AHMPs Rarely Have To Talk People Down From Bridges – Police Do
Two words sum up why police detain so many people under section 136 of the Mental Health Act: suicide intervention. Many detentions are of people who are hurting themselves or threatening to hurt themselves in public.
Article two of the Human Rights Act places a positive obligation on the police to protect life. We have to intervene, yet it is not an offence to commit suicide. So when you find someone threatening to jump off a bridge what are you to do with them after you have talked them down?
The only way to compel them to receive a medical mental assessment is via section 136.
Social workers are rarely there during the crisis
Approved mental health professionals (AMHPs) play a vital role in mental health response and it was interesting to read some of their views on section 136 use. But generally it is not AMHPs who are faced with trying to talk someone down off the bridge.
AMHPs are rarely there during the crisis. Most likely they will turn up hours after the event where a person has been detained in a cell or place of safety and has been calmed by spending hours talking to the officer with them on constant supervision.
Only the most extreme cases present in the same traumatised way as they were initially found by the time an assessment happens.
There is something to be said for having an emergency Mental Health Act assessment capability. This is supposed to exist but in reality it takes hours to mobilise. This is not good enough.
Issues with social services and medical responses
Just as a small number of AMHPs are apparently reporting issues with the police response to mental health issues, I have seen a number of cases where social services have initially refused to come out and carry out Mental Health Act assessments on the basis that the detainee is already “on the books”.
In one case the social worker was adamant that the person was known to them, receiving treatment at home and would not be sectioned.
Guess what? When they did eventually come the person was sectioned as their condition had deteriorated to such a point it was necessary.
I have also had doctors refuse to section detainees because they are already working with them. This seems a conflict of interest to me but in one case police were left with a screaming, naked female who was covered in her own excrement but whom the doctor said was not sectionable and should be released immediately.
In my experience section 136 is being used increasingly by the police but I am yet to see a case personally where the detaining officer hasn’t made the decision for the right reasons.
Recently, officers I know were criticised by a hospital nurse for detaining someone under section 136 instead of arresting for a criminal offence which they thought was more appropriate.
This criticism was unjustified because the offence had not actually occurred. The person had simply presented as in need of immediate care and control. When he acted adversely to being stopped by police he was violent.
The nurse thought police should have used the Public Order Act and taken him to a cell. That way, of course, he would never have had to go to hospital. The officers made the correct decision in the circumstances.
Mental Health is the major issue facing policing
Police generally receive little or no formal mental health training and are asked to make subjective decisions on a person’s mental health at the roadside. Placing someone in a place of safety so a more informed decision can be made seems reasonable to me. Police cannot simply walk away and hope that someone will be ok.
Mental health is an increasing demand on police time. At least one chief constable has referred to it as the “number one issue affecting policing today” and he was absolutely right. We get several calls a day either from or about suicidal people. Often the police are called because the caller can’t get help elsewhere.
Whilst I accept that there is room for improvement in police response and handling of section 136 issues there is a very real need for the true scale to be identified and, more crucially, for the capability of mental health services to respond to crises to be increased.
This is a replication of an article I wrote in September 2012 for Mad World . This is the blog area of Care Space (the online community for social care).
The full website for Community Care can be found here.
The original article can be read here.
This article and the online magazine is edited by @andymcnicoll.