In NSW, cops are first responders to mental health emergencies, but are there other options?

Friday, 6 September, 2024.

Content Warning: This article discusses the issue of police violence, self-harm and mental health issues. Reader discretion is advised.

NSW police officers. Photo courtesy: Robbie Mason. 

“How cooperative or non-cooperative were the police in the aftermath of Jesse’s passing?”

“Not passing,” Judy Deacon corrects, “death.”

“He didn’t really have the chance to pass away. It was a violent death,” Judy’s daughter, Lucinda, explains.

Of course. How else do you describe a police shooting of a 43 year old man experiencing a mental health emergency, mere seconds after forcibly entering his home?

In July last year, Judy’s son, Jesse Deacon was going through a mental health crisis in a public housing block in Glebe. At one point, he approached a neighbour and asked for a cig. He was not aggressive in any way. Jesse’s arm was bleeding and the neighbour, concerned he was self-harming, called an ambulance. But instead of paramedics the police arrived at Jesse’s home. He was holding a knife. One officer fired a taser, which failed to work. The other fired his gun.

Jesse died from the gunshot wound. There was no time for family and friends to say goodbye.

This is Jesse’s story but he’s far from the only fatality of state violence. Over a period of four months last year, NSW Police killed four members of the public with guns and tasers in remarkably similar circumstances.

Their names are Clare Nowland, Steve Pampalian, Jesse Deacon and Krista Kach. They were all enduring mental health episodes or dementia that left them detached from reality.

It was a particularly bad episode for NSW Police but it wasn’t an anomaly. According to the Australian Institute of Criminology, almost half of fatal police shootings nation-wide involve people with some form of mental illness. Psychotic disorders, such as schizophrenia, are the most common underlying factor.

In NSW, the issue has reached crisis point. Recent data shows that, across the last 5 years, 52 people in NSW have died as a result of interacting with police while experiencing mental health distress. It’s a steep increase from the 19 people who died in the same circumstances in the 20 years before this (1997 to 2017).

The problem is so severe that not only are health professionals and aggrieved families publicly demanding we make mental health workers the primary responders to welfare checks; some police representatives have joined the chorus too.  Sure, resistance to public scrutiny and cultural issues remains within NSW Police and they have actively obstructed the campaigns of families of police shooting victims seeking justice.

But what makes Jesse Deacon’s case unique is that his mother, Judy, is working with the Police Association of NSW (PANSW), the trade union for cops. It’s a ground-breaking decision which makes the lack of change at the political level all the more mind-boggling.

Consider this: you or a neighbour of yours or maybe someone sleeping rough is experiencing a mental health emergency. Who do you call? Who do you want attending the scene? It doesn’t seem like there’s much choice at the moment.

There are some localised rapid-response programs in NSW which involve mental health clinicians as first responders but many people don’t even know they exist. If you’re worried about police escalating the situation or you’re aware that the race, class, housing status and mental illness of the impacted person substantially impacts the chances of a safe resolution – yes, this is statistically proven – what the fuck do you do? 

What happens when you call 000?

As it stands, police are often first responders to mental health crises and welfare checks when someone calls 000.

Now, when you’re staring down a drug-induced psychosis or stuck in a rut of deep depression, the last place you want to visit is the cop shop. You may also want to avoid a hospital emergency department, for that matter. And the last way you want to get to these places is in the back of a police paddy wagon.

Mental health should be treated as a health issue, not a criminal issue. Even the state’s police union agrees.

Kevin Morton, President of PANSW says, “a health issue needs a health response, not a police intervention.”

“Being the 24/7 problem solvers in every instance also takes them away from responding to their core duties in urgent frontline response. It’s only natural that this would take an emotional toll on our police, who are already coping with the strain of being stretched too thin across so many fronts.”

There is a pilot program in place in NSW called PACER, which stands for “police ambulance clinicians early response”. It’s a ride-along system where police and mental health practitioners jointly attend mental health calls.

However, PACER units only operate in a handful of local area commands and are only staffed for 8 hours a day. Furthermore, PACER mental health workers remain secondary responders, available via phone and only able to offer face-to-face support after police arrive. It means people who have a mental breakdown or psychotic episode late at night may not interact with a mental health worker, even if they’re located in an area with PACER workers. It’s a real hazard for night owl stimulant-using communities.

Additionally, PACER mental health workers will not attend a scene where there is a weapon present – at least until police have de-escalated the situation, which is far from guaranteed. This is the case even when a knife is being used to self-harm, as happened with Jesse Deacon.

Numerous community organisations – Justice Action, BEING and the Redfern Legal Centre, for example – argue that the PACER program, while promising, doesn’t go far enough.

Sam Lee, senior solicitor at the Redfern Legal Centre, believes that “training police will not be the answer” to welfare checks on people experiencing mental distress.

“We need a whole new model and for police not to be at the forefront of that model,” she tells Users News.

There are already examples of mental health workers as first responders close to home.

The ACT’s PACER program, has police attend mental health calls in an unmarked vehicle with a paramedic and mental health worker, and no sirens blaring. In Adelaide, meanwhile, paramedics and mental health professionals attend mental health calls of low to medium severity without police. In the trial phase of this program team members attended to 607 calls in central Adelaide and helped almost two thirds of those people receive treatment in the community, so the data is promising.

These alternatives not only work but work well.

They’re intended to pair struggling people with appropriate care and divert people away from prison cells and loud emergency departments, which are likely to increase distress.

“We don’t have to reinvent the wheel,” Judy Deacon says. “The solutions are already out there. Get police out of first response.”

Judy wants to make life easier for Australian residents. She wants to see the introduction of a nationwide ‘000’ mental health line. It means when you call 000 the operator will give you a fourth option – police, fire, ambulance and mental health. For now, it’s a vision dependent on a big injection of federal funding and the building of new health infrastructure. But her demand has attracted widespread support.

We hope it comforts our community to know that there are good people out there fighting for your safety.

Memorial rally for Jesse Deacon, 20 July, 2024. Lucinda Deacon (left), Leesa Topic (centre), mother of Courtney Topic, who was shot and killed by police while experiencing her first psychotic episode in 2014, and Judy Deacon (right). Photo courtesy: Judy Deacon.

What other options are available in NSW?

In NSW options are limited, but there are some alternatives.

If you’re located in Western Sydney and find yourself needing immediate intervention, you should can call 000 and request help from the Mental Health Acute Assessment Team (MHAAT).

MHAAT is a rapid-response team of mental health workers who attend 000 mental health calls alongside paramedics. The service is intended to offer immediate assessments from highly-qualified personnel and refer patients to appropriate care facilities or ensure medical follow-up. An evaluation in 2017 clearly laid out the program’s positive results, which has included treating almost 70% of patients outside of hospital emergency departments and transporting two thirds of patients directly to mental health facilities.

Unfortunately, this service isn’t available to people outside western Sydney.

In some other parts of NSW, there are Acute Care Teams (ACTs) attached to major public hospitals (sometimes also called “crisis assessment and treatments teams” or “CATTs”. Made up of mental health specialists and social workers, these teams are available 24/7. They’re all about community-based treatment and short-term help for severe mental health episodes.

You can obtain help from an Acute Care Team by calling the NSW Mental Health Line on 1800 011 511 (it’s a free call) or by calling 000. If your life is at risk, you must call 000 for the most immediate help possible.

One word of warning, however. These CATTs are heavily under-resourced. They’re often swamped, meaning they will assess calls based on urgency. On the phone, they may have to make tough decisions about how quickly you can receive help or if you’re eligible to receive help at all.

In a submission to a recent NSW parliamentary inquiry into mental health accessibility, Justice Action reported the public has developed disparaging nicknames for CATTs including “Come Again Tomorrow”, “Can’t Attend Today” teams and “gatekeepers of hospital beds”.

That said, many people do find these programs helpful and less stigmatising than police, or even paramedic, intervention. In a nutshell: there’s a mixed bag of highly-varied experiences out there.

What if I need help right now?

Here’s a list of 24 hour services you can call (or text) for free to receive immediate support:

• Lifeline is helpful for anyone experiencing a personal crisis – call 13 11 14 or chat online.

• Suicide Call Back Service is helpful for anyone thinking about suicide – call 1300 659 467.

• Beyond Blue is helpful for anyone feeling depressed or anxious – call 1300 22 4636 or chat online.

• 13 YARN is a free confidential crisis support service run by Aboriginal and Torres Strait Islander people for Aboriginal and Torres Strait Islander people – call 13 92 76.

• MensLine Australia is catered to men experiencing mental distress – call 1300 78 99 78 or chat online.

While only available between 3 PM and midnight every day, QLife offers free anonymous LGBTIQ+ peer support over the phone or via webchat. Call 1800 184 527 for support.

For less immediate help, the Black Dog Institute also has a range of free online self-test tools and resources for those concerned they may have mood disorders, anxiety or depression.

If you want information about drug-related mental health issues, you can also call NUAA’s Peerline. This is a confidential peer-run phone service dedicated to supporting people who use drugs, who are on the OTP or who are seeking treatment across NSW. Call 1800 644 413 or email peerline@nuaa.org.au.

Why are police not the people we want responding to mental health crises?

It’s important you’re equipped with knowledge about not just police protocol, but police behaviour and gaps in police training as reality is often very different from the PR front that police forces display to the public. This way you’ll know what you’re in for if you call 000 or police unexpectedly rock up at your home for a welfare check.

As Judy Deacon emphasises, it’s clear that police are not experts when it comes to mental health.

The Deacon family fiercely favour peer support models for mental healthcare whereby those with lived experience of mental health struggles, or caring for someone with mental health issues, dominate the workforce.

“Friends and families” of the deceased are the “real experts” here, Judy asserts. “We may not have qualifications or wages but we are probably more important in some respects than the people whose job it is to have meetings and give recommendations, which never get implemented anyway.”

Greens MLC Sue Higginson (far right) and then Judy Deacon, Leesa Topic and Sam Lee from the Redfern Legal Centre at a memorial rally for Jesse Deacon on 20 July, 2024. Photo courtesy: Robbie Mason. 

Supporters at a rally at Town Hall, advocating for policing and mental health reforms. 20 July, 2024. Photo courtesy: Robbie Mason. 

Trying to track the history of police training for responding to mental health emergencies is like attempting to find and then untangle a ball of yarn left outside during a cyclone. It’s hard. It’s a story of stops and starts. The force has scrapped a number of optional mental health courses in recent years due to under-resourcing. In May last year, the state’s police watchdog, the Law Enforcement Conduct Commission (LECC), released a report that found mental health training in the NSW Police Force is “extremely limited”. As it stands, trainee police officers only have 18 hours of mandatory mental health training with no further mandatory guidance after graduation.

Citing “recurring systemic and organisational issues”, the LECC report found that the Mental Health Intervention Team (MHIT), a specialist police unit, was woefully understaffed, limiting the delivery of an optional award-winning four day course to 300 officers per year. As a result, only 2420 officers completed the program between February 2008 and September 2019, when the program was axed. (According to the NSWPF Annual Report 2022-2023, there were 17,062 officers employed at the time of publication. So only a fraction of the force have completed this particular training.)

Furthermore, as Jesse Deacon’s sister, Lucinda, tells Users News any police mental health training is “still miniscule compared to the many years of experience of a psychologist who works with vulnerable people everyday.”

In short: police are way out of their depth in these situations. Police officers can be quick to resort to deadly force when they feel threatened – indeed, many activists, lawyers and aggrieved families of police shooting victims have argued they are far too quick to use tasers and guns on people suffering mental health episodes. So it’s vital you don’t act aggressively towards police if they do turn up, even if the sight of uniformed cops and weapons is triggering. We know this isn’t easy when you feel cornered.

The Deacon family tell Users News they’re now extremely hesitant to call 000 for a mental health matter.

“Jesse would not have been dead if police hadn’t arrived,” she says. “That would not have been the outcome. The injuries to himself would not have caused his death.”

This isn’t to say an outcome like this is guaranteed if police turn up at your door and we’re not here to tell you what to do. But it’s important to consider the possible implications of calling 000, to consider alternatives and to develop plans of actions involving your support circles if your mental health suddenly goes downhill, whether that’s friends or families or support workers or someone else. Personal tragedies and traumatic memories can strike at any moment.

Obviously, in a really intense or violent situations it may be necessary to call 000. But, as shown in this article, there are other ports of calls, whether it’s calling the NSW Mental Health Line (1800 011 511), seeking support from family members or friends who know the person in distress well and checking someone in at a hospital emergency department yourself.

Ultimately, if you find yourself or someone else in extreme emotional distress, you should call whoever you feel safest calling.