The responses of professional groups to the use of Section 136 of the Mental Health Act (1983, as amended by the 2007 Act) in Gloucestershire

Emergency workers' experiences of the use of section 136 of the Mental Health Act 1983: interpretative phenomenological investigation

AIMS AND METHOD

To explore the experiences of emergency workers dealing with incidents in which section 136 of the Mental Health Act 1983 is invoked by the police. Data from interviews with police officers and ambulance workers in a London locality were subject to interpretative phenomenological analysis.

RESULTS

Participants felt they were the first port of call and that training should be improved to help them deal with those experiencing mental health crises in the community. Police participants noted time pressures trying to gain individuals' trust and described section 136 detention as sometimes feeling like a betrayal of the individual. Most participants had negative experiences of admissions to the 136 suite; several suggested ways of improving the admissions system. Several went beyond their expected duties to ensure that distressed individuals were supported before accessing mental healthcare services.

CLINICAL IMPLICATIONS

Improving training of emergency workers in dealing with mental health crises would also help with aftercare decision-making. Learning identified from the participants' experiences lends support to collaboration between emergency and mental health services, an important step towards improving the section 136 process so that detainees can access help without unnecessary delay.

Repeated Police Mental Health Act Detentions in England and Wales: Trauma and Recurrent Suicidality

Most police Mental Health Act (Section 136) detentions in England and Wales relate to suicide prevention. Despite attempts to reduce detention rates, numbers have risen almost continually. Although Section 136 has been subject to much academic and public policy scrutiny, the topic of individuals being detained on multiple occasions remains under-researched and thus poorly understood. A mixed methods study combined six in-depth interviews with people who had experienced numerous suicidal crises and police intervention, with detailed police and mental health records. A national police survey provided wider context. Consultants with lived experience of complex mental health problems jointly analysed interviews. Repeated detention is a nationally recognised issue. In South East England, it almost exclusively relates to suicide or self-harm and accounts for a third of all detentions. Females are detained with the highest frequencies. The qualitative accounts revealed complex histories of unresolved trauma that had catastrophically damaged interviewee’s relational foundations, rendering them disenfranchised from services and consigned to relying on police intervention in repeated suicidal crises. A model is proposed that offers a way to conceptualise the phenomenon of repeated detention, highlighting that long-term solutions to sustain change are imperative, as reactive-only responses can perpetuate crisis cycles.

Police detentions of 'mentally disordered persons': A multi-method investigation of section 136 use in Sussex

This research was conducted in response to governmental and public concern regarding the escalating use of section 136 of the Mental Health Act (1983) nationally and of the excessive use of police custody as a place of safety in Sussex in particular. A retrospective analysis of all detentions in Sussex during 2012 was combined with qualitative data from 37 people with lived experience of detention, as well as police, National Health Service (NHS) and allied staff and volunteers. Predominantly, police used s136 as suicide prevention (80%) when no other services or help were available. During the period of study (2013-2016), effective joint working strategies, such as the street triage pilot, were able to reduce the overall rates of s136 detentions and to increase access to NHS place of safety suites markedly. Although the research acknowledges idiosyncratic local factors which contribute to the high rate of detentions across Sussex, the results have wider implications for national policy and practice.

'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.

Ethical and technical considerations for the creation of cell lines in the head & neck and tissue harvesting for research and drug development (Part II): ethical aspects of obtaining tissue specimens

BACKGROUND

Although much has been published for the development of cell lines, these were lab based and developed for scientific technical staff.

OBJECTIVE OF REVIEW

We discuss the ethical implications of tissue retention and present a generic consent form (Part II). We also present a simple and successful protocol for the development of cell lines and tissue harvesting for the clinical scientist (Part I).

CONCLUSION

Consent is also more proximate and assurance can be given of appropriate usage. Ethical questions concerning tissue ownership are in many institutions raised during the current consenting procedure. We provide a robust ethical framework, based on the current legislation, which allows clinicians to be directly involved in cell and tissue harvesting.