Police Patrol Officers (PPOs) increasingly encounter individuals experiencing severe mental ill health who may pose a risk to themselves or others. In such situations, PPOs may act either independently or in collaboration with healthcare professionals, navigating a complex interplay between legal duties, safety considerations, and ethical responsibilities. This qualitative study aiming to explore PPOs’ ethical competence in such situations employed focus group interviews (n = 5) with PPOs (n = 32) and applied a deductive qualitative content analysis based on Lechasseur et al.’s framework of ethical competence, comprising ethical sensitivity, ethical knowledge, ethical reflection, ethical decision-making, ethical action, and ethical behaviour. The findings suggest that PPOs demonstrate several dimensions of ethical competence yet describe challenges related to emotional detachment, managing uncertainty, and balancing caregiving and law-enforcement responsibilities. Ethical competence was mainly articulated in relation to professional duty, harm reduction, and efforts to balance safety, autonomy, and support. The findings indicate a need for continued ethics education, structured opportunities for reflection, and strengthened interprofessional collaboration to support ethically grounded practice in encounters involving individuals experiencing severe mental ill health.