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...

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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 I’m not hyperlinking to the old blog post precisely because it is now redundant and out of date – it was written a few years ago, well before the 2017 changes to the Mental Health Act which took effect in December 2018.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:

Is a hotel room a place where...

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This post arises from a specific event, but it’s far from unique.  I want to use it as an example of something so straight-forward and obvious, yet complex and intractable and which raises a number of questions I suspect are often overlooked or set aside.  It relates to the conveyance of patients who have absconded from hospital and then turned up out of area – ie, out of the area of the police force to which they’ve been reported missing.  It’s about the return of AWOL patients (those who are absent without leave under the Mental Health Act 1983) but it allows me to cover a few things I’ve mentioned before, in a new context of a real incident.  So apologies to those who’ve read of some of these things before, but I’m re-painting the Forth Bridge here, as requested!

Last week at work, another police force had re-detained a patient in their area who was missing from a hospital in our area.  When the patient was reported missing to us by the hospital, we had undertaken certain initial enquiries and asked the other force to conduct...

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Mental health stuff in policing is not my job any more – not really.  I’m still asked to offer advice or opinion from time to time and most of the other inspectors on my team have used the phone-a-friend service which is inherently on offer when I’m on duty!  I’ve reviewed some incidents and policies when requested, written the odd guidance document over the last nine months but I stopped working full-time on mental health at the end of March last year.  Since April, I’ve been an operational police officer, working 24/7 across the West Midlands and in a few days, I’ll move to another 24/7 role in our force control room, working as a Tactical Firearms Commander (determining whether armed police are deployed to high-threat incidents involving firearms or other potentially lethal weapons and dangers offenders).  It was against the background of my professional role changing I decided some time away from mental health and social media was required whilst I focussed on my new role and took stock of myself as I started to see this...

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No-one involved in the discussions and debates around mental health care provision can have failed at one point or another to have bumped up against the question of whether we have enough psychiatric inpatient beds for the country’s needs. There are loads of reasons to wonder about this and plenty of time has been spent discussing it: formal reports, print media and no doubt in mental health units, GP surgeries, police custody areas across the land. If you go back a few decades, there were over 67,000 inpatient psychiatric beds in England – we now have fewer than 18,500 and this reduction needs to be seen against a backdrop of a growing population, increased psychiatric morbidity in the population and increased demand for mental health services.

A bit of background before I get to the point of this post: I have no objection to the principle that we need to reduce the number of inpatient beds to the minimum and reserve compulsory hospitalisation for those situations where nothing else will do. I often hear people say we need more beds and...

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On New Year’s Eve 2018, a man seriously assaulted a number of people at Manchester Victoria railway station – including one of the police officers who arrested him shortly after the attack began. I remember blogging about the incident, frustrated at the immediate calls for his extra-judicial murder and frustrate that many suggested that he’d “play the mental health card” or that him being ‘sectioned’ under the Mental Health Act was some kind of ‘easy way out’. We often see these things in cases of serious crime involving someone affected by their mental health. All normal so far.

Mahdi Mohamud was sentenced to life imprisonment today, with a recommendation from the judge that he serve a minimum of 11yrs. In addition, the judge imposed a so-called ‘hybrid order’ under s45A of the Mental Health Act 1983, which means that Mohamud will be detained in a psychiatric hospital in the first instance and this short post just seeks to explain what s45A does in practice, in the context of this particular case. In addition,...

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It’s that time of year: new data released for the police use of section 136 of the Mental Health Act 1983, available in a Home Officer bulletin reporting of wider use of various police powers. It gives use various express clues, if you read the thing closely, that there is increasing pressure on the system, ongoing confusion about the ‘new’ legislation from two years ago and difficulties which could still yet manifest itself in untoward events gone awry, which would seem unjustifiable given the lessons we’ve previously learned the hard way from other incidents over the last 20years.

The headlines are –

• Use of s136 MHA is still rising year on year: it’s up 12% since last year to 33,238 – remember that in 2007 when the IPCC did its seminal report on the use of this power, they found 18,500 uses in a year.
• If it rises again next year as it did this, for example, the use of this power will have doubled in 13yrs.
• 81% of people detained were removed to a healthcare setting that was NOT an Emergency Department – last year 85% people...
  
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I would like to attempt to slay one of the biggest fallacies in all of the debate about how the Mental Health Act should operate, not least because it often happens in connection with operational policing.  And I’m going to fail – because I know that the very proposition I’m about to tackle will lead to the proposition being repeated as proof that the attack on it is fallacious!  You’ll have heard it said many times, especially by Approved Mental Health Professionals (AMHPs) – “you can’t section someone unless you’ve got a bed”.  Also, “You can’t make an application [under the MHA] unless you know you’ve got a bed”.

We’ve seen this play out in Coroner’s courts, most notably in recent times in the death of David Stacey where this whole ‘bed’ thing ended up with a finding of legal neglect contributed to David’s death.  There was discussion in that case and a Preventing Future Deaths notice about legal compliance and like David’s case, this stuff often unfolds in connection with policing.  It arises...

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The next time the Home Office publish statistics on the use of s136 and the locations to which people are removed after use of police powers under the MHA, we should learn that it’s down in to double figures – under 100 for the whole country. Given that it was over 11,000 around 2008, this is quite an achievement, on the face of things. Of course, it’s always going to be “right” that people in crisis access settings which not custodial, like prisons or police stations, and the 2017 amendments to the Mental Health Act preventing the use of police cells as Place of Safety in all but the most exceptional circumstances for adults.

To provoke debate and prompt thought amongst my fellow police inspectors who must authorise this stuff(!), I would never, ever authorise the use of a police station in exceptional circumstances. This is mainly because someone matching the criteria would be at grave risk away from the kind of urgent medical support that would (or should) be available in mental health units or emergency departments and because there...

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Last week, the prosecution of a defendant under new legislation specific to emergency services personal was was abandoned as “not in the public interest” after a defendant had been charged with spitting at a police officer. The headline in the Daily Telegraph did a cracking job of conveying vagueness about the reasons behind this and because it relates to the mental state of the defendant, I thought a short blog of pure speculation on my part may be helpful to considering what may have gone on here.

First things first, the decision to abandon this prosecution was obviously nothing whatsoever to do with the fact it was new legislation and it was not a statement that spitting at police officers (or anyone else) is not in the public interest to pursue. Despite my reaction to the specifics of this being as uninformed as everyone else’s, what did strike me was how this was about the coverage and social media reaction to the Crown Prosecution Service decision was apparently focussed on whether this says something about the effectiveness of...

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