International Development Law Organization

Good Cop, Caring Cop: Policing the Frontline of Public Health

15 Nov 2012

So you’re a police officer. You’re on patrol. The call comes: a man is threatening to jump off a bridge. You rush there. The community, and your own conscience, expect you to ‘do something’. 

Most likely, somewhere in the depths of his ailing mind, the man on the bridge is also longing for you to ‘do something’. 

So that’s what you do — drawing on intuition, tactical nous, sheer empathy and (if you’re lucky to have had it) prior specialist training: gently, patiently, you talk the man out of jumping. 

You’re no doctor, and yet you’ve just saved a life. 

In the state of Victoria, Australia, this is an unexceptional — if admittedly extreme — scenario. It’s certainly one that police officer Nicole Turner has found herself acting out. 

Sergeant Turner mostly sits behind a desk these days, a mixture of cop and theoretician, researching the intersection of law enforcement and public health. But in her background is two decades’ worth of hands-on police work, much of it on the beat. 

“I’ve sat with a mentally ill person in the back of a police van, “ she says on the line from Melbourne, where she’s helping organize a global conference on what is still a little-explored subject. “I understand the frustrations of the job: police can’t do it on their own; health practitioners can’t do it on their own. We need to find a way of getting the system right, of having it properly resourced, and working creatively and collaboratively.” Nor is the Melbourne event all about suicide prevention: it is, more widely, about the role police must carve out for themselves in the diverse environments of large, edgy cities; about understanding that harm reduction, as Sergeant Turner explains, is as much a matter of public health as one of public order.
At stake is making the law and the health sector function in tandem: less like separate, robotic arms of the state, and more like co-ordinated limbs. For this to happen, police must be recast as empathetic first responders, particularly where crime is closely linked to mental illness or alcoholism. 

Seamless referral systems must also be established — and in Victoria, the process is taking place: the idea is for individuals (no longer suspects, but patients) to pass quickly and smoothly from the hands of the law into those of health professionals — as opposed to clogging up police cells and court systems, losing more sanity into it, and becoming near-certain repeat offenders. 

David Patterson is the International Development Law Organization (IDLO)’s delegate to Melbourne. “In a highly regulated society,” he says, “many behaviors can be technically classed as illegal. But it doesn’t serve us to go down the criminal route if what’s in front of us is a public health issue. If someone is walking down the street screaming because they’re having a psychotic episode, you could arrest them for being offensive and disturbing the peace — or you could refer them to health services.” 

The latter approach to policing, as outlined at the conference by the Victoria state police, is one IDLO is keen to see replicated in the developing world. Mr Patterson, who runs IDLO’s social programs, talks of potentially dramatic health benefits precisely among those communities which traditionally fear law enforcers: people with HIV, sex workers, drug users, men who have sex with men, migrants. 

The theory is that changing the way police forces in developing countries deal with such groups, and changing these groups’ perception of the police, could move entire demographics out of the criminal shadows, placing them instead within reach of life-saving health services. The effect of such a cultural shift would be felt, and magnified, over time. Decent police treatment would breed better health — and greater dignity, too. 

But is the model truly exportable? 

Police attitudes developed and codified in a first-world, diversity-conscious, rights-oriented society like Australia may not be echoed in national environments that are poorer, more confrontational, and riddled with moral and legal taboos. 

Many of the behaviors which cause people to be labeled ‘vulnerable’ to begin with — sex work; homosexuality; drug use; migration — are, as it happens, illegal or intensely stigmatized in much of the developing world. Where police culture is, moreover, highly punitive, or violent, or predatory — isn’t the notion of turning those cops into nurses rather far-fetched?

Not necessarily, argues Nick Thomson, a director with the Johns Hopkins Bloomberg School of Public Health, and one of the main figures behind the Melbourne conference. 

“Take Cambodia,” says Dr Thomson, who has a long history of professional involvement in south-east Asia. “The police there are notorious — Human Rights Watch have had a field day. But even there, what we’ve seen over the last twelve months is a willingness to become engaged in more appropriate policing of vulnerable communities — protecting them, rather than arresting them. It’s a positive story. The challenge now is to scale things up. It’s not just about vulnerable groups — it’s about a whole policing philosophy.”

Similar examples, while still localized, are multiplying: in Ghana, although sex work remains illegal, reports suggest that prosecutions have ceased, with police officers handing out condoms rather than clapping on handcuffs. 

For IDLO, which is eyeing such developments with great interest, there is a tantalizing notion here that the rule of law — the organization’s bread and butter — may sometimes mean, paradoxically, taking liberties with the law: ensuring, for example, that harsh laws are not applied; operating at the law’s equivocal margins, so that the marginalized may benefit; carving out space for justice and empathy where the law doesn’t.

Public health, the conclusion seems to be, trumps the letter of the law. If the two can be made to fit, so much the better. 

And if police can tap into both mindsets, a new frontier may be crossed in the understanding and design of our frontline public services.

 

LEPH2012: The First International Conference on Law Enforcement & Public Health, Melbourne, November 11-14, 2012 (http://www.policing-and-public-health.com/

HRW, Tell Them That I Want to Kill Them: Two Decades of Impunity in Hun Sen’s Cambodia, November 13, 2012 (http://www.hrw.org/node/111248)

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