Quick Guide – Mental Health Crisis in Private Premises

  • This guide is an attempt to “operationalise” complex issues and you should refer to your area’s policy and your supervisors for specific local requirements.
  • BACKGROUND
  • Assess the situation as best you can, with regard to mental health, injury / illness / overdose.
  • Call an ambulance, where appropriate.
  • Keep in view: mental health presentations can mask underlying medical conditions or complications.
  • In private dwellings, the police service in the UK have no powers to utilise mental health law to resolve a mental health crisis.
  • They only have powers to arrest for criminal offences or for a breach of the peace and to force entry in order “to save life or limb”.
  • There is no power to force entry for a ‘welfare check’.
  • The Mental Capacity Act 2005 (England / Wales) and the Adults with Incapacity (Scotland) Act 2000 are of only limited capacity in private dwellings – where there are imminent and serious risks involving people who lack capacity.
  • INITIAL ACTION
  • Considered in this order –
  1. Proceed voluntarily – most support / interventions should seek consent or cooperation, where possible.
  2. Mental Capacity Act 2005 – have you attended a (more-or-less) life-threatening or life-altering medical emergency where someone 16yrs or above lacks capacity?
  3. Criminal or Common law – do you have police powers to arrest someone for an attempted / substantive offence or for a real Breach of the Peace.
  4. Mental Health Act 1983 – consider whether grounds for using s136 woul be met, had the encounter occurred in a place where the power could be used?  << This is a benchmark: escalate the incident to 24/7 MH or AMHP services for consideration of an MH / MHA assessment.
  5. Children – the MCA cannot apply to those who are not yet 16yrs of age, but parental consent may provide the basis to act for younger children, or a PPO under s46 of the Children Act 1989 may apply if the child “would otherwise be likely to suffer significant harm”.
  • Once considered and where appropriate to the treat and risk: call an ambulance to the scene – you have attended a healthcare incident and what you consider to be a mental health presentation may, in reality, be something else.
  • Consider relatives or friends who could be called to assist and support the person, especially if all discussion indicates there is no legal power by which to act.
  • SUBSEQUENT ACTION
  • Make a decision of whether you can proceed voluntarily or whether it is possible to effect a restrictive intervention.
  • Having called an ambulance, consider calling one or more of the following sources of intervention, support if it is felt that follow up mental health care is necessary:
  • Ensure any referral is made for safeguarding to the appropriate authority or confirm the ambulance service are doing so.
  • LEGAL REMINDERS
  • There are no powers for police officers to act under the Mental Health Act in private premises.
  • There is no ability to stop people moving around their own home, accessing rooms or locking them, leaving the premises or picking up items within the premises which could be potentially harmful to them or others:
  • Unless –
  • It constitutes a criminal offence or a Breach of the Peace.
  • Article 8 of the European Convention is of application to people’s right to peaceful enjoyment of their possessions.
  • Parliament intended the coercive response to mental health crisis in private – except where there are imminent, life-threatening risks – to be an AMHP and DR (or MHO and DR) undertaking assessment for urgent admission under law.

Winner of the President’s Medal,
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award

 

All opinions expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2019


I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current.  Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.

Government legislation website – http://www.legislation.gov.uk


One thought on “Quick Guide – Mental Health Crisis in Private Premises

  1. Could I throw in a question/consideration please? It sort of relates to:

    “Consider sources of information, including the patient themselves, to establish professionals connected to ongoing care, if any”.

    From the point if view of a MH service user who has had much recent contact with police, there is one issue that keeps popping up for the officers dealing with me… Namely, refusal to attend A&E for mental health assessment.
    Reaons are that I feel I cannot cope with the wait in A&E (average 4-6hrs, sometimes significantly longer) and as the end result is invariably being sent home with the crisis team’s phone number (which I already have) it’s utterly pointless. It actually makes things worse as I’m basically in the same position just several hours later, with the added indignity of attending A&E with cops. (though they are usually very nice!)

    I know you’ve written about powers for police to remove someone to a place of safety, and mental incapacity – but I’m talking about people who are suicidal/very emotionally distressed who know full well they need help but know equally well they will not find it at hospital. Mental health workers definitely fall on the side of “being suicidal is not grounds for incapacity”, though most police officers I have met in these circumstances (understandably) use this power anyway.

    I guess what I’m trying to say is that it may be better for the person NOT to attend A&E, although I suppose it gets complicated around responsibility if something happens. Once someone’s been assessed, even if overall it makes things worse for them, the (potential) finger of blame is not pointed at police. Is there any way to contact the mental health professionals and sort of officially pass the responisibity over to them, without removing the individual in question to a potentially unhelpful environment in A&E?

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