All our evidence supports the fears now being raised across the mental health spectrum over the increased use by the police of CS gas in the restraint of the people known to have a severe mental illness. ("Man's death raises alarm over police use of CS spray", 11 August).
Present police guidelines on the use of CS gas are inadequate, particularly when its immediate and long-term effects on people with a severe mental illness are so poorly understood.
In pre-deployment trials, carried out in 16 police forces in the spring of 1996, CS gas was found to be "least likely to be seen as effective on those believed to be suffering from a mental disturbance". The report of those trials also noted that, of 59 people found to have relevant pre- existing medical conditions, such as asthma and epilepsy, only the person with schizophrenia was advised to seek further treatment for the after- effects of CS gas.
Deployment has seen CS gas develop into the preferred method of restraint in many police forces. It is not surprising, but it is still shocking, that increased use of CS gas against people suffering a mental health crisis should throw up more incidents of serious injury and even death.
The failings of community care have put the police in the front line of dealing with mental health crises 24-hours a day. They need the best training based on clear guidelines to protect the mentally ill, the police and the health staff.
We know that the solvent used in CS spray acts directly on the nervous system. CS gas itself can cause heart problems, exacerbating the cardiac side-effects of some drug treatments for schizophrenia. The full interaction with psychiatric drugs is unknown but potentially very dangerous.
The Association of Chief Police Officers' guidelines on the use of CS gas need to be urgently reviewed and tightened up.
There should also be a full review of the use of CS gas on people known to have a severe mental illness, taking on board the experiences of not only the police and the mental health professionals, but also people with a severe mental illness and their carers.
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