Section 136 and Children

There are various references to children throughout posts I have done so far, but it has been suggested I bring together in one piece a few thoughts about police dealings with children with mental health problems.  I think it might take a couple of posts so I thought I’d start with s136 Mental Health Act and equivalent legislation.  My favourite subject!

Firstly, all the standard stuff about s136 applies to children.  If you look at the FULL INDEX, above, you will find loads of different articles about s136 and alcohol, exlusion criteria, private premises, responsibilities, etc., etc. as well as practical guidance for police officers.  All that still applies, plus the requirements of involving specialists for children in the assessment.  There are some additional practical issues, though:

The use of s136 is not age restricted.  My own force has arrested children as young as 11 and 12 under the Mental Health Act, as well as some very elderly people.  The first problem you encounter when children are detained is a reluctance of the general mental health or NHS services to have anything to do with them, even as a holding position until Child and Adolescent Mental Health Services (CAMHS) are available.

  • When NHS services design and develop Place of Safety facilities, they tend to be within the ‘general adult’ units, because most people detained are adults of working age.
  • CAMHS are often a distinct part of a mental health trust because of the specialist nature of the work OR they are a totally separate mental health trust altogether.
  • So, some NHS areas do not allow their PoS to be used for people under 16 or sometimes under 18.
  • Of course, the PCT could commission in way that overcomes this problem, and whilst some do, more don’t.
  • In many areas CAMHS specialists are simply not available 24/7 or out of office hours to respond to s136 detentions or children in police custody for offences for criminal offences if MHA admission is thought necessary.
  • Where the police in one area arrest an 19yr old under the Mental Health Act, they go to an NHS facility, arrest a 17yr old and they have to go to the cells.
  • The numbers of people being arrested under the MHA in any area is predictably low – perhaps as few as 2 or 3% of total numbers.  In some areas, this amounts to 2 or 3 children a year.

What justification is given for this?

Often, it is a theory that placing a child in an ‘adult’ PoS, within an adult mental health unit, presents safeguarding risks.  It is relevant to explain, that if a child is EVER admitted onto an adult mental health ward, rare though that should be, the NHS Trust have to undertake significant safeguarding functions, exceptional reporting requirements and special nursing arrangements.  However, this relates to a child fully detained under the Mental Health Act on an adult psychiatric ward where there are other adult patients.  How there is a ‘safeguarding risk’ to a child in a PoS within an adult unit where there are locked in a bespoke facility for one person, with controlled exit / entry points and where the only other people present with the child will be trained, vetted professionals and / or the child’s family, I’m unsure.  Indeed, I know NHS lawyers and others have rejected the whole argument that it is any safeguarding risk at all.  Especially when compared to the alternative.

Of course when you ask where the child should be taken instead and they explain, “the police station” you immediately win the counter-argument:  “You want me to take this child for safeguarding reasons to a place where I cannot possibly control whether or not there could be drunken, violent men; child pornographers, rapists and burglars? Say that back to yourself and listen to it more carefully: in proximity to violent / drunken / sex offending adults?

Incidentally, those who argue the kids or anyone else for that matter, should go straight to the cells should be reminded to read para 10.22 of the Code of Practice:  when an NHS facility is not available or non-existant, there should be no automatic presumption of the police station being used.  Why don’t we run these kids home, assess the safety and suitability of their home address, the cooperation or otherwise of parents / guardians, etc.?  If satisfied it would be appropriate explain, “Your son / daughter has been formally detained by the police under the Mental Health Act and needs to seen and assessed by a Doctor and an AMHP.  If you agree to let me remain here with your child, they can be held here for assessment.  If you don’t agree to my remaining here, I’ll have to take them to the police station.”  <<< All legal, if done with care and attention to safety and suitability.  Which parent would say “No”?  Probably the ones whose houses you would assess as unsuitable so you wouldn’t have asked.

What must it be like to be 13yrs old, arrested whilst undoubtedly scared? – I don’t care how tough they think they are or claim to be: you get arrested or detained by the police when you’re mentally ill, you’ll be scared.  Imagine being taken to a sparse looking cell block not knowing what will happen, where you find there are people thumping on cells doors FOR HOURS; screaming abuse and telling custody sergeants that they hope their kids get cancer; that they are going find and rape their wives (usually verbalised more graphically).  Put my son there and I’ll be off to see a solicitor.

Of course, using police cells instead of an ‘adult’ mental health facility PoS, it still won’t overcome the ability to engage CAMHS specialists in the pathway of assessment or admission, if required.

I once took a senior NHS manager to a cell block in my area.  Fortunately, his hospital was just across the road from the busiest custody facility in the force and it is a listed building from the 19th century, so the custody area looks like the set from Porridge.  A multi-level, Victorian Gaol.

I couldn’t have arranged things better if I tried on a Wednesday afternoon – howling, fighting drunks, screaming shouting.  Hysterical female shoplifter being booked into custody screaming about picking up her kids from school and spitting at the arresting officers; there was a rapist in custody being dealt with by the Public Protection Unit as part of his sex offender registration requirements.  The custody sergeants were looking a bit stressed and just grunted when I explained who I was, why I was there and so on.  I gave the NHS guy the tour and showed him the medical room: this is a ‘cell’ that has had a medical ‘bed’ put in it, a desk with two chairs and a few kitchen cupboards for forensic and other kits.

I just looked at him and asked, “Have you got any kids?”  I didn’t hear the answer because the drunks were screaming.

No child detained under the MHA goes to a police custody area in my force.

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4 thoughts on “Section 136 and Children

  1. My local CAMHS place of safety is a paediatric medical ward. It’s not the idea environment, but it’s well-staffed and secure. The nursing staff are pretty good on mental health, and largely free from the negative attitudes towards self-harmers that you sometimes see on medical wards.

  2. Thanks for sharing this info, I work in a CAMHS team and this has helped me think about the info I share with professionals (camhs&social care) in terms of s136 and PoS. I guess I’ve also never thought about the reality of being placed in a cell! Our local paeds wards are usually pretty good till we can get there the next morning to carry out a MH assessment.

  3. When you said it’s rare to see kids on adult mental health wards its not in my experience. I spent 4 months on an adult mental health ward when I was 16, still in school and detained as a child under the mental health act. I should of been transferred to a CAMHS unit but there was a long waiting list and in the end I was just kept there. There was also a 13 year old and two other 16 year olds on the ward in the time I was there, all detained as children yet kept in amongst adults.

    It was scary because some of the adults where violent and I didn’t feel safe and the nurses didn’t really know how to handle kids, as the are adult mental health nurses and not CAMHS. I had to leave school because the didn’t bring in a teacher to help me with my school work and I spent 3 months not allowed to leave the ward. It was horrible and I don’t ever want to go back there.

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