviate pressure on police time but will ensure a better response to those in need.

“I am confident that police will continue to respond to mental health demand when there is an offence or an immediate risk to life or safety.”

Changes need to be done with careful, planned approach - Mental Health Foundation

Mental Health Foundation chief executive Shaun Robinson said on paper the changes outlined in the Cabinet report sounded positive and reasonable, but he wanted to know it was being done carefully, with supports in place.

“The onus is on the police not to say ‘we don’t have enough staff, we need to get out of mental health.’ The onus is on police to show how they’re mitigating the risks ... really show that they are genuine about doing this in a careful, safe and planned way.”

The foundation had “always argued that the police are not a mental health service”.

“I think the real danger is going to be in implementation. The biggest risk here is that police go too gung-ho and start pulling out before there are other supports available.

Mental Health Foundation chief executive Shaun Robinson wants to see the changes done in a careful way. File photo / Chris Skelton

“If police officers come under pressure to get out of emergency departments as quickly as possible . . . that could create a real tension where they are going to not err on the side of caution, but err on the side of risk [and] potentially leave people vulnerable.”

Robinson said it could be easy to get it wrong when assessing whether a person was “low-risk” enough to be left at hospital by police.

“If there are instances where the risks are not well judged then people could be left with inadequate support.

“We’re not trying to sort of set unreasonable standards for police or have the bar so high to say that they can’t make any changes. These are really just important factors that we want to be sure that they’re paying close attention to.”

System not ready for change without higher staffing levels in health - PSA

PSA organiser Alexandra Ward said patients deserved safety when seeking and receiving care.

“As it stands mental health services – especially crisis services - are desperately understaffed. The action this Government could take that would make the biggest difference to safety for mental health workers is to guarantee safe staffing levels.

“Decreasing support from police before increasing the number of health workers will cause harm and increase the workload pressure on an already overstretched clinical workforce,” Ward said.

“Under the current conditions, our members are concerned withdrawal of police support from their current practice in mental health crisis will create a risk to worker and patient safety.”

It was essential that alternative safety structures were established and more resources devoted to safer staffing, she said.

Patient and staff safety a ‘top priority’

Mental Health Minister Matt Doocey said the Government had been working with police to explore the range of options available when somebody presented with mental distress.

“One of those options is extending the co-response models with police and other agencies tailored to meet local needs.”

Health New Zealand Te Whatu Ora’s director of specialist mental health addiction, Karla Bergquist, said they were currently considering the implications of the change to the police operating model.

“We want to emphasise that patient and staff safety are always our top priority.

Mental Health Minister Matt Doocey said they were working with police to explore options on how to respond to people in mental distress. File photo / Mark Mitchell

“The Government has announced the trial rollout of mental health and addiction peer support specialists in five EDs across the country. These specialists will provide support to people arriving to hospitals and who are being accompanied by police, family, or on their own, assist in providing mental health support to patients in crisis, and connect patients to community services.”

Staff would be supported through the transition so they could continue safely providing care, she said.

“Health NZ will continue to work closely with police at a local, regional, and national level to ensure people experiencing mental distress receive the right support when they need it.”

A police spokesperson said “police are working through the details of how we respond to those in mental distress with our partners at Health and expect to have more information available in the coming weeks”.

Melissa Nightingale is a Wellington-based reporter who covers crime, justice and news in the capital. She joined the Herald in 2016 and has worked as a journalist for 10 years.