For some time now, I’ve been concerned about the impact on vulnerable people of ‘normalising’ the involvement of the police in their mental health care. Regular readers will no doubt recall some observations I’ve made based on real cases or things I’ve learned by listening to people. It’s because of my concern, I decided a blog is called for, despite now writing here much less often. It follows my reading of a case which yet again makes plain this point, but it actually goes one step further than anything I’ve come across before: the impact of involvement of the police was directly linked in a Preventing Future Deaths (PDF) report from a Coroner as a ‘probable’ cause of death. Of course, as with all situations involving complex and vulnerable people, there is rarely one single explanation for why someone died and it’s not listed as the only thing which contributed to someone’s death. There were nine things overall, but remove any of them and would we still have an inquest? … who knows.
I don’t think I fully realised last week what a privilege it actually is to have to physically go to work – I get to ride 10miles there, get out of my home for a bit, see other people outside my family and then ride back again in the fresh air. I’m now on my fourth rest day (of four) and very much itching to get out on my bike for a quick lap of the lanes; and perversely looking forward to my 4:30am alarm call to get out of the house again and off to work. Mrs B and Master B are working / schooling from home and I can see the restrictions taking effect on them in small ways. I’m also conscious of my elderly mother living on her own in the North-East who is pretty much locked in and being supplied by others, as required.
So what does the law say (on Monday 30th March! – because it may change later if tougher restrictions are brought in, as may be considered potentially necessary). There are various reasons I’ve decided to write-this, but all of them rotate around the frustration of misinformation and misunderstanding! —
Last week, I published a post about the temporary amendments to the Mental Health Act 1983 which will be brought in by the Coronavirus Bill 2020, if passed ‘as is’. That Bill goes before Parliament today, to commence its process towards becoming law and it may or may not change as the process unfolds. Me being me(!), I was a bit curious about the other health related implications for the police service so I kept reading beyond the Mental Health Act amendment stuff and this post summarises the police related powers in Schedule 20 of the Bill as they relate to ‘infectious persons’. If you want to read this for yourself, open the draft Bill and go to Schedule 20 on p215 – I will warn you now(!), it’s quite a dense read, hence I thought I’d try to summarise the main aspects of it.
You may quite reasonably wonder what this has to do with policing and mental health?! … potentially nothing at all and I’m conscious of straying outside my domain of interest – this is legislation related to so-called ‘physical’ healthcare...
First things first:this post is based on reports some social media sources I’m inclined to trust, including from a health journalist but it has NOT yet been confirmed with published materials from the Government. Once the Government publish something that confirms or refutes this, which they will potentially do on 19th March, I will either remove this disclaimer or remove / re-write the post as a whole.
We know the UK Government is introducing emergency legislation to the House of Commons which will temporarily change aspects of the Mental Health Act 1983, including some parts affecting the police. It’s all part of the COVID-19 response, in the Coronavirus Bill 2020. This short post summarises what appears to be coming on the police-MHA changes, based on what certain charity professionals and health journalists are reporting —
In no particular order of importance —
One Doctor to ‘section’ a patient – where mental health services wish to ‘section’ someone, the Approved Mental Health Professional will now require only one...
On the 01st October 2020, we anticipate the Mental Capacity (Amendment) Act 2019 will take effect, bringing certain changes to the Mental Capacity Act 2005. Some of the terminology the emergency services may hear and occasionally wrestle with will change, and the wording of section 4B of the MCA, which governs urgent deprivations of liberty for life-sustaining treatment, will be made more wordy! Calls to #Team999 occasionally do involve patients who are subject to (the current) ‘deprivation of liberty safeguards’, known as DoLS in the current framework, but from October, these orders be replaced by Liberty Protection Safeguards, following literally years of discussions and debate about the DoLS frameworks introduced just over a decade ago. It’s never quite worked as hoped and the 2014 Cheshire West case brought thousands more people with the grasp of DoLS and there have been problems and debates ever since.
Liberty Protection Safeguards are the end result of a Law Commission report and the Government’s own deliberations...
I’m not sure how many inquiries and thematic reviews in to public services have ended up focussing on clear communication and information exchange – this has certainly been said during investigations and inquests where the police became involved in mental health incidents. There more than are a few situations where clarity of communication between organisations tends to be problematic and I want to focus on a few of them, by way of making the same point: that we need to be both clear and precise with each other about what we’re asking and saying as we work in partnership to put those of us affected by our mental health at the centre of decision making.
Threat / risk assessment – if we’re saying that someone is facing a level of risk and we need to support each other in managing it, what is that risk and how likely is it to be realised?
Legal context – what is the legal situation within which the request sits? For example, is the patient you’re asking us to return, subject to a legal framework which allows for this?
This post comes at the direct request of a mental health professional, touching on matters I’ve written about before but which keep coming up, somewhat resistantly – it follows an incident where officers local to them came to an Emergency Department with a person in handcuffs for NHS assessment around their mental health and where the liaison staff had questions about the legal situation. During discussion, it was suggested the police should consider the application of s136 MHA, but the officers (who no doubt have a perspective to offer that may not be identical) chose not to follow this suggestion. And to be completely fair, they may have had their reasons – many people don’t realise, for example, that the use of handcuffs by the police is not JUST something that is done following an arrest; or even during a detention under the Mental Health Act 1983.
Police officers can and do use handcuffs to restrain people in a number of situations, relying on a number of legislative authorities to do so. For example, it’s not unknown for...
One of the last things I did at the College of Policing was attend a meeting in London with the Crown Prosecution Service who had begun to review their guidance on the ‘prosecution of mentally disordered offenders’. The CPS issue prosecution guidance on a large number of topics, all publicly available on their website and they’d decided mental health guidance needed revising. First things first: the title of the old guidance sounded date and pejorative by modern standards so I’m glad to find that new guidance gets rid of the term ‘mentally disordered offenders’. Apart from anything else, as Professor Jill PEAY points out in her (wonderful) book “Mental Health and Crime” from 2010, it’s not a straight-forward enterprise to determine a mentally ‘disordered’ offender from a mentally ‘ordered’ one.
So in October 2019, the CPS issued two new documents –
If you’re involved in criminal investigation in the police, you’ll need to read both of these.
In light of the number of discussions I had over the years with...
We’ve started the new year with some familiar messages – more preventing future death reports (PFDs) from UK coroners after someone tragically lost their life in circumstances which gave rise to fears that aspects could be repeated and lead to future tragedy. PFDs are statutory notices, something the Coroner issues to an agency who may control aspects of what went wrong or contributed to the outcome. This could be anything from training of staff, to policies and procedures within or across agencies to anything else thought relevant. The organisation in receipt of such a notice has 56days to respond outlining their reaction to the recommendation(s) and these things are usually uploaded to the Office of the Chief Coroner’s website, where the notices are categorised by theme.
I’ve regularly browsed this website for a number of years and this post comes after another recent session – you may find these links useful, if you wish to do the same. These things are tagged in the way that a social media blog would be, so you may find the same...
I’ve written about the issue of the Mental Health Act and hotel rooms before – focussing on the stated case of ‘Rosso’. I’m not hyperlinking to the old blog post precisely because it is now redundant and out of date – it was written a few years ago, well before the 2017 changes to the Mental Health Act which took effect in December 2018. Forget it – Rosso is now history and has been for a while. I want to go through how the police now need to think about hotel rooms and the Mental Health Act 1983, specifically sections 135/136 MHA. This post follows the desperately sad inquest in to the death of Dr Deborah Lamont who, the Coroner ruled today, died by suicide in a Cardiff hotel in March 2019.
It will be necessary and relevant to see the full PFD report from the Coroner to answer some of the questions I’m interested in, but a big issue emerges from this inquest in the immediate media coverage and which addresses a question I was asked only yesterday, during the delivery of training in my own force: