The Committee’s main findings are:
- The Mental Health Act 1983 should be amended so that police cells are no longer stated as a place of safety for those detained under section 136.
- It is clear that too many NHS Clinical Commissioning Groups (CCGs) are failing in their duty to provide enough health-based places of safety that are available 24 hours a day, seven days a week, and are adequately staffed. CCGs must not only acknowledge local levels of demand and commission suitable health-based places of safety, they must also design local backup policies to deal with situations where places are occupied. CCGs need to provide more “places of safety” in NHS hospitals so the police are not forced into filling the gap.
- The police need to make sure they use their powers in relation to mental health correctly, to reduce the numbers detained and so reduce pressure on both the police and the NHS. Frontline staff need to learn from one another, and each organisation needs to understand the priorities of others.
- The fact that children are still detained in police cells under section 136 reflects a clear failure of commissioning by NHS Clinical Commissioning Groups. The de facto use of police cells as an alternative relieves the pressure on CCGs to commission appropriate levels of provision for children experiencing a mental-health crisis. The NHS needs to make places available to look after such children locally.
- People encountering a mental health crisis should be transported to hospital in an ambulance if an emergency services vehicle is needed. Transportation in a police car is shameful and in many cases adds to the distress. It enables the patient’s health to be monitored on the way and improves access to healthcare pathways.
- Early indications of the effectiveness of the Street Triage scheme are very positive, it is important that the scheme is fully appraised. We recommend that the Government give a clear commitment that funding will be made available for schemes which have been proven to be cost-effective.
Rt. Hon Keith Vaz MP, Chairman of the Committee, said:
"The prevalence of people with mental health illnesses in the criminal justice system is a scandal. It is unacceptable that the police should be filling the gap because the NHS does not have the facilities to look after mentally ill people. The detention of over 6000 adults under s.136 in police cells in England last year is far too high. These people are not criminals, they are ill and often are experiencing a great deal of trauma.
The detention of children with mental health issues in police cells must cease immediately. Last year 236 children were detained in a police cell under s.136. NHS places must be made available for children locally.
The cost to policing budgets of police officers in custody suites having to deal with mentally ill people is huge. This puts enormous pressure on officers who are not suitably trained and is the starting point for those that are mentally ill to enter the criminal justice system. Many begin a journey which will eventually end in prison.
Street triage has been shown to work effectively but needs clear funding. In addition, transporting mentally ill people to hospital in an ambulance, rather than a police car, shows that this is a health problem, not a policing one."
Mental health is estimated to be a factor in between 20% and 40% of police time.
At the moment, the law allows the police to detain someone for 72 hours if they think that person’s behaviour may be a risk to themselves or others, compared to only 24 hours if they think that person has committed a crime.
Detention under s.136
The police can detain someone using s.136 of the Mental Health Act 1983 if they think they may be a danger to themselves or others. The person is taken to a “place of safety”, in either a mental health facility, A&E or a police cell, so they can have a mental health assessment.
In 2013-14, 24,489 people were detained under s.136. Of those, 6,028 were taken to a police cell. The compares to 7,761 in 2012-13, and 9,000 2011-12.
The Royal College of Psychiatrists recommended target time for assessments in a hospital is three hours. The average delay waiting in a police cell for an assessment is over nine and a half hours.
There are 161 health based places of safety in England, 35% of which do not accept anyone under-16 and 16% do not accept anyone under 18. In 2013-14, 753 children under-18 were detained under s.136 and 236 ended up in a police cell.
Under 18s detained using s.136 are statistically more likely to be taken to a police cell than an adult: 31% of under-18s went to a police station (236 out of a total of 753 in 2013-14) compared with 24% of adults went to a police cell. (6,028 out of a total of 24,489 in 2013-14.)
Regional variation in the use of s.136
There is a huge discrepancy between police forces and their use of S.136.The Metropolitan Police detained 1,645 adults under s. 136 but only 75 adults went to police cells. The Met detained 45 under-18s and zero were detained in a police cell. (The rest went to hospital.)
Sussex Police detained 1,355 adults under s.136 and 855 went to police cells. Sussex detained 45 under-18s but 20 of them went to a police cell.
Reducing the use of s.136
Some forces have made better recent progress than others in reducing the use of police cells under s.136. In 2012-13 Greater Manchester police detained 206 people, but in 2013-14 Greater Manchester police had got this figure down to fewer than five people in police cells.
In 2012-13 Thames Valley police detained 273 people in police cells, and in 2013-14 Thames Valley detained 270 people in police cells.
Deaths in custody, and shortly after contact with the police, and mental illness in 2013-14
11 people died in custody 2013-14, and of those 11, four had been identified as suffering from mental health problems.
68 people committed suicide within two days of release from police custody in 2013-14. Of these, 45 were reported to have mental health concerns (e.g. suicidal thoughts, depression). Three had been detained under the mental health act.