Interim Hospital Orders and Unusual Places of Safety

You will remember very vividly because of the attention you paid what a hospital order is, under s37 of the Mental Health Act. You’ll also remember how the Crown Court can ‘restrict’ a hospital order under s41 MHA. If you can’t and you want to refresh your memory, you can read my original post on Restricted Hospital Orders – I won’t tell anyone that you needed to but beware the test at the end of term!

Something open to a court which is considering a hospital order is to give it a “test drive” as a potential way forward and impose an “interim hospital order” under s38 MHA. This interim order can be imposed by the courts initially for a period of 12 weeks and it may then be renewed for 28 days periods up to a maximum of twelve months. If whilst a patient is detained under s38 the court is provided with information which leads it to conclude that a full hospital order under s37 is required, they can make it a substantive order without the patient having to be brought back before a court.

The criteria for making an interim order are that “the offender is suffering from mental disorder and that there is reason to suppose that the mental disorder from which the offender is suffering is such that it may be appropriate for a hospital order to be made in his case.” So I would like to put forward a inexact comparison with section 2 and section 3 MHA:

  • Sections 2 and 38 allows for detention because of mental disorder in order to establish a full diagnosis and treatment plan.*
  • Sections 3 and 37 allow for detention because of mental disorder in order to provide treatment for a confirmed and established diagnosis.** I am aware that is a very generalised comparison! – intended for colleagues in the police.

UNUSUAL PLACES OF SAFETY

Where are court is exercising a power under either s37 or s38, it may be the case that the hospital bed to which the patient is to be admitted is not immediately available. In such circumstances the court has powers – under 37(4) and s38(4) – to remand the patient to a place of safety for up to 14 days. In this legal context, the PoS definition applies to adults only and is:

“Any police station, prison or remand centre, or any hospital the managers of which are willing temporarily to receive him.”

When we think about a “Place of Safety” we normally think about police powers under s136 and s135(1) and we think about the definition in s135(6) of “residential accommodation provided by the local social services authority, a hospital, a police station or anywhere else temporarily willing to receive the person.”

Well, this is only one of two definitions of a place of safety under the Mental Health Act. That definition relates to those police powers under Part X of the Act; but there is another definition in s55 MHA and it relates to a PoS after the exercise of a Court’s powers in Part III of the Act – the part concerned with patients in connection with criminal proceedings.

Did you spot the bombshell for custody sergeants?! – yes(!) there are, in theory, just some circumstances in which a judge could direct the police to detain a patient in custody for up to 14 days! I have never heard of this occuring but I did recently hear of a prison being used as a s38(4) PoS which is what prompted this blog.

ABSCONDED FROM s38

Finally, only a police officer may re-detain someone who has absconded from a s38 MHA order and they must then return the person to the custody of the court; not return them to the hospital. The court may then decide how to sentence or handle the situation which could include remand to prison; return to hospital under s38 or proceed to full sentencing of whatever kind the court thinks is appropriate.

Update on 01st April 2015 – since writing this article, a new Code of Practice has come into effect in England.  It doesn’t substantially alter the post but certain reference numbers have changed.  My summary post about the new Code of Practice (2015) is here, the new Reference Guide is here and the full document is here.  The Code of Practice (Wales) remains unchanged.

______________________________________________________________________
The Mental Health Cop blog

Badgewon the ConnectedCOPS ‘Top Cop’ Award for leveraging social media in policing.
won the Digital Media Award from the UK’s leading mental health charity, Mind
– won a World of Mentalists #TWIMAward for the best in mental health blogs

ccawards2013 was highlighted by the Independent Commission on Policing & Mental Health
– was referenced in the UK Parliamentary debate on Policing & Mental Health
was commended by the Home Affairs Select Committee of the UK Parliament.

Advertisements

3 thoughts on “Interim Hospital Orders and Unusual Places of Safety

  1. There is much abuse going on with these diagnoses. My daughter was sent to the Bethlem Royal Hospital for a drug free period of assessment which I have in writing by Professor Robin Murray. No sooner had she arrived they offered Clozapine. My daughter flatly refused this drug and was against it and had signed an Advanced Declaration which was totally ignored and so was Professor Murray’s promise of a drug free period of assessment. What they did was terrible – after allowing my daughter to settle in the consultant psychiatrist said he would be reducing her but by 150mg off Seroquel. I complained this could not be done and he insisted this was what was going to happen. H e took her off this amount and mixed with with Olanzapine. As Dr Ann Blake Tracy, Head of the International Drug Awareness Coalition rightly says “this is how they keep someone for their establishement” “what they do know is that any sudden change in drugs can cause psychosis and mixing one drug with another can cause instability and this is what they did – they caused my daughter to go unstable and they caused the psychosis and slapped on a Section 3. They then cut my visits down to just 1 hr supervised/escorted only and constantly they threatened me when I turned up once and the promised room was not provided and they refused to let me even speak to my daughter. The Bethlem Hospital Fitzmary II ward staff then threatened to call the police and have been arrested – in fact I lost count of how many times they did this. If this is how they treated me as a parent then you can imagine how they treat the patients, these poor patients were all speaking about their human rights being abused and this is the reason why the staff did not want me on the ward as I was horrified by what I saw. When I complained my daughter’s face was covered in bruises and wanted to know what had happened I got labelled myself – aggressive and threatening and the ward manager of Fitzmary II asked me when this had happened as she saw no sign of bruising and obviously this was not brought to her attention or else she knew about it. Another m ember of staff said “I am happy with that”. I then got to find out they put her on Metformine which is being given off label for weight loss but should only be given for diabetes and then Clozapine and my daughter did not know she was on Clozapine. They test new drugs here using the patients as human guinea pigs and I am in touch with another mother whose son is so ill he can hardly move. So, the Section 3 I see is given for a firm diagnosis. I am sure you will see from my point of view that a proper assessment was not given to my daughter and therefore I cannot accept the diagnosis of Schizophrenia as only if a drug free period had been given according to the letter of Prof Murray, I would have been more prepared to accept a diagnosis. There are multiple diagnoses and after 14 mind altering drugs these have made my daughter worse, not better. Besides there are hundres of diagnoses in DSM V that apply to everyone and as the expert I have lined up to represent me in court says “its a travesty – I’ve been trying to change the system for 20 yrs” – thank God there are some honest experts. So where is the proof of this confirmed and diagnosed disorder of Schizophrenia when all the professionals know full well you cannot take someone off so steeply a drug given at 750 mg and mix it with another without causing psychosis? this resulted in the most distressing phone calls all day which I received at work from my poor daughter. I am furious with the rotten law in place that fails to protect vulnerable people like my daughter and the drugs that are allowed to be pushed left right and centre and then the so called professionals who are allowed to dish out label after label when there are no scientific tests to prove them. I am now demanding along with a group of other mothers a proper assessment by Dr William Walsh of the Walsh Institute and so far this has not been refused as I am willing to pay. I believe the enforced drugging of patients should be stopped. I think the police should be getting out there to meet some of these patients – not just to arrest them as they are suffering so much thanks to the rotten care and law that fail to protect them.

    1. Hi Susan, I’m a mental health advocate in Victoria, British Columbia Canada. It’s important for stories like yours to be told. The relavence of your story with the heading above raises the question “Who are we detaining and drugging, and who are we refusing treatment and why”?

      How many institutions would fear being audited, I mean surpised audits, where government officials walk in unannounced and review reasons for detenions, compare who’s being treated and whose being refused treatment. Is it possible some medical professionals are cherry picking their patients. If authorities are found to be acting in Good Faith many can accept the loss of a citizen’s liberties under MHA Law, but when some un-ethical authorities cross that line and Act in Bad Faith for what ever reason, then we all should be on alert, are there citizens being treated who do not need to be there, if so those beds could be filled with the pro-posed patients identified in this story.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s