Another Day, Another Outrage

Another day, another child detained in police custody for a protracted period in sensitive circumstances. This time it was under the Mental Health Act as a place of safety and she was there for 44hrs “without food or drink”. Her Majesty’s Inspectorate of Constabulary came across the case when undertaking a routine inspection of child protection issues in Nottinghamshire. Their report covered very many more issues and areas than mentally unwell children in custody, but this was very much the headline story. When I first read about it on the BBC news website the headline made it look deliberately tortuous on the part of the police, as if they had deliberately denied her food and drink. Reading the article in full, Assistant Chief Constable Steve JUPP explained that she had been repeatedly offered food and drink but had declined those offers and the headline was altered later in the day.

I admit to the wording of report itself is curious (p23) –

“The most serious case seen by inspectors involved a 16-year-old girl who was detained for 52 hours in the central police custody suite before being transferred to a healthcare setting. It was only after the girl had been in custody for 44 hours that custody staff realised that she had gone without food or water. She was subsequently treated by a paramedic before being taken to hospital.”

The police cannot force those in their custody to eat and drink – it’s against the law! I wondered whether this meant that she was repeatedly offered sustenance but the first point where her repeated refusals were assimilated into one broader, cumulative concern was almost two days after her arrival? Easily done when custody shifts are changing three times a day. Ordinarily, everyone who comes into custody is fine within 12-24hrs and I’ve often wondered how long you would let someone detained under the MHA remain there if they are not eating or drinking? At what point do they become unfit to be there at all, if they ever were?

This situation is exactly the sort of thing that the Home Affairs Select Committee said only last must “immediately stop”. The Government indicated in their review of sections 135/6 of the Mental Health Act that they will legislate to prevent this sort of thing in future because it is very far from being the first case to outrage us in recent times and some might wonder what other kinds of outrage we have to learn about to ensure that it doesn’t happen again?

AGAIN AND AGAIN

We are only a few months on from the case of the 16-year-old in police cells in and you may or may not remember that one feature of the MS v UK human rights case heard in 2012 was a detainee who refused to eat or drink, probably because his condition being so acute he was paranoid that police officers were trying to poison him. It should come as no surprise that some very unwell people often don’t react well to the police. In the MS v UK case it was remarked that the patient was in “dire need or psychiatric treatment” that could not be undertaken in police custody.

So whilst the media were having a discussion about the almost torture-like deprivation of food and drink, no-one was adequately questioning why that situation came about in the first place? Any person detained under the Mental Health Act should expect admission to a mental health place of safety and police custody will only be used as a last resort, after the consideration of alternatives. That this young woman was in the cells at all indicates a lack of accessible NHS provision. I don’t know whether Nottinghamshire is one of those areas where u18s are denied access on the basis of age, or whether the PoS was full at the time of her original detention. But we can also infer from ACC JUPP that she had been assessed under the Mental Health Act so perhaps the protracted delay meant another situation in which a decision to admit had been taken, but there was no bed?

So whilst acknowledging that there will always learning for the police in these difficult cases, maybe the headline to the article should have read, “Police safeguard a young woman because of lack of available NHS services” or similar?!


IMG_0053IMG_0052Winner of the President’s Medal from
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award.


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8 thoughts on “Another Day, Another Outrage

  1. I thought the headline was appalling – as you say. Often people suffering from mental illness find it difficult to eat or drink in stressful situations. I have a friend who has been in the same situation although not for as long…….I am concerned that it appears that no one had spotted that she wasn’t eating or drinking though. However none of this would be an issue (for the police anyway) if mental health services did what they are meant to do. Waits for assessment can be enormously long, aggravated if there is effectively no out of hours service and a visit to A&E is needed. Then, as you say, she was presumably waiting for a bed, and surely there should be a better stop gap solution than leaving someone in custody. I think I have said before, that perhaps everyone in mental health services involved with this area of menat health should experience the whole thing for themselves ……..

  2. Dear Mentalhealthcop
    As always you make such pertinent points.
    For me, I feel that we need to scrap all the “mental” legislation altogether. Instead if a person is ill, needs healthcare, irrespective if it is mental, emotional or physical or a mixture.
    If a person is in danger, then there needs to be something sorted out by the legislators as to what happens next.
    Rosemary

  3. A person who won’t eat in a strange, temporary location with no privacy may simply be avoiding the need to defecate, especially if the person has some digestive problems, hemorrhoids, etc. or there is a chance of being seen or interrupted, or of becoming dirty and smelly afterwards and having to just stay like that. For some people, this bodily function is the main scheduling issue and reason to want more privacy.

  4. That headline was appalling, I know from personal experience how hard it is to accept food or drink while being under a 136 in a police station, it should of been spotted in this case and further action taken to help the young person in her needs

  5. Very valid points and yes, the girl shouldn’t have been there. However you are shoving all the blame onto the NHS-again. With cuts to services and “efficiency savings” we’re simply not able to provide the services we once did and the NHS Act makes it grotesquely easy for the private sector to undercut us and cause further service fragmentation. Put it this way; when I’m working a night shift in liaison there is literally one of me to get round anyone who is referred by A&E. I have had many disputes with (understandably) frustrated police officers as to why I am having to prioritise and may not be with them for several hpours.

    1. “Provide the services you once did” – this post is about s136 PoS provision and ten years ago you had less than you do now, not more. As outlined, funds were made available to sort this in 2005/6 and often, they weren’t even applied for. And it wasn’t me, the Givernment or the public who chose to give mental health a differential, disadvantaged cut of spending whilst at the same time underspending the NHS budget by billions.

      So, yes – I’m shoving most of the ‘blame’ onto the NHS … but I’d prefer we called it ‘responsibility’.

      I can’t for the life of me work out why the NHS is paying so much money for non-essential, non service delivery things before it has nailed down basic requirements like places to take unwell people in urgent circumstances.

      1. I remember o sitting in a meeting with a young adult relative,and representatives of police, AMHPS, CMHT and A&E. It was explained to us that unfortunately the s136 assessments couldn’t be carried out in A&E (if you needed to be there anyway for physical injuries) as the waiting time would risk A&E breaching their 4 hour waiting target. So you know exactly where you stand in the NHS list of priorities………..

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