Turgid Buffoonery

Discussion about mental health and policing often turn to the law.  Not only in terms of who can do what, but also in terms of how or when it should be done.  Some of these debates are delicious because in many respects the law is quite vague and many people COULD do certain things, but who SHOULD do them can be a cause of tensions and reasonably differing opinions. Sometimes, different opinions can be less reasonable.

I have a theory that in an attempt by professionals in each agency to cause the others to do certain things or to do certain things better, differently or faster; we’ve entered into myth-making on a near industrial scale and that this is represented in certain “legal” discussions.

As a police officer trying to get my head around mental health law some years ago – an effort I still make when I find myself uncertain – I found it very different in nature to law that I had studied in promotion exams for the police.  Far more inclined to be vague.

It is interesting that the syllabus for the legal examinations to sergeant and inspector do not include examination of ss18 and / or 135-8 of the Mental Health Act 1983 – these are the main sections for the police.  There are other sections of interest to those of us who are more involved in policy work around this, such as 6, 13 and 140 and all of Part III MHA.  Of course there’s then the Code of Practice to the Act: all police supervisors should read chapters 10,11 and 21, 22; and chapter 4 for those of us a touch more interested.

I find the Code of Practice itself interesting – the police have loads of these things for different laws and I’ve previously blogged about the difference in some cultural attitudes between the police and the NHS towards them.  I was interested last week for example, to be told of an NHS area who WANTED a mental health patient detained in the cells because they were under the influence of alcohol: “we cannot assess someone whilst they’re under the influence because it breaches the Code of Practice and we ignore this at our peril”. Well, it actually doesn’t – this is more mission creep: it is advised against except in some very specific circumstances.  However, my main concern was that this remark came from professionals seeking the removal of a person to the cells when a perfectly available NHS PoS was sitting there, empty.  They were worrying about hypothetical future patients, yet to be detained when someone was in need of the place – if we detain someone else in half an hour, we’ll cross that bridge at that time.  In the meanwhile, you want the police station used as an automatic second choice when you’re not unable but simply unwilling to let the NHS PoS be used?!  Please read 10.22 to the Code of Practice to the Mental Health Act 1983 and then read R (Munjaz) v Ashworth Hospital Authority (2005).

So, after a day at work as the duty inspector where I was exposed to some nonsense about missing patients, MHA assessments from NHS and to myths about the “capacity” of offenders by police officers, I just wanted to quickly list some other rubbish that I’ve heard in my time.  I hope to provide balance by being equally dismissive and disparaging of nonsense heard from each side.  Many of these things are urban myths and have become ingrained in some areas’ operating practices.

I am only including things in this list if I have reached a point of being utterly bored of hearing them owing to their frequency:

• The police cannot arrest under s136 MHA if the person is in A&E
• To decide whether or not to prosecute a mental health inpatient for an offence, the police need a statement of evidence from a psychiatrist affirming the patient’s “capacity”.
• Only the police can keep someone detained against their will in a Place of Safety, after being removed there under s135(1) or s136.
• Only the police can use physical force to restrain a patient in a community MHA assessment, in order to compel that person to hospital once ‘sectioned’.
• It is always the role of the police to recover AWOL patients.
• If the police are in a private dwelling dealing with a mental health crisis, they can use the Mental Capacity Act to remove the person to A&E or a place of safety.
• Victims of crime with mental illness are inherently unreliable at court.
• Once you’ve detained a patient who is AWOL from hospital, you can keep them in a police cell if the hospital to which they should be returned does not have a bed.
• A&E is NOT a place of safety.
• An AMHP cannot use force on a person who they’ve just ‘sectioned’ to move them into an ambulance.
• Paramedics cannot use force on a person that has been sectioned by an AMHP [who has properly delegated authority under s6.]
• An AMHP can order or instruct the police or ambulance service to detain and convey under s6 MHA, someone for whose admission to hospital has been applied.
• If we don’t have a bed into which the admit someone who needs ‘sectioning’ then we don’t have a bed and that’s the end of it.
• Violent patients detained under s136 MHA should always be detained in the cells.
• A person who is detained under the MHA in hospital can’t be arrested or prosecuted.
• You cannot get a s135(1) warrant for an MHA assessment if you already know you can get access to the premises.
• The police can neither apply for nor execute a s135(2) warrant on their own.
• You cannot arrest and remove a s37/41 hospital order patient from a secure unit after they have committed a serious offence.
• You can’t stop psychiatric patients leaving a hospital ward and going AWOL if they want to.
• You cannot arrest an inpatient for an offence, unless the RC in charge gives permission.
• There is no point, legally, in prosecuting a s3 patient for violence on wards because they’ll end up back in the same place getting the same care from the same professionals.

I might add to this list if more comes to mind – feel free to add your own, below!  But this stuff is just turgid buffoonery – some stuff is just “wrong”.  Which other way do we need to describe “wrong”?! … and we all do it to each other.

---

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

Winner of the Mind Digital Media Award

 

All views expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2012

---

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 – www.legislation.gov.uk