Earlier this week, the police Federation Magazine contained a call for the removal of police powers under the Mental Health Act. It struck me as an unusual and courageous idea and it prompted a response. Having since discussed it with the Police Federation lead on mental health and custody, Sergeant Kevin HUISH, I offered to publish any further remarks or replies he had. This is Kevin’s blog:
2 + 2 Doesn’t Make 10
Mental health should be subjected to healthy debate!
I first started the debate on removal of section 136 Mental Health Act powers from police officers at our annual conference in May this year but it didn’t really take off. Well all that changed this week with the comments in the ‘Police’ magazine and that’s a very good thing. Sometimes you have to put out what seems really unpalatable in order through the debate to get to the right solution. It is also very important to remember that the person in crisis is at the heart of our thinking and the best solution for their care is the outcome we should seek.
It’s important to point out that it isn’t Federation policy to seek the removal of the powers from police officers but an idea that through debate may prove unrealistic or inappropriate but then again if implemented correctly might just work. Michael has some very valid arguments and sound reasoning to think that complete removal of s136 powers from Police may be a step too far and I value his expertise and judgement but let’s not just write the idea off without due consideration. Let’s follow the debate through to its natural conclusion. I have no doubts the debate will continue at the National Custody Seminar in Stoke on Trent on 11th and 12th September check it out at – http://www.polfed.org/ranks/1439.aspx
Let me put some background as to how I came up with the decision to spark the debate. Like everyone else when it was first suggested to me (by a senior executive at MH charity) early this year that s136 powers be taken away from police I had the same reaction as many did this week, but then I thought long and hard about it and decided it warranted further scrutiny. That coupled with a senior member of the NHS speaking at a conference and criticising police for over and inappropriate use of the power, questioning if we should have the power or not. I concluded that it could be a real possibility but only IF and WHEN the right people working in MH were properly resourced, trained and funded to provide the necessary level of service as first responders to people in a MH crisis situation. My suggestion is that MH Crisis Teams be the ones resourced and trained to provide that service 24/7, 365 days a year but there may be a more appropriate team.
In a submission to the Home Office I’ve said that it will take time, probably 3 – 5 years, before the removal of s136 powers could take place; that investment in Crisis Teams will be necessary to achieve this but that real long term savings could be made through patients’ crisis being more effectively managed in the community leading to less use of Health Based Places of Safety (HBPoS) and greatly reduced admissions to hospital.
In the interim period other changes are required to allow us to be more effective and additionally I’ve asked for:
- Section 136 powers to be extended to include private premises with a power of entry;
- Provision of Appropriate Adults for adults put on a statutory footing;
- Police officers not called to MH premises to restrain patients;
- Section 136 detention at police station reduced to 24hrs in line with PACE (if transferred to a HBPoS then reverts to 72 hours);
- Mandatory MH awareness training jointly delivered by MH partners for all police officers (as per Lord Bradley’s recommendations);
- The PACE clock stopped for those arrested for criminal offences but in need of a MH assessment (with statutory time limits for the assessment to take place);
- Abolition of informal exclusion criteria by HBPoS around drugs, alcohol, aggression, children and learning disabilities;
- Statutory requirement on commissioning boards to provide an adequate number of properly staffed HBPoS;
- Removal of police stations as a PoS under the MHA.
Interestingly, when I presented this submission to the Bradley Group (formerly the National Advisory Group to the Health & Criminal Justice Board) which is made up of all the leading charities, Lord Bradley, the Children’s Commissioner, the National Appropriate Adult Network, the Royal College of Nursing, the Prison Reform Trust, Magistrates and Service Users amongst others – it was well received. They thought there was real merit in considering the transfer of s136 powers to MH professionals in the medium to long term.
I’ve heard it said that the ‘street triage’ scheme is seen by some as an expensive secure taxi service for MH nurses (and worse). It’s too early for a full and proper evaluation but they tell us that in Leicestershire it has led to a big reduction in the use of s136 powers by police, fewer admissions etc., and that’s just one car on ten shifts per week. So why not go the extra yard and have an emergency response vehicle staffed by MH professionals equipped with the right training and powers? Do you really need a police officer sitting next to them? Or why not put a MH nurse in a fast response ambulance car? At least then when they’re not attending a MH crisis incident they can still be of use whereas now Leicestershire have lost four PC’s for ten shifts.
What I have also said in my submission is that of course the police will still have a role to play in supporting health colleagues if members of the public are at serious risk of harm or the person is considered so volatile that police support is necessary to contain and assist in a person’s restraint in a public place. But other than to provide an escort to the HBPoS police involvement should cease once the person is restrained and controlled. Additionally we will of course continue to appropriately arrest people with mental ill health who commit serious criminal offences.
I will leave you with some information as food for thought: there is growing anecdotal evidence from around the country that police officers are not using s136 powers of detention but are instead arresting those in mental health crisis situations for a breach of the peace, section 5 of the Public Order Act or drunk and disorderly. To me this is a worrying trend and far from the aim of diversion from the criminal justice system. Is it because of the difficulty in getting a person into aHBPoSor because of a lack of them? Work is certainly required to ascertain the reasons and impact. It will certainly impact on the s136 figures and not be helping to give an accurate picture of those in need of help. It is not the answer to the s136 problem and we should not be criminalising those in need of medical care.
Winner of the Mind Digital Media Award.