Following the recent changes to S.136 MHA by the Policing
& Crime Act, there has been some discussion in mental health circles about
whether or not a person who has been arrested for an offence and is in police
custody can be detained under S.136 while still in custody.
This question would not have arisen prior to 11th
December 2017, as someone could only be made subject to S.136 if they were in
“a place to which the public have access.” A police station was most definitely
not such a place.
However, the new S.136(1B) has dispensed with this
requirement, and now states that the power can be used in “any place”, with
only a few exceptions, which include a private dwelling.
So theoretically at least, it would be within the law to
use the S.136 powers in a police station.
Let’s look at a possible scenario.
Scenario 1
Gary is arrested after he was challenged by police in the
town centre and threw a can of lager at the police officer. Once in custody, it
becomes clear to the custody officer that Gary is suffering from some sort of
mental disorder.
Prior to 11th December 2017 the custody officer would
have had to contact the local AMHP service, who would then have arranged to
conduct an assessment under the Mental Health Act at the police station.
Now, however, a second option is available: to detain
under S.136 and then either transfer them to a place of safety or allow them to
be assessed in accordance with S.136 requirements in the police station.
Clearly, the question of using S.136 in these
circumstances depends on the seriousness of the offence; it would probably not
be appropriate to consider moving someone to a S.136 suite who has been
arrested on suspicion of murder.
I can certainly see that S.136 could possibly be appropriate,
as well as legal, if the custody officer believes the person needs an
assessment of their mental health, and would be better served in a non police
based place of safety.
But what if the person in custody has already been
assessed under the MHA?
Scenario 2
The custody officer considers Gary has a mental disorder
and an AMHP and two doctors assess him in the police station. They conclude
that he has a mental disorder within the meaning of the Act, and that he should
be detained in hospital.
However, no bed has been identified, and the 24 hour PACE
clock is running out.
Again, prior to December 2017, the custody officer would
have had no choice but to watch the PACE clock run out and then make a decision
whether or not to release someone who has been assessed as needing detention in
a hospital because of risks to themselves or others, or to keep them in
custody, outside of any legal mechanism.
Unfortunately, because of the dire nationwide shortage of
beds, exacerbated by an even worse shortage of specialist beds, such as
Psychiatric Intensive Care Units (PICUs), and placements for children, this
scenario is not uncommon. In a few instances in our area, people have been kept
in legal limbo in police custody for up to 72 hours before a bed has been found.
A custody officer could be forgiven if, after perusal of
the revised S.136, they exclaimed “I can detain this person under S.136 and that
gives another 24 hours to find a bed!”
But would this be legal? My first response to this
scenario would be to say that it would not, but close reading of S.136
throws up complications.
Let’s look at what the MHA, and the Code of Practice, has
to say.
The first thing that an AMHP would focus on is their
duties under S.136. This is to be found in S.136(2):
A person removed to, or kept at, a place of safety under
this section may be detained there … for the purpose of enabling him to be
examined by a registered medical practitioner and to be interviewed by an
approved mental health professional and of making any necessary arrangements
for his treatment or care.
The Code of Practice stresses:
The purpose of removing a person to a place of safety in
these circumstances is only to enable the person to be examined by a doctor and
interviewed by an AMHP, so that the necessary arrangements can be made for the
person’s care and treatment.(para16.25)
An AMHP (myself included) would argue that in Scenario 2
Gary has been assessed, and therefore does not need another assessment. Would
it not be an abuse of S.136 to use the powers simply to manage the PACE clock?
However, what is the precise wording of S.136(1), where
it relates to the police’s powers?
This says:
If a person appears to a constable to be suffering from
mental disorder and to be in immediate need of care or control, the constable
may, if he thinks it necessary to do so in the interests of that person or for the
protection of other persons…remove the person to a place of safety.
What this section is saying is that all a constable has
to establish in order to exercise their power is to be satisfied that a person
appears to be suffering from mental disorder and is in immediate need of care
or control.
They don’t have to worry about the niceties of assessment
by an AMHP and a doctor, even though that is the legal consequence of using
S.136.
Essentially, S.136(1) provides instructions for the
police alone, as AMHPs would only be involved at that stage if the constable’s
duty to consult with a mental health professional was being exercised.
S.136(2), however, provides instructions for the AMHP. The constable has no part
in decisions relating to disposal of the person once detained, except for
circumstances in which the police are required to manage the person.
So the custody officer in Gary’s case would certainly
have the evidence of mental disorder. After all, Gary has had a full MHA
assessment and a decision has been made that Gary should be admitted to
psychiatric hospital. The custody office could equally conclude that, being
mentally disordered, and having been arrested because of his behaviour, Gary
was in immediate need of care or control.
He could also legitimately conclude that Gary, being
definitely mentally disordered, would be better off in a S.136 suite than in a
police station.
On this reading, there would be nothing in law to stop
the custody officer from detaining Gary under S.136.
I just hope they don’t do this too often, or AMHPs are
going to have an even greater workload.
I must say I hesitate to agree where the person has already been assessed - unless this was some time ago or the presentation is sufficiently different. I fear the above apporach is in danger of atomising s136 and, thereby,divorcing its powers from its purpose. My view is that this section needs to be viewed as a whole. The element which relates to the police (the gateway trigger and consequent power to take and convey), is intimately related to the power to detain to enable an assessment (the element relating to the AMHP and doctor). They serve the overall purpose of the section which is to enable the provision of care and or treatment of those who need it. Although the police and AMHP have seperate processes they form two halves of the whole which is parliements purpose for the section. On this view, I think there is a serious question as to whether the police power would be available where the purpose of the power has been fulfilled.
ReplyDeleteBut, in view of what happens in these mental hospitals, as exposed last night on TV Dispatches, in the Priory, and US multinationals like Acadia, licking their lips at the billions profit to be made from hospitals in UK, at min £950 a night secure £13,000 a week for 'treatment' will these very vulnerable people be better off? I think not, and the sentence is interminable without trial and drugs enforced even for life and labels never lost.
ReplyDelete