I recently passed a professional and personal milestone, having joined the police service twenty years ago and I hope to receive an email soon outlining I’ve qualified for a Long Service, Good Conduct medal. All things being as they were supposed to be, this would mean I’ve got just ten years left to do before I retire from the service but it will probably end up being about eleven and a half because of pension changes forced upon me and I’ve long since started questioning whether we’ll actually get to the position I want us to be in by the time I do retire. So this post just puts those thoughts down and I’ll look again in a decade as I start to wrap this all up and get on with what’s left of my life.
I started properly piling in to policing and mental health about fifteen years ago, when a Chief Superintendent in West Midlands Police was seeking officers from Birmingham who were interested in doing some extra work to improve policies and procedures across the city, following the merger of two mental health trusts. I’d been...
An AMHP and two doctors, one of whom is s12 approved, attend a patient’s home following concerns about their mental health deteriorating. They conclude the patient will require admission to hospital and that admission under s2 of the Mental Health Act will be required – the application is duly made under the Act so the patient is now ‘liable to be detained’, the precursor step to being detained in hospital. The patient is unwilling to travel and for a range of reasons, neither police nor ambulance crews are available to attempt to persuade, influence or effect the admission of the patient to hospital. A decision is taken to leave the patient at home with their family and try against the following day but by then, the bed in to which the patient was to be admitted is no longer available, it having been given to someone else overnight.
The MHA application appears to lie in tatters, but then a bed becomes available at the original hospital to which the application had been made and the ‘exam question’ arises –
You’ll remember I’ve been banging on for a number of years now about the problem of people being in police custody for many hours or even for many days, waiting for Mental Health Act assessment, or more usually waiting for a mental health bed in to which they can be admitted after assessment. This noise I’ve been making is now well in to its second decade, in all fairness and I’m bored of hearing myself talk about it. However, we’re starting to get somewhere in the sense that this matter has been raised with the Department of Health and the NHS at national level, who accept the premise that there is a problem. It has also been discussed with Government ministers and questions have been raised in the House of Commons. The BBC even did a news piece about it, just prior to Christmas 2017. So we may be getting somewhere, however slowly.
This post argues that custody sergeants and duty inspectors or superintendents are now much more in the driving seat of some of these issues that they’ve ever been before, because a) we actually...
On Monday in the House of Commons, questions to the Home Office occupied some of the afternoon. Mental health questions came up and I’ve re-produced two brief exchanges from Hansard for that day. The purpose of doing so is to document the lack of specific understanding that exists on these topics. The Government response is incoherent, given the questions that were asked – none of the three responses below actually address the public policy question inherent in the preceeding question. I’ll let you read the exchange and will then outline why –
Preet Kaur Gill (Birmingham, Edgbaston)
How many people have been unlawfully detained for more than 24 hours while awaiting a mental health assessment in each of the last three years. 
The Parliamentary Under-Secretary of State for the Home Department (Victoria Atkins).
Provisions in the Policing and Crime Act 2017 ban the use of police cells as places of safety for under-18s, restrict their use for adults and reduce the maximum period of detention to 24 hours. Information on the length of...
You guys seemed to use the BLOG a lot last year, way more than any other single year since I started in 2011 and that was really encouraging on one level. However, I couldn’t help but notice the vast majority of the increased use was down to two things —
The series of posts which related to the Policing and Crime Act amendments of the Mental Health Act 1983, introduced in to law last December.
A series of posts in which I just said again the same things I’ve said for years, only in light of new events, seeking to ram home the same point as before.
There are now well over 700 posts on here – many of them saying the same thing over and over again and I don’t under-estimate that dripping like a tap is actually a necessary part of drilling home a message, particularly one that doesn’t always sit easily or appear straight-forward, but the essential messages in this blog are simple:
THIS BLOG – KEY ISSUES
We need to take responsibility for understanding the law of the country as it actually is, rather than as it’s rumoured to be.
Compare and contrast the following two pieces of law –
Section 136(2) says someone removed to a Place of Safety may be taken there to be examined by a registered medical practitioner and interviewed by an Approved Mental Health Professional; and of making any necessary arrangements for his treatment or care.
When you read section 135(1), it says someone may be removed to a Place of Safety with a view to the making of an application under the Act, or of making other arrangements for his treatment or care.
The bold is my emphasis – does it matter that the apparent purpose of one of these Place of Safety orders is interview AND arrangements, whereas the other is interview OR arrangements? … is this a distinction without a difference, or could it be crucial to something?! Both seem to imply the purpose of removing someone to a Place of Safety and we often think of 135(1) as being “like s136 but after a court warrant in someone’s own home”, but does this pedantry amount to anything real?
Since the MHA amendments took effect at the end of last...
I wrote this post in June 2016 and simply forgot to publish it. Having had a bit of a BLOG clear-out over Christmas where I’ve binned about thirty part-written blogs where I found myself just banging on again and again about the same old thing. However there were a couple I decided to keep and this is one of them, just for personal reasons.
I was thrilled to receive a letter in May, indicating that the Prime Minister wished to put forward my name to Her Majesty the Queen, recommending that I be appointed an Officer of the Order of the British Empire (OBE) for services to policing and mental health. Since the announcement, I have been smiling broadly and have laughed out loud a few times, overwhelmed by messages of support from frontline police officers as well as mental health professionals and members of the public. I was delighted but surprised to receive three very lovely letters from Chief Constables Phil GORMLEY and Simon COLE as well as Commander Christine JONES – the last three national policing leads on mental health. It has all been truly...
I’m a mental health professional – but I didn’t realise this when I first joined the police.
When I retire, the operational incidents that will live with me beyond my career are almost exclusively those which have involved very vulnerable people. The poor guy who set himself on fire; the man who killed his mum and neighbour; the young woman who inflicted more harm or herself than I’ve seen when people have been brutally attacked by others; the guy who was so profoundly and utterly terrified of us purely because he thought the police were there to kill him; the middle-aged woman who was so psychotic in police custody that she spent days and nights screaming without sleep; the man who barricaded himself in to his bedroom with a knife for his own protection in his own home and we spent hours attempting to resolve that without using force and even more hours disagreeing about police powers and the grounds for getting a warrant under s135(1) MHA. I could go on and list more … as could most police officers. There...
We’ve been playing with the newly amended police powers under the Mental Health Act for over a week now – I say ‘playing’ because it seems there are various kinds of games going on from the early feedback I’ve received! This post aims to just highlight those kinds of problems that have been drawn to my attention, so those of you reading may reflect on them and how things have been working in your area. It’s nothing major and new legislation always takes a while to settle – for example, we’re now more than 58yrs on from a Place of Safety being defined as ‘social services accommodation, a hospital and police station or anywhere temporarily willing to receive the person’ and we’ve still enjoyed a healthy dose of A&E departments insisting that they are NOT a Place of Safety under the Act. Fifty-eight years … are A&E departments not part of hospitals, then?!
The Royal College of Emergency Medicine has published a new guidance document about the changes which came in, to assist staff in EDs to navigate the new requirements....
Norman Lamb MP wrote to his local police force recently, asking about those kinds of cases I’ve been banging on for years now: people being held in custody for hours and hours, if not days and days, following their arrest for an alleged offence but whilst awaiting admission to hospital under the Mental Health Act 1983. The BBC covered this sort of thing last week, following the release of data by the National Police Chiefs’ Council and Mr Lamb’s contact with Norfolk Police led to some data for his local area.
Two things struck me —
68hrs is quite a short period of time compared to some of the examples we’ve seen in recent weeks. The NPCC data made reference to a child being detained for 5 days and to an adult being detained for 6 days, so less than 3 days makes me think some people got off quite lightly!
The Medical Director of the Norfolk and Suffolk NHS Foundation Trust gave a response to the media that made me wonder whether a) someone else who didn’t understand the problem wrote a press release that went out in the MD’s name...