Here is a common situation around Mental Health Act assessments, either for those in police custody as suspects for something or relating to people who have been removed to a place of safety under the MHA:
What do you do when there are inter-area disputes about who should deal?
This occurs in a few scenarios:
- The detainee is arrested in area A by the police from area A but for whatever reason, is taken to a custody office or place of safety in area B – they may be ‘known’ to services in area A.
- The detainee is arrested and detained in area A but they are from area B – they are known to MH services in area B.
You may have another few versions of this scenario and it doesn’t actually matter whether areas A and B are next door to each other (like Birmingham and Solihull) or considerably further apart (like Birmingham and Newcastle). The point will remain the same, nothwithstanding that it is easier to travel to Birmingham from Solihull than it is from Newcastle.
I have been a various rooms where this debate emerged. For example, the Place of Safety service for Coventry in my force area, is also used by Warwickshire Police for detainees from their area. It obviously raised the question, “Which AMHPs?” for the assessments. Coventry were understandably not keen on the sudden increase in hundreds of 136 assessments each year, mainly for a client group that they did not know. This also occured in Birmingham and Solihull where the comparatively low number of detainees in the latter meant that they achieved a health-based Place of Safety solution by reaching agreement to use the service in Birmingham.
In each case, proper discussion brought about an agreement about which area’s AMHPs would respond and there were both “office hours” and “out of hours” versions of that agreement. It is not usually these scenarios that causes problems in my experience because where areas know that an arrangement will deliberately remove people “over the county line”, you plan for it and agree the response in advance.
It is when these situations emerge unplanned, that problems can emerge in my experience. For example, in my force area, it is not unusual for my officers to arrest someone and transfer them to a custody office in a different local authority. Most people go to our local custody area, but with peaks and troughs of demand across the force, this cannot always occur. It is also frequently the case that my officers arrest people within our policing area who are not resident there. It is often the case that where the person detained needs some kind of health or social services support in custody – for example with mental health assessments or appropriate adults for juveniles – you can get dispute.
It seems perfectly sensible to me, that where people are known to services in their own home area and are in need of support in custody, that it comes from professionals or teams that know them. So I fully understand the instinct that if a Solihull resident is known to their community mental health team but detained s136 and taken to Birmingham, it makes sense to offer that assessment to professionals from the “home” team. However, if there is an inability or unwillingness to undertake that assessment, where does the responsibility lie to ensure it gets done? It lies with the area where the person has become detained, in this example, Birmingham.
How we make it be any other way? … section 13 of the Mental Health Act sets down the duties of local social services authorities around being able to undertake assesments for patients “in their area”. NB: not from their area. If we extended the geographical quandry to Birmingham / Newcastle, we would see how obvious it is. If assessment is needed in central Birmingham, we’re not going to be able to compel an AMHP from the North-East to do the assessment – we’d have a country of AMHPs waving to each other on motorways. Nothing prevents AMHPs from different areas sharing information to support the assessing AMHP, but the duty would sit in Birmingham.
I have seen such disputes less over the last few years, but they re-emerge when, for example, police services start recofiguring their custody provision and then achieve a consequential impact upon AMHP services. In several police forces that I can think of, we have a move towards establishing “super-blocks” for custody: larger facilities with thirty cells, perhaps as many as fifty cells and they are sometimes geographically situated to be accessible by officers from more than one geographical area. It’s all part of the “shared-services” mythology.
This can be a nightmare in waiting for the area on which the foundations are actually laid, but no different to other public sector configurations. I am aware, for example, of a very large NHS hospital trust whose building is rather past its best. They are building a brand new hospital on a new site about 1 mile down the road – just over the border! I’ve wondered whether the AMHPs in their current area have the opening date of the new hospital red-circled on their calendar and a team ‘do’ booked! … or whether AMHPs in the new area have a large black cross on theirs?!
Ultimately, unless a local agreement between neighbouring areas has been reached to do things in any other way to ensure provision, the AMHPs who work in the area where the assessment is needed have the responsibility for undertaking it, although the Code of Practice to the MHA does allow them to offer that assessment to AMHPs from the patients home area, especially if it is an adjacent area. This makes sense both in terms of knowing the patient and in terms of knowledge, for example, of any statutory aftercare they are receiving (under s117 MHA).
So! – just to test you: what if the police from area A have travelled to area B to make enquiries into something they are investigating and then arrest someone from area C in area B for an alleged offence in area D and remove them to a custody office on area E?! << A real example!! … this is fun, isn’t it?!
I’ll leave that one with you! ;-)
The Mental Health Cop blog won the Mind 2012 Digital Media Award, in memory and in honour of Mark Hanson.
The Awards celebrate the “best portrayals of and reporting on mental health in the media.”