There has been an 8% rise (at least) in the use of s136 of the Mental Health Act 1983, in the year ending March 2022. In one force areas there has been a 55% increase in the use of this power in a single year – West Midlands Police rose from 1,221 to 1,888. We’ve known that use of s136 has been rising nationally for a long time, but data quality on the power has always been questionable. Whilst there is still room to question, the Home Office stopped labelling s136 data as ‘experimental’ in 2016 and we’ve had annual reports ever since. That said, I still have questions and this post is just to raise them.
The highlights are –
- 36,594 detentions – an 8% increase compared with the previous year (excluding Dyfed-Powys who were unable to provide data in the year ending March 2021), and a 7% increase compared to the year prior to the COVID pandemic.
- 52% of detentions were men, 94% were adults (18yrs or over) and 84% from the white ethnic group.
- where the details were known, the person detained was taken to a health-based place of safety (ie, a mental health unit) in 68% of cases: 29% were taken to Accident and Emergency as a place of safety, and 264 people (or 0.8%) were taken to a police station.
This is the highest number of s136 detentions in a year, on record. It represents an increase in the number of people taken to (or kept at) a police station as a place of safety. These numbers at one point were just over 100 per year, representing a smaller percentage. But I still have a lot of questions about the quality of this data.
I’m interested in force usages: Greater Manchester Police and West Midlands Police are two of the largest forces in the country and have usage of 2,100 and 1,888, respectivelly. But Avon and Somerset Police, which is smaller than both of them, have usage that is almost as high as GMP at 2,015. Thames Valley Police has usage which sits broadly around the level they had 10-12yrs ago, at 1,508 so it’s interesting to note their’s isn’t rising. Some forces who invested heavily in street triage schemes have sustained significant reductions in use of s136 – Northumbria and Leicestershire, for example. But it’s noteworthy that some forces who tried triage and couldn’t initially make it work with the same effect, have seen increases, like Lancashire and Kent.
So there’s a lot going on in these numbers and I would caution against making simply comparisons about force areas and sizes, because to me, this variation in numbers reflects a complex network of variables. We know that forces working alongside mental health trusts rated highly by the Care Quality Commission are doing quite well with their s136 numbers; whereas forces which aren’t … well, they aren’t, put quite simply. But it’s more complex again than that, because there are also cultural factors in play.
USE OF A POLICE STATION
In this reporting year, 264 people were removed to (or kept at) a police station as a Place of Safety. The spreadsheet contains detail as to why and force listed one of the following reasons –
- Conditions in regulations met
- Arrested for a substantive offence
- Not known
I’d love to know more about what all of this means – because I admit, that I don’t necessarily understand. “Conditions in regulations” is easy – this means were the criteria in the Mental Health Act (Place of Safety) Regulations 2017 satisfied? In only 89 of 264 cases was that the reason. “Arrested for a substantive offence” confuses me: does this mean that in addition to detaining someone under s136 MHA, they were also arrested for a substantive offence and taken to custody because of the criminal issue? It happened 114 times in the year and West Midlands Police accounted for 62 of those occasions, over half of them. It did make me wonder what the forces are counting and it could include, for example, the use of s136 in a police custody setting as someone is being released from arrest for a substantive offence. If that is what this means, then one force accounting for half of the examples is worth understanding because a) that shouldn’t be the case in national data, even if the force concerned is a larger one; but b) use of s136 in a police custody setting as someone is being released, but where those 2017 statutory regulations are not satisfied is simply not an example of police custody being used as a Place of Safety. Section 136A makes this clear, if you want to read it for yourself.
And so that’s why I do not understand the “arrested for substantive offence” section and why I wish the Home Office would publicly define what they mean by this. National guidance on policing and mental health from the College of Policing advises against using s136 MHA and arresting for an offence and use of the power in custody as people are being released to be taken elsewhere shouldn’t be counted as use of a police station as a Place of Safety, in my view. We obviously cannot know why custody was used for “other” and “not known” categories because they’re not further explained.
This power is now sitting at roughly double the rate the IPCC estimated it to be in their 2008 report on Places of Safety when national usage was a little over 18,000. A doubling of the power in 14yrs, esp in circumstances where police officers are having to remain in A&Es or mental health units, represents a significant increase in demand. Most s136 detentions in my experience last almost all of the 24hr period and in many areas, this means 2 officers for that period of time. You can do the maths: 24hrs x 2 police officers x Increase in Number of Detentions = hours spent. Divide that number by 2,000 and you will know roughly how many full-time equivalent police officers are deployed on the security of vulnerable people during s136 processes. Then bear in mind that the 2011 / 2013 multi-agency guidance on the operation of s136 MHA suggests that in most cases where someone is removed to a health-based place of safety, officers should be released from there within 30mins. << Yes, really!
A&E must also be experiencing the fallout from rising usage: the numbers above show a good proportion of all those removed under this power are going to A&E – some will be for additional medical reasons, like cuts or an overdose but many will be in A&E purely because the local health-based place of safety is full. As demand has increased in some areas, the capacity of the mental health system to handle that rise in demand has not increased, nor has the provision and avaiability of AMHPs and section 12 doctors, who are ultimately crucial to timely resolution of assessments. Plenty of areas simply don’t have an AMHP on duty overnight, which I find remarkable.
A quick tour through the numbers and my reaction to them: there’s plenty more could be said about it all!
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, 2022
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