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The Guardian
5 days ago
- Health
- The Guardian
Cauchi's mass murders put harsh spotlight on failings of mental health and police systems
Joel Cauchi's mother didn't appear before the coronial inquest examining her son's life and the day her son murdered six people at a popular Bondi Junction shopping centre. But her presence was often felt, taking shape in the form of notes she had written to his doctor or in a conversation with a police officer. One of the most striking moments of the inquest was when Michele Cauchi, now in her mid-70s, was filmed via body-worn video camera on a police officer. She was standing outside her tidy home next to blooming hydrangeas, explaining how her son – who spoke multiple languages and had a university degree – had been deteriorating since he stopped taking medication. 'I don't know how we're going to get him treatment unless he does something drastic,' she says. These moments painted a picture of a mother engaging in a Sisyphean struggle to get her son – then living with untreated schizophrenia – help. But she could keep pushing only so far. Person after person who gave painful evidence at the five-week inquest told a similar story of doing their best in a 'fallible system'. It crystallised into a key takeaway: the system is letting down people in a crisis, like Cauchi. Cauchi's attack and the severity of it was a rare occurrence. But the system's failure to pick up on his slide after he stopped taking his medication for treatment-resistant schizophrenia is sadly a familiar story. Psychiatrists who appeared as experts before the inquest said the vision when mental health asylums in Australia were dismantled in the 1970s was for community services to instead support those people in need. But Queensland psychiatrist Prof Edward Heffernan told the inquiry the planned funding for community services 'never really followed' the shift. Psychiatrists also told the inquest that services hadn't kept pace with population growth. Meanwhile, psychological distress was increasing across the population, and patterns of substance abuse and other modern stressors had made things worse. Ian Korbel, a psychiatrist not part of the inquest, tells Guardian Australia he once worked in a mental health outreach team that would respond to people in crisis. But that program stopped running in the mid-2000s. Korbel says the team that worked in Sydney's eastern suburbs used to check the beaches for people experiencing homelessness. Cauchi was reportedly sleeping rough there before the attack. Korbel says the faltering of services has resulted in the buck passing to police and the justice system. 'They're in the punishment business,' he says. 'They shouldn't respond to this, but the health system isn't resourced to respond to it.' Police are increasingly responding to such crises. The inquest heard that in New South Wales, police responded to 40% more mental health incidents in 2022 compared with four years earlier. Sen Sgt Tracey Morris told the inquiry: 'We will always look at [those incidents] from a policing lens. That may lead to charges and them going through the court system when [it's] effectively because of the mental illness.' Morris works as the mental health intervention coordinator in the Queensland police district where Cauchi's parents live, in Darling Downs. The day Cauchi's mother spoke to police, they referred Joel to her role – which helps people link in with health services – for a follow-up check. But the officer acting in her role while she was on leave missed the email. This moment to get Cauchi help was described by a psychiatrist at the inquest as a 'missed opportunity'. Fighting back tears, Morris told the court this was no reflection on that officer's capability, but a direct consequence of under-resourcing. At least four people should be doing her job in that particular police district, she said. One of the cruelest ironies of that under-resourcing issue came during the inquest in a blink-and-you-might-have-missed it-moment, where Morris said no one was covering her role while she was at the inquest for the week. She couldn't find anyone to backfill it. Matthew Morgan, an expert in policing mental health responses who lectures at the Australian Catholic University, says: 'The only people really to blame here is the government. If they're not going to invest in a proactive and responsive mental health system that can provide the community around-the-clock care … then the buck stops with them.' A recent report Morgan co-authored analysed Queensland coronial inquests into people fatally shot by police while experiencing a mental illness. Twenty-four people have been fatally shot in the state since 2008. There is a clear patten, he says. 'The state has really just failed them. 'There's just lots of patterns of sporadic treatment, lack of follow-up care, and then the police get blamed for their criminalising and sometimes lethal response to such situations.' The inquest heard there had been multiple improvements in crisis response since police spoke to Cauchi and his mother in January 2023. Police can connect with health professionals to get advice on incidents, and there are co-response models where healthcare workers respond to call-outs alongside police. Those changes – as Peggy Dwyer, counsel assisting the coroner, pointed out in the inquest – have come after multiple inquiries, internal police and government reports and coronial inquests. All make a similar recommendation: health professionals should respond to mental health crises, not police – at least not alone. Joining calls for this change are families whose loved ones have been shot dead by police while they were suffering a psychosis. One of the loudest recent voices has been Judy Deacon, the mother of Jesse, who police shot dead in Glebe in 2023 after reports he was self-harming. But co-responder models have not been rolled out nationwide, despite recommendations to do so. The leading model in NSW, known as Pacer, operates in just 20 of NSW's 57 police commands. During the inquest, Dwyer asked Dr Brendan Flynn, the executive director of the mental health branch of NSW Health: 'Why has there not been an expanded Pacer across NSW where sufficient demand is demonstrated, when this report came out almost four years ago?' Flynn responded: 'It's a resourcing issue. It would require new funds, and that's a matter primarily for government.' Later Dwyer asked: 'Is there a risk that we just then get stuck here for another four years where there's no rollout of more supports?' Flynn replied: 'I hope very much that's not the case.' Even if a version of Pacer were rolled out across NSW, Korbel says, more work needs to be done. 'Nowhere in Australia do we fund mental health as we should,' he says. 'NSW is the worst. It gives 5% of its health budget to mental health.' Korbel says that figure 'would need to be doubled at least' to match similar programs in countries such as England and Canada. Investment in health services can save money in the long term. Prof Olav Nielssen, a Sydney-based psychiatrist who appeared before the inquest, spoke about a supported housing charity he works at. It supports people revolving between hospital, prison and the homeless sector. He estimated the cost of having people in supported housing was a tenth of what it would otherwise cost having them bouncing around a network of hospitals, prisons and other institutions. He said NSW had 'plans' to have 70 of these beds but that there should be 1,000 to meet the need. Elizabeth Young, the mother of Jade Young, a victim of the stabbings, appeared before the inquest and described her 47-year-old daughter's murder as the 'stuff of nightmares'. She also described it as the result of 'years of neglect' within the mental health system. 'It seems to me that my daughter and five others were killed by the cumulative failures of numbers of people within a whole series of fallible systems.' In Australia, the crisis support service Lifeline is 13 11 14. In the UK and Ireland, Samaritans can be contacted on freephone 116 123, or email jo@ or jo@ In the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on or text HOME to 741741 to connect with a crisis counselor. Other international helplines can be found at
The Guardian
25-05-2025
- Health
- The Guardian
Plans for NHS staff to restrain those in mental health crisis ‘dangerous', medics say
Plans for NHS staff to restrain and detain people experiencing a mental health crisis, instead of the police doing so, are 'dangerous', doctors, nurses and psychiatrists have warned. The former prime minister Theresa May has proposed legislation in England and Wales that would change the long-established practice for dealing with people who may pose a risk to themselves or others because their mental health has deteriorated sharply. But a coalition of eight medical groups, ambulance bosses and social work leaders said the switch would put mental health staff at risk and damage their relationship with vulnerable patients. The row has echoes of the controversy stirred by the Metropolitan police's decision in 2023 to stop responding to 999 calls involving mental ill health unless they involved a threat to life. The force said the change meant officers were attending crimes such as robberies faster, but mental health groups said they feared it could result in deaths. May and two ex-health ministers, Syed Kamall and Frederick Curzon, have tabled amendments to the mental health bill going through parliament which, if passed, would lead to mental health nurses, psychiatrists or other doctors being called out to restrain and detain someone under the Mental Health Act. Those professionals would each become an 'authorised person' who is allowed to detain someone under the act. May took an active interest in mental health issues during her time as home secretary and in Downing Street. She helped ensure those detained under the act were no longer held in police cells and were instead taken to 'places of safety', usually at NHS facilities. But in a joint statement on Monday the eight groups said the risks posed by someone in a mental health crisis meant police officers must continue to always attend. The groups include the Royal College of Psychiatrists, the Royal College of Nursing and the British Medical Association. At present, only police officers are permitted under the Mental Health Act to detain someone in a mental health crisis, for example because they are having a psychotic episode. The groups said: 'Removing police involvement entirely has hugely dangerous implications, as entering someone's home without permission is fraught with huge risks and is only currently done with the assistance of police intelligence. Without this, professionals may be entering homes without police help and therefore lacking crucial intelligence that could ensure their safety.' They added: 'While we recognise the immense pressures faced by police services, we also acknowledge that mental health crises in the community are becoming increasingly acute and almost never occur without some level of risk. 'The expertise, skills and equipment of the police remain essential for safely reaching individuals in crisis, especially where they may be in immediate danger to themselves, pose a risk to others or face a threat from others.' Dr Lade Smith, the president of the Royal College of Psychiatrists, said: 'Detaining, and if necessary restraining, someone is essentially arresting them and to do this safely requires specialist skills and legal powers. 'Expecting clinicians whose role is to provide therapeutic care to arrest people in the street or burst into their homes if they notice someone suffering a mental health crisis is simply inappropriate and indicates a lack of understanding of what health professionals do.' Chief constables are backing the change. They want to see responsibility for dealing with mental health crises become split between their officers and NHS staff. A National Police Chiefs' Council spokesperson said: 'We support the proposed amendments to the mental health bill, which will enable authorised medical professionals to effectively deal with some mental health incidents. This will ensure vulnerable people receive the most appropriate care without feeling criminalised because of their mental health issues.' They added: 'We will always attend incidents where there is a risk of serious harm to the individual or attending professionals, or where criminality is involved.' The groups opposed to the plan also include the Royal College of Emergency Medicine, which represents A&E doctors, the College of Paramedics, the Association of Ambulance Chief Executives, the British Association of Social Workers and the Association of Directors of Adult Social Services. The Labour MP Rosena Allin-Khan, the party's former shadow cabinet minister for mental health who is also an A&E doctor, voiced unease about the plan. She said: 'I am concerned that these amendments aim to turn practitioners into enforcers and could expose healthcare staff to increased danger. It runs the risk of eroding trust in dedicated and hard-working mental health staff by delegating police powers to them.' Ministers are also against the change. A Department of Health and Social Care spokesperson said: 'Extending police powers to other professionals would represent a major shift in the roles, responsibilities and practice for health and care staff and would place additional resource on an already stretched NHS at a time where we are trying to rebuild a health service fit for the future. 'It also raises questions around whether it is right for the health and social care professionals to have powers to use reasonable force, which could have implications for patient, public and staff safety, as well as potentially damaging the relationships clinicians have with patients.'
Yahoo
24-05-2025
- Health
- Yahoo
NHS to roll out 'pioneering' A&E units where patients can be seen in 10 minutes
The NHS has announced a new service that will allow patients with symptoms of a mental health crisis to be seen 'within 10 minutes'. The new mental health units seek to slash waiting times and avoid overcrowding in A&E departments, The Times reports. Dubbed 'mental health A&Es' by health bosses, the service will be staffed by specialist doctors and nurses and will be open to patients who present symptoms of a mental health crisis, such as suicidal thoughts or psychosis. READ MORE: High street store that closed all 236 UK stores in 2012 set to return READ MORE: Can you pass a British citizenship test? See if you can answer these 23 questions It comes amid a 'corridor care' crisis and pressure on emergency services. Figures show that more than 1.7 million patients waited 12 hours or more to be admitted, discharged or transferred from A&E last year, the Royal College of Emergency Medicine (RCEM) said. A 2022 report by the RCEM found that patients attending emergency services with mental health symptoms are twice as likely to wait 12 hours or more than other patients. Sir Jim Mackey, the chief executive of NHS England, told the paper: "Crowded A&Es are not designed to treat people in mental health crisis. "We need to do better, which is why we are pioneering a new model of care where patients get the right support in the right setting. "As well as relieving pressure on our busy A&Es, mental health crisis assessment centres can speed up access to appropriate care, offering people the help they need much sooner so they can stay out of hospital." Ten NHS trusts have already launched separate units for mental health emergencies, some of which are at sites of existing A&Es. The units are open to walk-in patients and to those referred to the service by GPs and police. The 'mental health A&E' scheme is expected to be expanded nationally to dozens of locations. The move is part of a 10-year NHS plan to be published this summer by the Labour government, according to The Times. Mental health nurse Toti Freysson, who manages the service, told The Times: "Anybody who walks in is seen by a mental health specialist within 10 minutes." Freysson added: "Normally in A&E they would have to wait for hours, surrounded by the noise and the chaos. Most of the people we see have suicidal thoughts. Here, they can come in and sit with their families. We are able to intervene early and link them up with treatment in the community. It means we can get them home much sooner." Claire Murdoch, the NHS national director for mental health, told the newspaper: "I would certainly hope to see these mental health A&Es across the country over the next decade." Dr Luke Evans MP, shadow health minister, said the Conservatives welcomed the move. He added: "However, this follows the Labour Government's decision to cut mental health spending as a proportion of the overall NHS budget and impose a Jobs' Tax that has forced mental health charities and local authorities to redirect their resources away from those struggling most. "This Government must now make sure that these units are funded properly so that those struggling the most with their mental health can receive the targeted and compassionate care they're in need of."
Yahoo
21-05-2025
- Health
- Yahoo
988 helpline offers crisis support for first responders
WEBB CITY, Mo. — First responders see tragedy on a daily basis, taking a toll on their mental health. Police officers we spoke with tell us the key is separating themselves from those stressful situations. That can come in several forms, like time with friends and family. There's also professional help, like speaking with a chaplain, for support in times of need. 988 helpline offers crisis support for first responders Torch run unites local law enforcement for Special Olympics Webb City honored for community-law enforcement partnership Golden Lion Award: Emma Hudson Volunteers restore homes for foster families in southwest Missouri 'Coping mechanisms is I always tell people take the bad days as they come and you take the good days as they come I think it's very important to process what you see,' said Tabatha Love, Webb City PD. Love says in her experience that being open about mental health is one of the most important things first responders can do. If a first responder is in a time of crisis, they can always call 988 for immediate assistance. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
17-05-2025
- Health
- Yahoo
Suicide mitigation signage installed on Piscataqua River Bridge
May 17—Following a string of suicides over the Piscataqua River, officials this week installed new signage on bridges aimed at mitigating such attempts, but some locals and advocates say more needs to be done. In less than two weeks, from late April to early May, three people died by suicide after jumping into the Piscataqua River. Two jumped from the Piscataqua River Bridge that carries Interstate 95 between New Hampshire and Maine, and another from the smaller Sarah Mildred Long Bridge, according to state and local law enforcement. Kelly Hartnett, vice president of community relations at Portsmouth-based Seacoast Mental Health Center, said seeing so many deaths in such a narrow window of time is "definitely unusual" compared to trends over the last decade. "I have not experienced this type of event in that frequency," in about six years on the job, Hartnett said. On Thursday, the New Hampshire Department of Transportation installed six signs on the larger bridge — three each on the northbound and southbound sides — Hartnett said. She said the agency, which assist with some crisis calls on and around the bridges, had already been working with the Portsmouth, New Hampshire, Police Department to install signage and other preventative measures. "We had been working on that initiative prior to the unfortunate events. That kind of accelerated the efforts," she said. The signs bear a relatively simple message: "There is hope. YOU MATTER. Text. Call. Chat. 988." That number rings the national suicide and crisis lifeline, which connects individuals with a live counselor and local resources. "It's a step forward, but we are looking now to add nets or some kind of barriers. That's the evidence-based model, having both (signs and barriers)," Hartnett said. When an individual plans suicide, they often do so hastily or impulsively, so a clear and quick message helps get through to those in crisis, Hartnett said. When more time is created between someone planning and acting on suicide, crisis teams have a better chance of intervening. In that sense, even physical barriers that appear scalable require additional effort and help create a buffer in time, she said. Multiple studies have shown that safety barriers are extremely effective at reducing the suicide rate on a particular structure and, in some cases, the overall suicide rate within a community. This latest string of suicides came as crews began installing safety fencing on the Penobscot Narrows Bridge in Augusta. That project is expected to cost about $1.35 million and is slated for completion in July, according to Maine Department of Transportation spokesperson Damian Veilleux. The fencing was mandated by the Maine Legislature in 2023 after a number of similar bills had failed to pass. The project was delayed slightly by testing to determine the fences' potential impact on the bridge's overall wind resistance. CALLS FOR MORE More than 1,600 local residents have signed an online petition calling for safety nets to be installed on the Piscataqua River Bridge. "In Portsmouth, New Hampshire, the threat of suicide is painfully real. The Piscataqua River Bridge offers a tempting means for individuals considering suicide," organizers wrote in the petition. That petition was created May 12, shortly after a minor — later revealed to be a Sanford High School student — jumped to his death. Police pulled his body from the water around 6 a.m. that morning, about nine hours after his empty car was reported stopped on the bridge. Friends, family and classmates gathered on Wells Beach Wednesday for a vigil honoring Jonathan "Jony" Hunter, a 16-year-old football player, Seacoastonline reported. There, his loved ones said there had been few to no warning signs that the teenager, known for his big heart, had been struggling. Hunter's death came less than two weeks after an earlier pair of suicides that took place April 30. New Hampshire State Police responded to a call of a stopped car in the Piscataqua River Bridge's northbound breakdown lane and determined that an unidentified man had jumped to his death, the department said in a written release. A few hours later, police in Portsmouth, New Hampshire, got a report of a missing person. The next morning, officers learned that a person matching that description had jumped from the Sarah Mildred Long Bridge, the local department said. Tyler Dumont, spokesperson for the New Hampshire Department of Safety, said the state police are "working closely" with partner groups to create additional suicide prevention methods, and he urged anyone struggling with thoughts of self-harm to call the crisis lifeline at 988. "The Department remains committed to doing all we can to reduce suicide risks and promote safety for everyone in our state," Dumont said in a written statement. ------ IF YOU NEED HELP IF YOU or someone you know is in immediate danger, dial 911. FOR ASSISTANCE during a mental health crisis, call or text 888-568-1112. To call the Suicide and Crisis Lifeline, call 988 or chat online at FOR MORE SUPPORT, call the NAMI Maine Help Line at 800-464-5767 or email helpline@ OTHER Maine resources for mental health, substance use disorder and other issues can be found by calling 211. Copy the Story Link We believe it's important to offer commenting on certain stories as a benefit to our readers. At its best, our comments sections can be a productive platform for readers to engage with our journalism, offer thoughts on coverage and issues, and drive conversation in a respectful, solutions-based way. It's a form of open discourse that can be useful to our community, public officials, journalists and others. We do not enable comments on everything — exceptions include most crime stories, and coverage involving personal tragedy or sensitive issues that invite personal attacks instead of thoughtful discussion. You can read more here about our commenting policy and terms of use. More information is also found on our FAQs. Show less
