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HM Inspectorates of Constabulary and Prisons, the Care Quality Commission, and the Healthcare Inspectorate Wales call for changes to ensure fewer people with mental disorders are detained in police custody.

The police have powers under section 136 of the Mental Health Act 1983 to take individuals who are suffering from mental health issues in a public place to a ‘place of safety’ for their protection, and so they can be medically assessed. Legislative codes of practice are clear that in all but “exceptional” circumstances, this should be in a hospital, or other health setting.

However, in 2011/12, more than 9,000 people were taken into police custody under section 136. This is clearly not an “exceptional” use of the power. Some of these detainees were as young as 14 years old. In the vast majority (81%) of the 70 cases examined in detail as part of this inspection, the reason for detention was that the person had either attempted suicide or self-harm, or indicated that they were thinking of doing so.

People detained in police custody under section 136 are subject to the same processes and procedures, and kept in the same style of cell, as those arrested for crimes: the difference is that they are ill, not suspected criminals. Police custody cells are not designed to support their needs – but the inspection found section 136 detainees spend an average of 10 hours and 32 minutes in custody, and that the law allows for them to be detained up to 72 hours, without review. By way of contrast, those arrested for a crime can only be held for a maximum of 24 hours, during which time they must be reviewed regularly. The report calls for this disparity to be resolved.

Looking after section 136 detainees until an assessment can be made or a more appropriate place of safety found also means that police officers are taken off their more regular duties. For instance, inspectors were told of one occasion when a custody sergeant was so concerned about the welfare of a 17-year-old detained in police custody under section 136 overnight (because no one from the child and adolescent mental health services was available to assess him between 6pm and 9am) that he placed him on ‘close proximity observations’, which requires either a police officer or police staff member to monitor the detainee constantly from outside the cell.

In many of the 70 cases examined in detail, the reason why the police used custody as a place of safety (as opposed to a hospital, for instance) was not given. When this was recorded, the most common explanations were: insufficient staff at a health-based place of safety; the absence of available beds at the health-based place of safety; the person had consumed alcohol; or the person either was displaying violent behaviour, or had a history of doing so.

Police officers interviewed as part of this inspection made it very clear that they do not use section 136 lightly, and many said they did not believe police custody was the appropriate place for these people to be. The inspectors agree with this view.

The inspection also found patchy and inconsistent recording in relation to use of section 136, gaps in training around how the power should be used, and limits to the way in which information was collected and shared between agencies.

The report concludes with a number of recommendations, including those aimed at improving training and monitoring of use of section 136. It also calls for commissioners of health, mental health and social services to ensure that they put the resources in place to receive people detained under section 136 in a health-based setting, and to assess them quickly.

Her Majesty’s Inspector of Constabulary, Drusilla Sharpling, said, on behalf of all the inspectors:

“This report finds that too many people are being detained in police custody under section 136. Their only ‘crime’ is that they have mental disorders, but they are treated in many ways as if they are criminals. This deplorable situation cannot be allowed to continue.

“To ensure the correct care and consideration is given to these vulnerable people our report outlines a series of recommendations not only for the police service, but also for other organisations responsible for protecting those suffering with mental health disorders.”

Notes to Editors

1. A copy of the full report can be found from 20 June 2013: at www.hmic.gov.uk
2. Fieldwork was undertaken in nine areas: Kent; Lancashire; Leicestershire; Norfolk; North Wales; Suffolk; and Sussex; and the Metropolitan boroughs of Bromley and Lewisham. This provided a cross-section of geographic and demographic areas in England and Wales, and included areas with particularly high and low uses of police custody as a place of safety for those detained under section 136.
3. HMIC inspects and regulates all 43 police forces in England and Wales together with other major policing bodies such as the Serious Organised Crime Agency, the Police Service of Northern Ireland, the British Transport Police and HMRC.
4. HM Inspectorate of Prisons is an independent inspectorate, inspecting places of detention to report on conditions and treatment, and promote positive outcomes for those detained and the public.
5. The Care Quality Commission (CQC) is the independent regulator of health and social care in England. We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.
6. Healthcare Inspectorate Wales is the independent inspectorate and regulator of all healthcare in Wales. HIW’s primary focus is on:
7. • Making a significant contribution to improving the safety and quality of healthcare services in Wales.
   • Improving citizens’ experience of healthcare in Wales whether as a patient, service user, carer, relative or employee.
   • Strengthening the voice of patients and the public in the way health services are reviewed.
   • Ensuring that timely, useful, accessible and relevant information about the safety and quality of healthcare in Wales is made available to all.
   • For further information please visit our website www.hiw.org.uk
8. For more information please see http://www.hmic.gov.uk/about-us/ HMIC’s press office can be contacted during office hours from 8:30am – 5:30pm Monday – Friday on 0203 513 0600.