Re-thinking Section 136 – The Time is Now

The IPCC report into the Met’s dealings with Nicola Edgington makes difficult reading for an experienced cop.

The report itself does acknowledge that there were clearly issues with the NHS handling of the situation and that she absconded from their care before going on to commit an horrific murder but the press have chosen to focus on “police failings” as being the cause.

One article even stated that there was a “series of police blunders” which led to this happening.

Once again it is front line officers dealing with something at the point of crisis taking the blame for events which could possibly have been prevented much earlier had someone else done their job more effectively.

The first lesson which comes out of this is about information exchange. Edgington was considered dangerous enough to have been a MAPPA subject. The first four letters stand for multi-agency public protection. Multi-agency.

We have learned that the NHS did not refer her for MAPPA consideration. Had they done so then it is likely that she would have been on several people’s radar as a significant risk. Intelligence would have been held and there would probably have been a plan in place to ensure that she didn’t slip through the net.

As it was, that referral was never made so she did slip through the net.

The events of the days leading up to the murder appear to show that Edgington contacted the police on numerous occasions and appeared to be in crisis.

She called the POLICE numerous times because she felt in crisis.

This is a problem. The police are not lead agency when it comes to dealing with mental health so how come this patient felt the need to call them?

Surely the first place she should have thought to have rung is a mental health crisis team. Is there any reason, I wonder, why she chose not to?

Irrespective of this the police have come into contact with her in the offices of a taxi company. A private place.

The IPCC have correctly noted that the police had no powers to deal with her for mental health matters here. She had committed no offence and answered their questions.

Officers could not detain her under the Mental Health Act because she was in a private place and the law does not allow police to exercise that power in private.

Instead they have talked to her and she has agreed to go with them voluntarily to a local hospital. The officers even called an ambulance but she refused to use it so they took her. In direct contravention of force policy but it was the right thing to do.

They would not have been able to take her direct to a mental hospital because she had not been “detained.” I have no idea whether there would have been any beds free anyway or whether that hospital would have accepted her because “the correct process” had not been followed to admit her. I have come across this several times myself.

In any event she ended up in A&E which the officers seem to have considered a safe place. NOT – I stress – a place of safety,

She had not been detained I remind you. That was not an option.

It would then appear that the officers have tried to leave and she has followed them. They escorted her back voluntarily.

The same thing then happened again. She went back with the officers voluntarily.

After the officers left she made several calls to the police and the operators receiving the calls have made the judgement that they believed she was in a place of safety and officers had only recently just left. They did not ask the officers to return.

The IPCC have focused on what operators did in response to those calls to the police. No-one seems to be asking why she made them in the first place or how she was able to. Was she being ignored by medical staff?

Edgington was admitted to a hospital voluntarily and from there she “absconded” and went on to commit a terrible crime.

The IPCC have criticised the officers for not conducting a PNC check on Edgington and for not exercising their powers under Section 136 once she left the hospital and came after them.

Had a PNC check been carried out, they say, then her previous manslaughter conviction would have been uncovered and this may have led to her being treated differently by NHS staff.

I am not so sure. What they are saying is that if this had been known it might have led to her being assessed differently or more quickly.

Here is why I am not so sure. In every case of mental health I have ever dealt with the assessment of the individual ha been based on how they are presenting at the time of evaluation.

They may have been floridly psychotic when initially detained by police but five hours later – when calmed – they seem much better and I have lost count of the number of people who have not been sectioned when my dealings with them hours previously made it seem a 100% certainty.

I can even provide an example of a soldier with terrible PTSD who was making all sorts of general threats to kill. He wasn’t sectioned either even though he repeated the threats to the assessment team.

Knowing someone’s history has, in my experience, often had little bearing on the outcome of a mental health assessment.

Even if that information is passed it is still down to medical opinion as to whether someone is sectioned or not.

This is also something of a red herring in that the NHS would have had access to her medical records and should have been able to see for themselves who they were dealing with.

Then we come onto the thorny issue of 136.

The officers were right not to use it at the taxi office. It would have been unlawful to do so. They have then gone beyond their remit and taken the lady to hospital.

Whenever they tried to leave she followed them. The IPCC are saying that officers should have used 136 to detain her at this point.

This is arguable. I have spoken with the very knowledgeable @mentalhealthcop about this today and we have a different opinion. The chances are that he is right because he knows more about it than I do – but the fact that there IS a difference of opinion amongst experienced officers suggests things are not clear.

I am taking a pedantic view. The law says that a person must be FOUND in a public place. Not – taken to. FOUND.

The report even points out that it would have been wrong for the officers to convince her to step outside of the taxi office and then detain her. That would have been unlawful too.

The IPCC say that she was in a public place when she left the hospital and followed them. I still ask where she was FOUND – the taxi office.

I don’t know if there was a break of continuity or contact but I would argue that if there wasn’t – she had still been found in the taxi office.

Had she been detained under the Mental Health Act at this point then it is likely that officers would have remained with her until she was sectioned or otherwise.

The fact is – the doctors and AMHPs chose “otherwise” and admitted her voluntarily. So at that point any 136 which did exist would have ceased to exist. She was free to go.

The doctors and social workers chose not to invoke Section 2 or 3 and make her attendance at hospital mandatory. They allowed her to go voluntarily.

Therefore, she didn’t “abscond” – she left – of her own accord and perfectly lawfully. No 136 detention would have affected that whatsoever.

Could one PNC check have prevented this? We will never know but is it entirely fair to blame what happened next on the police for not conducting it?

Doctors had access to her files.
Another senior medic had not sent her for MAPPA referral.
Officers could not initially detain her under 136.
The 136 detection ends when the assessment team make their decision.
The assessment team chose not to section her.

Nicola Edgington was a severely ill individual who had reached a point of severe medical crisis which needed intervention.

I ask you to look at the situation again and ask “what more could and should the police have really done in those circumstances?”

Should they have stayed at the hospital even with her not detained under 136? Effectively preventing her leaving – a de facto detention which would not be acceptable for a criminal matter (think Kettling.)

At what point is it reasonable for the police to walk away from the situation saying with confidence “This person is now in the care of medics”? Why is the handover process so abysmal? Should it be essential for the police to remain at every incident “just in case” or should we instead be asking questions about exactly when it is reasonable to expect others to assume responsibility?

If nothing else, the Edgington case highlights, once again, the need for S136 to be reconsidered. Had police had the power to detain her in the taxi office then the IPCC report could have read very differently indeed.

For a more detailed exploration of this matter, I heartily recommend “Elephants in the Room”. A fantastic blog by @mentalhealthcop which can be found here
http://tinyurl.com/cwdvp9d

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7 responses to “Re-thinking Section 136 – The Time is Now”

  1. stephen barr says :

    This makes the latest NCALT package on mental ill health very real. Many times do I hear a pt has walked out of hospital, with little or no information to back up why they are there in the first place.
    A designated place of safety in Coventry used by West MIds and Warks insist now on speaking with the officer detaining under 136, my experience is it is tied up in too much red tape, a ticky box exercise and only one bed available. When this is in use, we are told take them to A&E.
    Heads need banging together but not those of the cops on the ground, damned if you do, damned if you dont.
    Remember what Mrs May says – it’s all about crime – yeah right

  2. jonsharvey says :

    Good blog Nathan – which I think serves to highlight how blunt legislative intruments can be when faced with the complexities of a real life situation.

    From my experience, police officers, often with minimal training, can be extraordinarily sensitive to a person in crisis, especially a fluid crisis. No doubt some others get it wrong. I have no views about this case since I have no knowledge of what happened and all the contributing factors. I am not sure anyone is fully sighted (are they?)

    But I wholeheartedly agree with your conclusion that perhaps now is a time to review S.136 in the light of experience and application. Most laws deserve scrutiny from time to time – especially in complex areas such as mental health.

  3. Chris Hall says :

    Another good and sensitive blog Nathan. I’ve been Mr Angry shouting at the tele and the news that it isn’t the polices fault but was surprised that a PNC check hadn’t been done, mainly for their own safety, I’m sure the officers with her had picked up warning signs and had a conversation over her fears to take her to the hospital.

    People outside of the job will not see the restrictions we see, they expect the police to deal with it, the calls she made whilst there should have had alarm bells ringing but, and this is the clincher, where were the Police on TV to defend our actions. Why were there no senior officer or police spokesman explaining why it’s not our fault. The IPCC get airtime but we don’t or don’t bother to reply, thank god for the woman who went on to blame cuts in the services who said it wasn’t the polices responsibility.

    Don’t even get me started on why she was in the community and not secured after killing her mother, system failure as usual from that part of the health service. If you’ve killed someone you shouldn’t be out on the streets but safely incarcerated where you can be administered medication to make you safe. There aren’t that many individuals who come under this category.

    Operation Stable door is now in progress.

  4. bananaman999 says :

    Good points.
    First of all – how many operators pass previous convictions from PNC? I can honestly say I would be looking for warnings or missing markers.
    Secondly – I totally agree its how they present at the time. If I remember the definition correctly, it says ‘in need of immediate care or control’ I have lost count of the times we have been asked by MH teams to ‘136’ someone for them which on its own is unacceptable.

    From both your blogs , the overriding issue to me is the dependence on the police by the NHS and mental health patients.

  5. Chris says :

    I think most Police Officers have been in this situation many times, but fortunately without these final consequences. Yet again this is a cogent description of another sad and misunderstood event where the Police are left taking the can.
    Did the officers do wrong? Probably, by not completing a PNC check, but would this have flagged up anything in the face of Edgington’s current demeanour at the time? Probably not. I agree that they are otherwise blameless in this incident.
    Mental Health, the wider issues of Local Authority care (Child & Geriatric) homes and the much bandied ‘Care in the Community’ all need to be totally overhauled. This should be done identifying specific and not vague areas of responsibility. Although Human Rights legislation may initially appear to be an obstacle it should support the rights and protection of the individual and the public at large.

  6. artois52 says :

    I have been detained under section 136 and, whilst my experiences have not been ideal, I do not blame the individual officers for this. It must be difficult, the police are not trained mental health experts, but there must be a better place to hold someone, for their own safety, other than a police cell?

    http://artois52.hubpages.com/hub/Section-136-A-Place-of-Safety

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