Mental health law varies by country, even within the UK.  As soon as you start comparing mental health laws in non-British countries with our own approach you see even more ways to that such complex matters are handled.  In Germany, the courts play a far greater role in psychiatric admission than in the UK where they are usually not involved at all.  As if that’s not enough, where a person’s mental health becomes relevant to criminal proceedings it all moves up one or two more notches and as Professor Jill Peay noted (in Mental Health and Crime, 2010) the work done at the interface of mental health and criminal justice is amongst the most challenging of all.

The Court of Cassation in Paris, France’s highest court, has recently ruled that a man who admitted killing a woman in her sixties will not stand trial.  Kobili Traoré admits killing Sarah Halimi in 2017 by beating her and then throwing her from the window of her third-floor Paris apartment in what was described as an “anti-semitic frenzy”.  Psychiatric reports stated that he was...

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It’s really gratifying to receive emails via the blog from front-line staff in various agencies seeking confirmation of legal issues, views on incidents and so on.  It’s great that people want to discuss and reflect, or to enhance their learning but can I admit to being a little restricted in my capacity to answer the queries I get?!  As well as being a front-line, 24/7 police officer, I’m married man with a family and am newly obsessed by endurance-cycling and I’m no longer posted to work on this area of policing.

The whole point behind creating a blog 10yrs ago was to address the questions I was regularly asked and put the answers and various resources on to a free-to-access, publicly available platform so people from any profession or background can access it for themselves whenever they need it.  There are now over 800 published articles on all the topics I can think of, as well as on various specific incidents in the public domain and court cases of various kinds.

Putting links to this stuff on a website means I can focus on my...

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This tweet from a @TiredSgt has provoked quite a bit of discussion today (and just for the sake of balance there was another, unrelated thread in which a psychiatrist said the police “couldn’t recognise capacity if it slapped them in the face with a wet fish” —

So first of all, I’m glad we’re all getting on well and making friends – collaboration and improved understanding can only possibly improve as a result of such shared respect, I’m sure!

I’ve chosen to blog about this one because it’s not unique or isolated – plenty of service users have stated on social media in recent months that they’ve reached out to services of one kind or another when in crisis or feeling suicidal and the principle response has been focus on legal capacity – “you’ve got capacity to make the choice, so it’s up to you” sort of thing.  We can obviously see our very tired sergeant is a tad frustrated, and who wouldn’t be?  Taking this account at face value (mainly because it’s so often claimed, that some of these accounts have to be...

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An east London coroner issued a preventing future deaths report this week, following a suicide in the capital after a man was discharged from a hospital to which he had been ‘sectioned’ under the Mental Health Act.  What interested me for a number of reasons, was what was NOT flagged as a ‘matter of concern’ because it happens often enough, albeit most usually in connection with incidents which end  non-fatally.  Perhaps that’s why it’s usually less obvious …

Mr Steven Stout was detained by the Metropolitan Police on the morning of 14th October 2019 under section 136 of the Mental Health Act.  He was intoxicated and appeared to have self-injured so he was taken to an Emergency Department for treatment to injuries, before being transferred to a s136 Place of Safety, presumably in a mental health unit.  The PFD notice says, “after a Mental Health Act assessment, Mr Stout was made subject to an order under section 2 of the Mental Health Act.  After a three-day delay, Mr Stout was admitted to a mental health ward on 17th...

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As far as I can tell, the tragic death of 60yr old Mr Michael Thompson in March 2016 was not widely covered by the media.  An inquest in Southwark in 2017 returned a verdict that Mr Thompson had died an accidental death after he set fire to his own property whilst in mental health crisis at home.  He died from the effects of smoke inhalation, bringing on a cardiac arrest, contributed to by his mental health crisis meaning he was unlikely to have understood what he was doing in setting the fire.  It’s all kinds of tragic on its own, but in the 18hrs or so prior to the Fire Service pulling Mr Thompson from the building and beginning CPR, there was contact by the police and ambulance services and this was examined at the inquest.  The court considered what powers, if any, may have been available to police and paramedics on scene the previous evening after Mr Thompson’s family had called 999 hoping somebody, somewhere could do something.  This followed attempts to engage a GP or MH team, given previous mental health problems in years...

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This is a second post looking at the January 2021 UK Government White Paper on Reforming the Mental Health Act 1983 — the first post covered proposed criteria for developments on detention in hospital, this will look at various issues to do with rights and risk.

We’re going to have to get used to spotting the difference between a “substantial likelihood” and a “substantial risk”.  My best guess is that “likelihood” would mean something approaching probable, whereas “risk” may end something closer to possible (p25).  Introduction of both terms is suggested in the paper amidst the criteria for various things – substantial likelihood for initial detention or re-detention under the Act (ie, admission) but substantial risk to authorise or review the use of Community Treatment Orders (CTOs), “a substantial risk of significant harm [without using a CTO.  It is argued, CTOs are over-used and the White Paper suggests that consideration was given to removing them from the legislation. ...

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My break from blogging was deliberate decision to step back from it all but the publication of the Government’s White Paper on Reforming the Mental Health Act 1983 motivated me to think some things did need saying and summarising, for whatever that’s worth.  I was involved in this review which leads to the White Paper and I cant deny my interest in how it develops towards potential legal reform.  My first post of 2021 covered in brief some of the more-obvious police-related implications of the White Paper, written after a fairly brief read.  Having now made a more concerted effort, there are other points worth making and which are not linked (directly) to policing but are for general awareness of what may be coming.  It gives a context about the broader system in which the police will always play a limited role.

Of course, this is still just a White Paper, it changes nothing in law (yet) and the various proposals may or may not make it to the statute book.  At the first meeting of Professor Sir Simon Wessely’s Advisory Group...

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The Government has today published its White Paper on Reforming the Mental Health Act 1983 (MHA) —

This publication follows the report of Professor Sir Simon Wessely in 2018, after an independent review of the Act.  It’s 184 pages long and it covers a lot of ground, some of it surprising, some of it not.  The UK.GOV website also has a host of other formats, inc easy-read, executive summaries, Welsh language editions and so on.  This post is restricted to the police-related aspects only, for your information and consideration.  (May blog again later on the other stuff, as I’ve quite enjoyed writing this one, after many months away from it all!)

I want to highlight five main issues —

• Legislation to end all use of police cells as a Place of Safety under the MHA by 2023/24.
• Revision of s5 of the MHA, to allow for detention by healthcare staff in an Emergency Department
• Reform of s35/36 of the MHA, to allow Magistrates to remand mentally unwell defendants to hospital at first appearance
• Section 140 MHA
• Conveyance after use of...
  
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I missed something last year, probably because I’d changed roles and I’m not focussing on this stuff as before.  In 2019, the Care Quality Commission reported some findings after a review of the implementation of the Code of Practice to the Mental Health Act 1983. Those who have followed this blog since the start will know I’ve done a number of articles highlighting parts of the Code which are especially obscure, helpful to know or widely misunderstood. My particular favourite has always been paragraph 28.14 (and helpfully, this paragraph reference number is correct for both the 2015 English Code of Practice and the 2016 Welsh Code of Practice but this post relates only to the CQCs review of the English Code):  28.14 reminds us that where patients are Absent Without Leave under the Act, it is ordinarily the responsibility of hospitals to return them to the ward.  Support from the police should only occur ‘where necessary’ (and I’ve covered how we should think about that, elsewhere).

It is also worth remembering what the status of...

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The Mental Capacity Act continues to consume a number of the queries I receive about policing and mental health.  The point of this post is not to repeat the content of those I’ve already written, but just to highlight the ongoing issues which form my focus when I listen to the questions coming on social media.  You can read the previous posts I’ve written in the paramedic series of blogs (which, of itself, tells you that many of these situations involve the police’s interface with the ambulance service) and of course, the Quick Guide on the MCA.  It’s worth bearing in mind also, the Mental Capacity (Amendment) Act 2019 will take effect at some point and this will provide far more words within section 4B of the Act, which you’ll see shortly, is key to many of the problems we continue to see.

I want to emphasise three things here, above what I’ve written before –

• The balance of probabilities
• The least restrictive principle
• ‘Restraint’ versus a ‘deprivation of liberty’.

THE BALANCE OF PROBABILITIES

I may, later today,...

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