Section 136 use in the London borough of Haringey

A retrospective cohort study describing the characteristics of patients under 18 years old in one section 136 suite

Section 136 of the Mental Health Act 1983 is an authority allowing police officers to remove a person 'who appears to him to be suffering from mental disorder' from a public area. There has been much media coverage regarding the inappropriate detention of minors under section 136 and the suggestion that many were taken to police cells, as there were no suitable places of safety. Although previous studies describe characteristics of a typical individual detained under section 136, few distinguish the differences between adults and adolescents. Profiling these adolescents can help to identify adolescents at risk, allowing for earlier intervention and prevent the inappropriate detention of individuals. Data were collected retrospectively for all patients under 18 years of age who were brought to a section 136 suite in south-west London over a five-year period. The typical profile of an adolescent presenting to this suite was a 16-year-old female of white ethnicity who was sectioned in a public area due to attempted suicide or deliberate self-harm. The individual is more likely to have mental or behavioural difficulties, a history of abuse, be under the care of local authorities and have had previous convictions compared to adolescents in the general population.

Bendelow G. Diagnosing vulnerability and “dangerousness”: police use of Section 136 in England and Wales

Purpose

– Police in England and Wales are empowered, under Section 136 of the Mental Health Act 1983 (s136), to detain individuals thought to be a danger to themselves or to others. Use of this authority is widespread, but varies across districts and attracts controversy because of inconsistent application and the fact that it requires police to make judgements about mental health. The purpose of this paper is to examine police attitudes to and criteria for using s136.

Design/methodology/approach

– The authors conducted focus groups with 30 officers in urban and rural areas of three different regions across England and Wales. Group interviews were audio-recorded, transcribed, and analysed using open and axial coding.

Findings

– Use of s136 authority has major implications for police work; liaison with mental health services is seen as desirable but often ineffective due to resource constraints and the latter's lack of availability. The decision to invoke s136 depends on social context and other particulars of individual cases.

Research limitations/implications

– Although the findings have limitations with respect to generalisability across the whole of the UK, there are patterns of responses which have major implications for policy recommendations.

Practical implications

– Police decisions to apply s136 reflect an implicit values-based classification of and response to emotionally disturbed behaviour, in light of available institutional and social supports.

Social implications

– Tasked primarily with protecting the public and keeping the peace, police “diagnoses” of risk often contrast with that of mental health professionals.

Originality/value

– A highly original piece of research which has attracted further funding from BA/Leverhulme.

Emergency department as a 'place of safety': reviewing the use of Section 136 of the Mental Health Act 1983 in England

Section 136 provides the lawful authority for the removal, by the police, of the person to whom the provision applies, from a place to which the public have access. There has been a longstanding debate as to the most appropriate place of safety for these patients. The aim of this article is to review the literature and determine the ideal place for the detention and assessment of these patients and clarify the responsibilities of the staff of the agencies involved in the detention. It concludes that there is no single most appropriate place of safety for all groups of patients. Rather, there should be a range of options to enable the assessment in the most suitable environment for individual cases according to their needs at the time.

'A frightening experience': detainees' and carers' experiences of being detained under Section 136 of the Mental Health Act

AIMS

This research reports on the views of detainees and their carers of their experiences of being detained under Section 136 (S136) of the Mental Health Act 1983. Individual interviews were conducted with 18 detainees and six carers.

METHOD

A semi-structured questionnaire was administered face-to-face to gather qualitative data, which was analysed using a grounded theory approach.

RESULTS

The results indicated a general dissatisfaction with the quality of care and treatment from both police and professionals. Though several detainees recognized the need for police to be involved, most felt they lacked the skills needed to meet the needs of mentally ill people. Nearly all participants felt that the police station was an inappropriate setting for further assessment, and found their experiences in police cells distressing, making them feel like criminals.

CONCLUSIONS

Detainees and carers would like to see the provision of a place of safety other than emergency departments or police stations, and this study reinforces the Mental Health Code of Practice 2008 which states that police stations should only be used on an exceptional basis.

Demographic and referral patterns of people detained under Section 136 of the Mental Health Act (1983) in a south London Mental Health Trust from 2005 to 2008

This study aimed to retrospectively examine demographic and referral data for all detainees under Section 136 of the Mental Health Act (1983) at a 'place of safety' in one London Mental Health Trust over a three-year period. Data were collected for 887 consecutive detentions and indicated a clear over-representation of black detainees compared with their representation in the local population. A high proportion of detentions (41.2%) did not result in hospital admission. Implications for practice and service user experience should be considered as long as Section 136 remains an entry point to mental health services for many black people. There are implications for interprofessional practice where Mental Health Trust resources are expended supporting Section 136 detentions in which no hospital treatment follows.

Section 136 of the Mental Health Act: a new literature review

Section 136 of the Mental Health Act 1983 (amended) provides police officers in the United Kingdom with the authority to remove individuals who appear to be suffering from a mental illness from any public place to a designated 'place of safety' for appropriate assessment. A considerable amount of research has been dedicated to investigate who is detained under this section and how it is implemented. A review of the literature revealed a high prevalence of schizophrenia, personality disorders and mania in individuals detained under Section 136 and an over-representation of black detainees. Several studies also reported poor communication between different agencies and poor levels of knowledge regarding the implementation of the section. There is a lack of qualitative research exploring detainee and professional experience of Section 136 and in particular the patient pathway to mental health care via Section 136 experienced by black detainees. Implications for clinical practice, multi-agency collaboration and future research are discussed.