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I Need Your Help!

BooksLast week I published a post on an idea I’ve had for a while – an Emergency Mental Health Law course. I was really delighted by the response from the full range of professionals at whom the idea was aimed and I’ve also been contacted by some academics and senior people expressing interest in the idea and potentially thinking of what might be done to realise it.

I’d now like to ask for help —– I have started fleshing out some ideas of what such a course may involve in terms of legal issues. But obviously, this is just one policeman’s view and if such a course is going to be useful to those in other professions I’d need a wider viewpoint!

In particular, I want to know what those of us who use mental health services think – what is it about issues around mental health law in urgent or emergency situations that you think professionals need to know?  Perhaps based on experiences of where things were well handled or where it could have been better.

Remember(!), the point here is not just about issues a particular professional would want to know (more) about – it is also about coverage of issues affecting all the relevant professionals that you think others need to know about. This is about attempting to achieving greater consensus about the law, as well as an enhanced understanding of it.

PROPOSED OUTLINE

So the following ideas are outlines and initial thoughts only – I think I’ve spent about fifteen minutes putting this together (whilst watching tennis!) and I’d like any comments you have in the comments section below.

  • Principles of emergency mental health law – human rights, health & safety, least restrictive principles, etc..  Section 1 MHA.
  • Emergency detention – s136 MHA, s135(1) warrants, s18 AWOL patients inc revocations and recalls of CTO and s42 patients.  Definition of a “place of safety”.
  • Entry and Inspection – warrants under s135(1) and s135(2) MHA, s17 PACE, s115 MHA
  • Mental Health Act admissions - informal patients, s2, s3, s4 and s5; planning, preparation, s6 MHA, s135(1) warrants
  • Urgent deprivation of liberty – emergency application of the Mental Capacity Act
  • Obstruction and the Criminal Law – obstructions offences against police, AMHPs and emergency services; other offences under the Mental Health Act; offences of wilful neglect and misconduct in public office.
  • Liaison and Diversion – assessment in police custody; prosecution decisions and links to MHA admission.  Use of police bail during MHA admission.
  • Codes of Practice – to the Mental Health Act (England / Wales) and the Police and Criminal Evidence Act

I’m sure there will be additional details that occur and contribution of your ideas is welcome below as well as feedback on whether I’m missing anything huge and obvious!  If I am, I was writing this whilst watching MURRAY v FEDERER and will be sticking to that excuse!

Let me know your thoughts.

Michael./20140122-111752.jpg

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– won a World of Mentalists #TWIMAward for the best in mental health blogs
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17 thoughts on “I Need Your Help!

  1. I think this covers everything I can think of. As long as it’s joined up thinking where all professionals involved follow the same curriculum and learn as well of each other’s problems and pitfalls. I consider that it is vitally important that all services work together and also to realise that where one person may react better to a nurses or paramedics uniform, there are times when the best reaction of a person with mental health issues will be towards a police officer and their uniform. WE ALL NEED to WORK TOGETHER especially on the front line

  2. Hi Mike, Good idea..how about useful web sites post read? I’m a Warks trainer.If you wanted to get delegates you would need a list of learning aims and objectives and an idea of how long.You could arrange courses of different length depending on learners.

    As an ex police officer I would want what us trainers call ‘affective’ issues included..eg fear of the patient,covering your backs in case of complaints down the road,frustrations of working with some agencies,a look at how some complaints were looked at and the results for officers.Also something about the ACPO Decision Making Model.Just afew thoughts.Good luck with it,get back if I could help further.

    Phil

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  3. I35(2) warrant applications
    A short piece on applications for a Section 135(2) warrant for the return of AWOL patients. Possibly a framework or template to use when completing a warrant aimed at police officers who may as you described in a previous blog had to obtain directly. This would prevent each person making an application re-inventing the wheel every time a warrant has to be written. Making an application for any warrant is an exact science at the best of times, having to wrote one for something you may never of had to before at half past stupid o clock in the morning with no one about to assist a guide or template would be a great help.
    Also a short explanation for JP’s & the courts as to who can apply for such warrants, which may prevent such a delay as you described experiencing in the past.

  4. If you needed any information from someone who has been involved in Mental Health services as a patient, and has a long history of been on the other side of the law on many occasions i would be happy to help. That’s if you wanted that perspective.

  5. I agree that its about working together & seeking to resolve practical issues/problems in the best possible way, considering risk etc & trying not to finger point about it. Sharing a common understanding of the law will contribute to this. I also think that it is vital to also share different perspctives & understandings of mental distress/illness & to also understand the very real blocks & limitations in the whole system. I have to remind myself & colleagues that sometimes it appropriate to do nothing, but the worse position to be in as an AMHP is wanting to make an application but having no where (bed) to write on the Pink Form. I also find myself reminding colleagues that it is indeed a legal process & that I am not minded to remove an indivuduals liberty, unless it is required.

    BTW Michael I am happy to help :-)

  6. As both a patient and academic I have a number of examples from personal experience, both good (life-saving) and those with significant room for improvement. Also some general areas for consideration especially reflecting on the longer term impacts of emergency interventions – which are obviously relevant to future interactions where the mental health problem is severe and enduring. It has often been my experience in these situations that staff on all sides act as if the immediate outcome – not the longer term consequence – of their approach is all that matters. They see an emergency as a one off event and do not consider their behaviour in the context of the individual as a person who is likely to have needs at some timepoint in future, and so with whom there may be merit in preserving some fragments of trust. Is there an email address I could send detailed thoughts to? If you contact my email address on this post I’m happy to elaborate.

  7. Might be helpful to look at softer stuff too – for patients and relatives often first time they experience police/ custody etc is in a mental health crisis. So reminder that what is standard to poice isn’t to the people involved and where standard stuff about custody may not apply eg phone calls, visits, keeping your mobile, getting food sent in, appropriate adults, alternative ad hoc POS, relative at assessment if requested etc etc . Sounds small stuff but getting it right and explaining it really helps….. First time it happened to a relative of mine the custody sergeant took the time to sit down with me and explain what was happening, and what they would be doing

    1. I second this. As a recovery/support worker, my role involves advising and supporting clients, so this kind of soft info would be really useful

  8. I have just heard about your blog and was thrilled that something is being done to encourage joint partnership working. I realised then how brilliant it would be if the services could work together so 14 years ago I tried to encourage this initiative myself. Having spent several years working with the Crisis and Home Intervention Team I lost count of the occasions that we had to involve the police. I started, with a few colleagues, going to the local police stations so that the officers got to know us and a bit about the team and what we did. We also invited officers from the local police stations in Bristol to pop into to the Crisis Team base and actually see what we did. Unfortunately I relocated to Bournemouth and it all stopped. I am now a Mental Health Act Officer and check all the legalities of section papers. I am therefore able to help you with any information you would like on mental health act sections, what they mean, how long they last, forwers to treat under common law. Please contact me if you would like any help with this project.

  9. I believe such a course might also want to include professional accountability and responsibilities and potential conflict of interests. Would also include professional versus organisational issues! Not just MHA code but also NMC framework of ethics!

  10. It may not be quite within what you are addressing, but I have faced issues relating to disclosure of information to the police – balancing duty to public, duty of confidentiality, potential impact upon therapeutic relationship. Complex ethical dilemmas regarding interface of professional ethics and disclosure? Also potential impact of implementing new Data Protection. Guidance on sharing of info is yet to be tested?

  11. I’m a bit late to the party (been working hard) but I’d suggest including some general principles too. Stuff like the Bolam test and the common law Doctrine of necessity for example, especially if not all participants are used to thinking about the law per se. I’d aso suggest including human interest stories (Winterwerp, Bournewood, Donaghue vs Stevenson etc). I find that these accounts of basic legal principles provide context for much more specific stuff later.

    Cheers,

    Stuart

  12. “frontline” practical stuff (see your other recent blog!) – transport (MHA CoP); restraint / pain compliance (NIHCE) are just two examples where not only can the Police say no, but actually MUST say no.

  13. Sorry 3 more soft and fluffy thoughts.
    1) For police, what is life like in a mental health unit, what sort of diagnoses mean that you are likely to be detained, what does it feel like to be detained under a section, how long is someone likely to be detained under s2, s3.
    2) For mental health professionals, what does it feel like to be detained under s136, what
    is likely to happen (restraint, searching etc), what is it like to spend time in Custody (if that still happens in your area)
    3) For police, likely reactions from peopel who you are detaining under s136 and medical isuses arising
    4) The adverse psychological reactions from repeated detentions particularly under s136

  14. Could it be a modular course, maybe with a certificate of completion for each module?
    I’m thinking from my point of view as a St John Ambulance volunteer who occasionally does NHS support – some modules might be relevant to us but some might not.
    What about other volunteers – are Police Specials likely to be involved in mental health situations? How much training do they get?

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