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Restraining

In the News Today – Emergency Response Belts – Wednesday 15 March 2017

October 2012.  And Thomas Orchard, 32, a paranoid schizophrenic, has not taken his medication for a week, which no doubt contributed heavily to his mental health meltdown on a public street that must have been frightening for anyone in the vicinity.  Clearly, Mr Orchard needed to be taken to a place of safety where his condition could be stabilised before any harm came to anyone, including himself.  Instead, the use of an ERB contributed to his death in policy custody.

Questions before we go any further into this tragic story: WHY had he not taken his medication?  WHY was he not properly monitored by the system?  Can we hold a schizophrenic responsible for not taking their medication? Or is it the job of health professionals to ensure vulnerable and mentally unwell people take the tablets prescribed? Were the police aware of Mr Orchard’s mental condition?  Whom did they contact once they’d arrested him?  Did they assess how best to contain the situation in a responsible manner?

No doubt the police officers and detention staff tasked with calming Mr Orchard were anxious and probably fearful, quite rightly, for their own safety.  They can’t be blamed for that, given the unpredictability of behaviour and actions by anyone with schizophrenia, especially when they’ve failed to maintain their regime of medication.

However, Mr Orchard himself, despite his illness, must have been in an enhanced state of anxiety and agitation, given that no fewer than 7 police officers attempted to quieten him prior to his transportation to the police station.  Let’s be honest, 7 against 1 – un-necessarily aggressive?  Once at the cell, it was still 3 against 1 as the police continued their attempts to calm Mr Orchard.

Whether or not the police knew about Mr Orchard’s schizophrenia, their tactics are seemingly heavy handed.  Wrapping an ERB (Emergency Response Belt) designed for thigh, not facial, restraint, around someone’s face for 5 minutes is, I’m afraid, bound to result in some sort of tragedy.  In any situation where adrenaline is flowing and fear is involved, I don’t believe anyone can honestly demonstrate that only light pressure was used – if you believe you are being threatened and in danger, and Mr Orchard was allegedly shouting “I’ll bite your f****** face off”, you may THINK you’re being cautious, but the human instinct to protect and survive kicks in and the harder someone threatens, the harder you’ll defend, it’s human nature.

As Sky News reported on Tuesday 14 March:

“CCTV showed him motionless for 12 minutes before officers went back into the cell and found Mr Orchard had suffered a cardiac arrest.

His brain damage was caused by prolonged cardio-respiratory arrest “following a violent struggle and period of physical restraint”, a pathologist concluded.

Mr Orchard’s parents, Ken and Alison Orchard, said: “Today we join a growing group of people who have lost loved ones in police custody and have found no sense of justice.

“Thomas cannot be brought back but we want his needless death to bring about change.

“The change we want most is in the attitude of the police, particularly towards those with mental health vulnerabilities.”

Worryingly, an article on ERBs on todays BBC News online by Rachael Thorn and Sian Davies confirms that the DOH is aware of ERB usage in our hospitals:

“The Department of Health said the ERB is used in exceptional circumstances in some hospitals but its use is subject to rigorous assessment.

It said it did not record how many hospitals use the device.

In England and Wales, 46 patients detained under the Mental Health Act died within seven days of restraint being used in hospitals between 2000 and 2014, the IAP found.

The majority of these – 41 – occurred between 2011 and 2014.

However, none of these can be directly linked to the use of ERBs.”

Is there such a thing as a safe restraining technique?  Should we restrain people at all, even when it’s for their own safety?  Do we have the RIGHT to restrain?  And if we don’t, what are the alternative ways of safely containing and reducing a potentially dangerous situation?

What is certain is that the police have got to control their heavy handed tactics, especially in relation to those with mental health issues.  There has to be accountability and the police have to take some responsibility for deaths in custody.  They aren’t accidents, where there is no fault.  They happen because a situation is mis-managed and flawed and because personnel appear unprepared and untrained.

The police officers in Mr Orchard’s case have been cleared of manslaughter at Bristol Crown Court.  However, the IPCC confirms that for a total of 7 officers, gross misconduct procedures are being considered.