Just Imagine …

Just imagine if you confidently knew your powers of entry when asked to locate and return a patient who is AWOL under the Mental Health Act 1983? – because if you knew the Act contained no power of entry without warrant, you would know that after knocking on a door, you had no right to then try the handle and enter the premises … then, you would not have found yourself involved in a restraint related incident in which an AWOL patient died and which then led to you being prosecuted in the criminal courts for wilful alleged neglect with all the disciplinary issues that flow from that and an inquest which found that your actions ‘more than minimally contributed’ to the patient’s death.  It’s a relatively simple point and incidentally one which was made very clear in 1992 when the case of D’SOUZA v DPP (1992) saw the police successfully challenged for seeking to rely upon s17 of PACE to justify entry to a premises when the law demanded that a warrant under s135(2) MHA.  The nugget of legal knowledge on the part of a frontline cop could have prevented all of that.

Just imagine you assertively understood the Mental Capacity Act was something you could rely on legally to defend your actions in forcing an unwell, alcoholic man to hospital after paramedics and his GP expressed concern that he could have a bleed on the brain and that he may well very seriously deteriorate?  Imagine if the paramedics had taken your refusal as your final answer on the subject and left the patient at home because he was too aggressive and resistant to do otherwise, not showing significant tenacity in working to overcome the obstacle you had come to represent … imagine knowing that it was only this paramedic’s determination to push beyond your refusal that prevented an IPCC contact death inquiry which would reveal you didn’t understand the legal frameworks you worked within and that the paramedic was utterly vindicated in pushing you professionally after the patient’s arrival in the hospital because he deteriorate so significantly that they ended up in an Intensive Care Unit in a critical condition.  He would probably have died at home, overnight.

I could go on.  In fact, I think I will ….

Just imagine you felt so despondent at the response of your local ambulance service after you detain people under s136 of the Mental Health Act that you stopped bothering to call for them because it was a waste of time?  Imagine if the vaguely confused man you had detained had been popped in a police vehicle for conveyance to the local mental health unit or police station and off you went, without trying or waiting for an ambulance.  Imagine you were just going into the building when he collapsed, unconscious because he actually wasn’t mentally ill at all, but someone with undiagnosed diabetes whose blood sugar was nowhere near normal after a day without food and a couple of beers at lunchtime … imagine if, by the time the ambulance got to custody or the MH unit, the wait had been too long to allow paramedics to start getting a clinical grip on the situation and that by the time he’d arrived in A&E the consultant was now managing an unconscious patient who was seriously unwell.  I wonder what the IPCC would think about the disregard of chapter 11 of the Code of Practice (2008) which will be chapter 17 of the Code of Practice (2015).

I think the point is made and trust me, I could go on.  And on …

Legal knowledge is important, for all of the reasons that these three examples highlight.  They are real examples, in case you were wondering!  The most basic level of legal knowledge that I suspect frontline officers need to have held in their head is all contained in just one post I wrote and which is not even 500 words in length. It is even in bullet point format to make it extra easy and at the risk of sounding dramatic, it may well actually save your career and even ensure your ongoing liberty to live your life – so it’s probably worth a giving it a read and committing it to memory.  Try and encourage your colleagues to do the same – because the above examples are just a few of those that I find where we’ve gone awry for the lack of a little knowledge and some persistence!

So just imagine how you would feel if you only realised afterwards how little you needed to know to prevent something going so very badly wrong?!

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

Winner of the Mind Digital Media Award.


One thought on “Just Imagine …

  1. It is very true in the first example , that if the officers had not entered, without the legal authority to do so the poor chap would probably not have died, having been restrained as described. However I will make the following observation – if the officers had sought the 135(2) warrant & used it, the chap might still have ended being restrained as described, with the same awful consequences.

    The warrant as you know allows entry, it does not dictate what the officers do once in the property. Sadly we will never know & perhaps the time taken to seek the warrant might have allowed an opportunity to talk etc.

    This case highlights, for me anyway, the need to do this kind of work together………but we simply don’t do it well enough. I wonder what steps the ward, cmht, RC, even his GP etc had taken to return the chap? & I wonder if MH services should have been with the police when they were knocking the door. I say that out loud knowing the resource implications for all the partner agencies. Even an ambo to convey. In this tragic example the presence of others might have helped prevent the prolonged restraint? I don’t know, but it is awful & makes me worry lots & very sad.

    Plz don’t think the above is a pop at the police in general. Because I think that we are all at times placed in almost impossible positions & clearly as you have articulated knowing the law is a very very good place to start.

    Correct me if I am wrong, but I think I saw the MCA example on a certain social media platform?

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