New coverage in the Independent today of statistics on the Mental Health Act. They went with the a headline from a service user exprience where Kelly stated “You lose your human rights” (ie, when you’re sectioned under the Act and compelled to hospital.) Hers sounded like a very difficult experience, involving male nurses, coercion and her body being exposed which allows to understand why she summarised her experience as she did. Her story sits within the broader point that detention under the MHA is still rising (in keeping with trends over recent years) and may be as much as 12% higher – they cited a year-on-year comparison of December 2021 with December 2020 and there had been rise of roughly that magnitude.
When it comes to looking at police powers within this, there are two bodies of statistics worth knowing about, but both come with difficulties. The NHS England figures which sit behind the Independent’s coverage today; as well as the Home Office statistics are about police powers more generally, but within this sits coverage of police powers under the Mental Health Act. This post is about the obvious questions arising from the coverage within each. The NHS England data as published in October 2021 and relates to the period 2020/21 – it claims, by way of example, that s136 MHA was used by the police a little over 20,000 times in that year. This struck me as especially low, because I recall from previous years, claims of it being over 30,000. For that reason, I checked the last batch of Home Office data on police powers (for the same period, 2020/21) and it shows usage for s136 MHA sitting slightly under 32,000.
There are various things to be wondered and understood here: the first big one is why the figures are so very different. Obviously, health are reporting figures to NHS Digital for the NHS England publication and police are reporting to the Home Office as part of a mandatory data set. But there’s quite a difference between 20,000 and 32,000! It mostly underscores the warnings on both sets of data about quality and completeness. The police are obliged to add detail to their data: what method of conveyance was used to transport the person from the point of detention; to which kind of location was the person first removed; if it was a health location, what kind; and if it was a police station, for what reason?
Settle in – lots of numbers pending:
Hard to know detail and I’ve certainly got questions I cannot answer, from reading this. For example, a police station was used 132 times in the reporting period (representing 0.4% of the use of s136 overall. I want to get in to this, but have to say how gratifying it is to see that figure so low, nationally. When I first started working on policing and mental health policy in 2004, all detentions under s136 MHA involved vulnerable people going to custody and that was over 1,000 people a year, just for one police force. The IPCC report in 2008 estimated around 11,500 people a year were going to jail, so 132 is a right success story. But I have questions! –
The Home Office data tells us that of those who went to custody –
Where the power is used, 76% of those remove to a health-setting were taken to a specific Place of Safety (usually in a mental health unit) and which is set up for reception of those of us detained under ss135/136 MHA. 18% were removed to an Emergency Department and that leaves 6% unexplained. Some of the 6% (132 of them) will be those removed to police custody, but that’s only 0.4%. It seems for +5% of people, we just don’t know – assuming I’ve understood the numbers correctly. Worth noting at this point: both NHS England and Home Office data sets have warnings about incomplete numbers and data quality problems.
The Emergency Department numbers are worth thinking about: removal to an acute hospital ED may follow because someone is injured or additionally, acutely unwell at the point of detention. Perhaps they are thought to have taken an overdose, or require treatment for physical injuries. But we also know that ED comes in to play when a health-based Place of Safety is not available. I often see incident logs where people are in ED purely because there is insufficient capacity in a mental health setting, to accommodate someone. Sometimes this is because of high numbers of s136 detentions occurring at the same time, otherwise because the Place of Safety is out of play for other reasons. Some Places of Safety are used as “swing beds” for s2 or s3 patients where no ‘proper’ inpatient beds exists after they are first ‘sectioned’.
The police service is also required to report on it’s transportation mechanism –
Of the reasons for using a police vehicle –
There’s your whistle-stop tour of the data – the documents are worth reading, but remember the caveats about quality and content. There are a lot of unanswered and curious questions arising, as ever. We can’t really understand detail sufficiently, from these data sets.
Winner of the President’s Medal, the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All views expressed are my own – they do not represent the views of any organisation.(c) Michael Brown, 2022
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