World Mental Health Day provides a timely opportunity to reflect on last week’s announcement that an independent review of the Mental Health Act 1983 will be carried out.
In making this announcement, the Prime Minister recognised that the Act as it currently stands is not fit for purpose. Many of its provisions have not been revisited since its passage almost 35 years ago. Since that time, extensive research and cross-partnership working has established an understanding of best practice that currently is not reflected in the legislation.
The Prime Minister acknowledged the rise in detention rate for those experiencing mental ill-health. We’ve seen this trend repeatedly in recent years, with the number of detentions in 2015/16 increasing by 9 per cent compared to 2014/15, the highest number in a decade.
This is clearly an area in need of examination and we welcome the Prime Minister’s commitment. However it is critical that we also continue to strive for improvement with regard to the practical aspects of this detention, namely where individuals are taken to as the designated ‘place of safety’.
Earlier this year, a huge milestone was reached with the announcement that it would become unlawful to use a police station as a place of safety for a person under 18 years of age. It is easy to envisage the hugely traumatic effect being detained in police custody would have on a young person in that situation.
Unfortunately, mental health crises do not discriminate based on age, and we have expressed our concerns that police cells will continue to be used as places of safety for adults. The police service, with support from partners and Police and Crime Commissioners, has made significant progress in reducing the number of times this occurs and the Government does specify that cells should only be used in “exceptional circumstances”. But this does not go far enough. Detaining these individuals in a police environment not only adds to their trauma, but places too much strain on frontline police officers, who are not in a position to offer them the requisite care, and leads to the inappropriate criminalisation of mental health.
It is of course inevitable that police officers will often be the first to come into contact with those in mental health crisis, perhaps through concern for welfare incidents or missing persons reports, so it is critical that they are able to quickly divert the individuals to the correct service. Too often, we are seeing significant delays before assessments are completed and an appropriate bed is found. This can leave police officers, who cannot legally keep the individual in custody without charge, with little choice but to release people at risk without receiving the necessary care.
We hope that the review will delve into these issues, looking at the true impact of a detention increase. We are pleased to see that the review will also consider the reasons for disparity in detention numbers across different ethnic backgrounds. It is crucial that support is available indiscriminately across our communities, and the root causes of any disproportionality are addressed.
The areas of examination alluded to in the Prime Minister’s speech are hugely important, but there are other aspects of the legislation that require reform.
There are areas that require simplification. As a result of complex time related measures, individuals who have removed themselves from a hospital or otherwise specified location before a practitioner deems it safe to do so, present a challenge for those in a safeguarding role. Whether it is practitioners or police officers, the legislation does not make clear how long professionals are legally empowered to return that individual to the place of safety.
Other areas can benefit from existing work. Earlier this year, the College of Policing coordinated the production of a memorandum of understanding (MoU) around the use of restraint in mental health and learning disability settings. It aimed to better define the role of police in clinical settings, helping practitioners and officers to assess when police attendance is necessary and appropriate. At present, this remains a set of advisory guidelines set by professional bodies and the mental health charity Mind. We will continue to work to embed these recommendations and any changes to legislation should be shaped by best practice that is already established.
In recent years, we have seen vast improvement in the field of mental health and policing. However, there is still a long way to go and this review will be an important starting point for the next phase of development. We look forward to contributing to the project and taking every opportunity to raise our concerns in order to create a better service for the public.
Martyn Underhill, PCC for Dorset
APCC Portfolio Lead for Mental Health and Custody
Matthew Scott, PCC for Kent
APCC Deputy Portfolio Lead for Mental Health and Custody