Anyone fancy doing a PhD?! – we’re badly in need of some proper research to be done on section 136 data so we stand a chance of knowing what on earth is going on! Friday saw publication by the National Police Chiefs Council of the latest data on the use of this power and we can see various ways of looking at this stuff if we wanted to provide a tabloid-style headline. So depending on whether your glass is half full or half empty –
“Use of police cells as a Place of Safety reduces by over 50%!”
“Police use the Mental Health Act more than ever before!”
In then bears much further scrutiny and begs many more questions –
- Why are some police forces of similar size using s136 very differently?
- Why are some forces using this power to a very similar extent when they are so obviously different from each?
- Why have some forces with street triage schemes reduced their use of s136 and sustained that, whilst others reduced it but it has returned to normal levels?
- Why have other forces not reduced it at all, despite street triage?
- Why are some forces still relying upon police custody for almost half of their Place of Safety provision, but some haven’t used the cells at all?!
- Where s136 has been used in the street, how long does it take to sort out where someone will be removed to and how long are officers sitting in queues for hours until they can even get in to those locations?
Here is the Press Release from the National Police Chief’s Council (containing links to the last two year’s worth of detailed data). The image below, broken down by force area, is for 2015/16 and at the bottom, in yellow, are the total figures for the last three years. During reaction to the release of this data, I raised caution about the accuracy of the numbers involved: not only are simple year or year comparisons sometimes unhelpful, but we know there are still problems with this data despite the effort of NPCC to collate it.
Comparing this year with last year, use of s136 is up by almost 5,000 to 28,271. However, we know there was an incomplete data last year! To point out one big example of that, in 2014/15, the Metropolitan Police reported incomplete data (for whatever reason) which put their annual numbers at 829. This year it was 3,693 – up by almost 3,000 and back to where you’d roughly expect it to be (albeit rising). Factoring that in along with other data omissions, we can see the 2014/15 data needs a lot of salt! –
- 28,271 (15/16) – inc 2,100 to custody.
- 23,602 (14/15) – inc 4,537 to custody.
- 26,137 (13/14) – inc 6,667 to custody.
Here is the detailed breakdown, across England and Wales. The header image of this post, above, is the (inaccurately!) recorded use of s136 going back over a decade.
WHAT’S GOING ON?!
Who knows what’s really happening?! In reality and based on what we know there are a large number of significant factors influencing all of this and understanding the relevance of them to different areas is fairly important. It is quite beyond me to understand it all without a great deal of work in each area that I don’t have the time to do! So I would encourage people reading this in various areas to try to ensure the conversation starts and perhaps engage some decent academics to look at it?
I still receive enquiries at the College of Policing about mental health street triage with people asking, “What’s the best model to operate?!” and I always reply, it depends what your problems are and what you’re trying to achieve. And of course, none of this even begins to discuss the issue of the ‘conversion’ rate, which is a major piece of information used by some professionals to argue the police are over-using this power. Previously, just 17% of people detained under s136 would be admitted to hospital under the MHA but we know two things that put this figure in context –
- The threshold for admission is not a constant factor – many MH professionals have been arguing it has risen over time as the number of available inpatient beds has significantly reduced. Is it any wonder that with fewer beds, fewer patients become inpatients?!
- How many ‘successful’ outcomes do not involve admission under the MHA – how many patients were admitted informally, referred or re-referred to a community mental health or other health service? If a cop spots a vulnerable person who is subsequently cared for by a community MH team who transforms their life, isn’t that a success?!
I would argue, for a few reasons, there are forces in represented in the above data who are under-using this power and need to think about how to use it more. I argue this because section 136 is just one legal power from a a whole range of legal authorities that can be applied by the police in various situations. To fully understand section 136 usage, you also need to understand how it fits in to those overall options. How many people arrested for criminal offences or to prevent a Breach of the Peace were subsequently and rightly assessed in police custody under the MHA because of concerns for their health? How are interactions between the police and people with potential mental health problems handled and what factors influence an officer’s decision to a) detain; and b) chose the framework for detention?
In other words: are some forces more likely than others to find their officers are using public order laws, drunkenness laws or other provisions where a further moment’s pause and interaction may make it clear that detention under the Mental Health Act is a more appropriate route – and how do forces encourage officers to make decisions where substantive offences are involved like possession of a knife or an assault? Only this week, we saw concern raised by a judge about a prosecution being dropped where a man was waving a knife around in a public place whilst mentally ill; this comes just a few months after a coroner raised concern that the police arrested someone with mental health problems for possession of a knife and didn’t detain her under the Mental Health Act.
This is the last set of data to be published ahead of the law being changed in 2017 and it’s obvious that some areas have far more work to do than others to prepared for the likely implications. If police stations are banned (one amendment to be discussed in the Lords next week will seek a total ban), there are seven police forces who need to be thinking of their contingency plan for over 100 people a year – will that mean unless there is provision, each of them is taken to A&E?! I fully accept colleagues in A&E may have a view about this but if the law literally bans the use of custody and there is no health-based Place of Safety, what are the other options?!
We are obviously still waiting to learn what ‘exceptional circumstances‘ will mean if that Lords amendment is defeated and the original proposal in the Bill is enacted. A further problem that is not reflected in these figures is the ability to access a bed for those who are to be admitted to hospital following the police’s use of s136 MHA. Only this week, I was called at 9:30pm by a triage car from one force who told me their duty inspector was putting pressure on them to sort a situation where someone had been in detention in a health-based PoS for around 30hrs and the MH trust were having a right old job finding a bed in either the public or private mental health sector. In eight months time, that situation will either be unlawful and a violation of European Convention Rights; or just a couple of hours away from becoming so.
Section 136 MHA and everything that flows from it and is associated with it needs to be better understood. In all fairness, there are PhDs being done as right now on the use of the power, on street triage and other aspects of policing and mental health. However, what access those research students have to some of the data, I don’t know. How many forces or MH trusts will be free with data that supports the notion that they are breaching the law or Codes of Practice to the Act because of the overall pressure on our mental health system. How much of this research will reflect operational practice where police officers are sometimes required to become involved in or responsible for highly un-desirable situations that should never have occured in the first place?
We have a lot still to do – and first of all: what is section 136 actually for?!
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2019
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 – http://www.legislation.gov.uk