HMIC report: ‘Using police cells as a place of safety’

A joint review by Her Majesty’s Inspectorate of Constabulary, Her Majesty’s Inspectorate of Prisons, the Care Quality Commission and Healthcare Inspectorate Wales to examine the extent to which police custody is used as a place of safety under section 136 of the Mental Health Act 1983.

The HMIC, along with other bodies, liaised with police forces and NHS Trusts across the country to assist their research.

MHA

Section 136 (1) and (2) of the Mental Health Act 1983 state that mentally disordered persons found in public places:

(1) If a constable finds in a place to which the public have access a person who appears to him to be suffering from mental disorder and to be in immediate need of care or control, the constable may, if he thinks it necessary to do so in the interests of that person or for the protection of other persons, remove that person to a place of safety within the meaning of section 135 above.
(2) A person removed to a place of safety under this section may be detained there for a period not exceeding 72 hours for the purpose of enabling him to be examined by a registered medical practitioner and to be interviewed by an approved mental health professional and of making any necessary arrangements for his treatment or care.

A place of safety is defined under Section 135, and this does include a police cell.

The report states that police cells are regularly being used as ‘places of safety’. For example, in 2011/12, more than 9,000 people were detained in police custody under section 136, while 16,035 were taken to a hospital.

It is worth noting that those detained under Section 136 have not committed a crime, but are detained as they are suspected of suffering from a mental health condition.

Reasons for police to detain someone under this Section are that the person may be attempting suicide or self-harm, or ideation of suicide or self-harm, or showing “concerning behaviour”.

They may be detained for up to 72 hours, without any requirement for review during this period. In contrast, a person arrested for a criminal offence may generally only be detained for up to 24 hours, with their detention regularly reviewed to ensure that it is still appropriate.

In the report, it was found that police are using cells as primary or secondary places of safety. The reasons given were that the person was under the influence of alcohol, showing signs of violent behaviour, the hospitals were under staffed or that there were no available beds.

Those showing signs of alcohol consumption would be less likely to receive a bed or an assessment in a mental health institute. Similarly, those who were violent were more likely to be detained at the police station.

Those detained, who had not committed a crime, were treated the same as any suspect who had been arrested. They were to undergo the same booking-in, risk assessment and search procedures. Some detainees spoken to said that they were made to feel like criminals.

Some forces had training sheets on how to deal with Section 136 detainees. However, some staff spoken to were unsure on procedure.

The report found that engagement with mental health crisis teams in section 136 cases varied from area to area. There was good practice in Kent, with crisis teams involved early on (from the scene, and before detention). This often gave officers options other than detention under section 136, which they welcomed, and the crisis teams were available every hour of each day; but in other areas, availability of this service was limited.

The Codes of Practice state that a police station should only be used as a place of safety for those detained under section 136 on an exceptional basis. However, data show that, in 2011/12, 9,378 of section 136 detentions were taken into police custody. The numbers of those detained through police custody have reduced by 18% since 2005/06, and the proportion of the total number of detentions under section 136 being taken into police custody has decreased even more significantly. However, the numbers being taken into police custody and the variation in the use of health-based places of safety is still far too high.

The use of police custody as a place of safety would be reduced if that part of the Mental Health Act 1983 which designates police stations as places of safety were repealed. However, this would put pressure on health trusts and, ultimately, could have a detrimental effect on those suffering from mental disorder, by increasing the waiting times for assessments.

An “exceptional basis” should be clearly defined in law and should reflect the wording currently used in the Codes of Practice, namely, where a person’s behaviour would pose an unmanageably high risk to other patients, staff or users of a healthcare setting.

And simply for my love of statistics, here is the demographic:

• 49 (70%) male and 21 (30%) female;
• age range from 16 to 57, including 16 and 17 year olds;
• the average age was 36 years old;
• six detained persons in the sample were from a black and minority ethnic background, and 62 from a white background. Ethnicity of the remaining two detained persons was not recorded in the custody record;
• five detained persons were identified as foreign nationals; 62 as British; and the nationality of three persons was not known.

You can read the full report here – http://www.hmic.gov.uk/media/a-criminal-use-of-police-cells-20130620.pdf

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