This post follows on from part 1 on AWOL Patients —–
(Equivalent guidance in Wales, Scotland and Northern Ireland. Also see the BLOGs legal resources, above).
So which situations should automatically be reported to the police? Well, the Code of Practice talks about three situations should always and immediately be reported:
- Patients subject to ‘part III’ of the Mental Health Act – this means patients connected to criminal proceedings, either before or after trial / conviction.
- Patients who are ‘dangerous’;
- Patients who are ‘particularly vulnerable’ – if anyone has a grey pencil of the correct shade to help us understand where vulnerable becomes particularly vulnerable, I’d be grateful to learn where you got it!
Nothing else MUST, by law be reported immediately or at all. However, as the police carry the responsibility of searching for people whose location is not known, so expectations around AWOL patients outside of the above three situations should be set out in a clearly defined protocol. This document should include:
- The duties of NHS staff before, during and after making reports:
- A search of the hospital – so that a dead patient is not found in the shower four days after ‘going missing’, for example!
- Information should be provided to the police – the future date upon which a police ability to use s18 MHA to bring the patient back expires <<< you should see the look on some nurses’ face when you ask for this. (Para 22.15 CoP MHA.) It is a duty for the reporting MH professional to specify the date, not leave the police to work it out.
- Finally, the Department of Health laid to rest in national guidelines the myth than MH trusts cannot take and provide photographs of missing patients, to assist police missing persons investigations.
A final point for me: if a patient is missing for more than a certain period of time, the NHS will often ‘re-allocate’ the bed to new patients. I’m told some areas use a 24hrs or 48hrs timescale.
If the patient is found after this time, there is no authority in law to hold that person in police cell until bed management arrangements can be sorted out. Section 18 allows that AWOL patients “subject to the provisions of this section, be taken into custody and returned to the hospital or place”. In this sentence ‘taken into custody’ does not mean taken into a police ‘custody’ area! It means taken into a condition of ‘legal custody’; ie, by the detaining authority exercising a duty under s18 MHA.