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...

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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...
  
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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,...

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I want to start 2020 by saying thank you for the great work over the seasonal period. We came back after what is a generally a busy period in good shape. This is very much my reflection of 2019. We are all pulling together! 2020 is a big year so let me make a few points:

We are reliable: Call handling times are good. There is a good use of webchat. We are much more reliable on attendance to calls. Great work.

We are cutting crime: Homicides have reduced. Burglary and vehicle crime are falling as are firearms discharges. Robbery is static. There are promising signs on violence. Positive outcome rates in these key crimes are good. Great work.

We have challenges: There is a big pressure to reduce outstanding domestic abuse offenders. This area of demand is still going up. We want to bring more people to justice for rape. Everyone needs to support PPU colleagues who work so hard. We need to make a bigger dent in violence.

We are recruiting: We are recruiting around 24 police officers a week. That’s not just to replace...

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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.

CAPACITY

In light of the number of discussions I had over...

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