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House of Commons Hansard
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Detention under Mental Health Act
14 July 2016
Volume 613

Motion made, and Question proposed, That this House do now adjourn.—(George Hollingbery.)

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As an ethnic minority immigrant to this country, I am intrigued by the way the House works. We have had two days of a deeply serious international debate, and now an ethnic minority immigrant has an opportunity to put a point on a small but important issue that is almost local by comparison. I am referring to the possibility of a small change in the Mental Health Act 1983 to enable our policemen and women to act somewhat more promptly in the care of any person they find to be in need of mental health assessment and immediate care.

I raised this issue in a ten-minute rule Bill in 2014. I did not proceed, as I was informed that there was an ongoing review. That review has come and gone, and I have read it, but this small point was not referred to in it. However, there will possibly be a negative change—from my point of view—in the Policing and Crime Bill as it progresses through the other place.

I was initially prompted to seek changes having seen the need for them first hand. I was on a police parliamentary scheme in 2014, as part of which I went round Wandsworth on foot or by car. I joined two young uniformed police officers in their response car. The first call was a dash to a flat on the 14th floor of a council residential tower block. The mother of the household nervously let the officers in to see her daughter—aged 22—who was standing on the window ledge and threatening to jump.

It was quickly established that the daughter had a short history of suicide attempts. With the back-up of two plainclothes officers, and with great expertise, the young woman was persuaded to come down. A young female officer sat on the bed beside her, and they calmly discussed the problem. The police officer suggested the young woman might want to go to a place of safety for psychiatric and medical help. That was refused, and when the woman was pressed a little further, it was followed by agitation and threats to jump out of the window.

Meanwhile, police officers outside the flat had contacted the psychiatric unit at St George’s hospital for assistance. After a couple of hours, an individual from the hospital arrived with an ambulance and crew. There was further alarm and rejection, and a struggle ensued, but in due course this sad lady was transported to the hospital as a designated place of safety.

The whole pantomime had occupied five police officers and three NHS staff, and it had taken about three to four hours to sort out. It was obvious from the beginning that the police themselves could have taken care of the young lady very quickly, therefore reducing the police and NHS manpower hours needed and the risk of the young lady leaping out of the window.

I have a second personal case, which involves a Mole Valley resident. A lady in a block of flats has been threatening neighbours with bizarre and often aggressive behaviour to such a degree that some other residents actually fear for their lives, let alone obtain any peace at any hour of the day. Contact between the mental health team and the police has not coincided until very recently. I asked the police officer in charge about section 136. Predictably, I was told the lady’s home was a private place, so no police action was legally possible. From discussions with Met police officers, I have found that that situation is far from unusual.

A more tragic case was the death of Martin Middleton in 2010. He was taken to a Leeds police station by officers who had visited him in his home and noted his serious preparations for committing suicide. The police officers believed they had arrested Mr Middleton under section 136. When they arrived at the police station, the custody sergeant refused to detain Mr Middleton, as the arrest had taken place in his private residence. The police officers therefore had to take him to what they hoped was some form of safety—a relative’s home. Sadly, later that day or the following day, he hanged himself.

At the inquest, the coroner had no hesitation in agreeing with Professor Keith Rix, who was called to give expert evidence, that Mr Middleton fell into a category of mentally disordered persons for whom there is no appropriate provision under the Act. Subsequent to raising this issue, I have heard from many front-line police officers and again from Professor Keith Rix, who is an academic psychiatrist and an expert in this area. I still have no doubt that the Act needs amending fully to protect the police and, of course, those suffering a mental illness crisis.

I am reliably informed that in the Republic of Ireland, the Garda Siochana have a clear operational advantage in that, under section 12 of Ireland’s Mental Health Act 2001, where there is

“a serious likelihood of the person causing immediate and serious harm to himself or herself or to other persons”,

a garda can

“enter…any dwelling or other premises or any place if he or she has reasonable grounds for believing that the person is to be found there.”

There are instances recorded in England where the police have had to act outside the boundaries of the law out of concern for the safety of the individual. There are also recognised incidences of the desperate police persuading the person out of their home, and therefore into a public place, to effect an arrest under section 136 and take the person for proper and appropriate care, thus preventing a suicide. Over the 10 years between 1997-98 and 2007-08, admissions to hospital as a place of safety increased from 2,237 to 7,035. The Minister is noted for his quick arithmetic, and he will recognise that that is a threefold increase.

It was calculated that 17,417 people were detained under section 136 in 2005-06. By 2011-12, the overall number of incidences of its use was recorded as 23,500. As I have indicated, although the powers under section 136 are limited to persons who are found by the police in a public place, there is evidence that the powers are sometimes used to remove an affected person from their home. In fact, one London-based social services authority’s audited figures indicated that some 30% of section 136 arrests were recorded as having been made at or just outside the detainee’s home. In other words, in desperation, the police have had to manoeuvre the individual outside their private residence. This is an indication of the desperation of the police to obtain care for disturbed individuals, and hence it supports my desire for a change in the legislation.

Put bluntly, on a strict interpretation of section 136, the admission to hospital of hundreds, if not thousands, of potential suicides is delayed or denied, thus risking their suicide or self-harm, merely because the police, who sometimes have to just observe the situation, cannot act because it is happening in the person’s home or someone else’s home. In many instances, as I found in Wandsworth, the police have to spend considerable time waiting until they can obtain a medical practitioner or a health official to give them the nod to transport the patient to care.

One argument against the amendment that I am suggesting is that the police already have sufficient powers. It is quite clear, from my own observation, that that is basically incorrect. The second argument is that it would extend the right of the police to enter people’s private properties. Clearly, in those circumstances, that is appropriate because somebody is in need of mental health care, and that is the whole point of the change I am seeking. It is already possible for the police to enter an individual’s private home to investigate a possible breach of the peace, assuming that the police would be utilising that eventuality to enter the property. Often, they have to help someone who is clearly suffering mental disorder. In many cases, other residents in the property can allow the police in, but having done so, as in the first case I cited, they are then still unable to act.

In my belief, and in my experience, the police are acting only in the very best interests of the individuals concerned and of the safety of the public, and we should give them the legal mechanism to do so. Doing nothing is not an option. I suggest that a simple solution would be to amend section 136 by simply removing the words

“in a place to which the public have access”.

I am hopeful of a positive answer from the Minister; I know that he is extremely flexible. I would be happy to work with him to seek a ten-minute rule Bill, or take a different direction through a tiny change to the Policing and Crime Bill in another place. If he has a problem with my suggestion, I would be grateful if he met me and Professor Rix to discuss a solution to help the police to save lives and injuries, and not, as the Department appear to be doing, produce exactly the opposite effect.

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I call the Minister of State for Policing, Crime, Criminal Justice and Victims, at the Home Office and at the Ministry of Justice, to reply to the debate.

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Far be it for me to ever contradict you, Mr Speaker, but I lost crime some time ago and now have fire. The title you gave me is correct, except that I now have no crime, but lots of fire.

I say to my hon. Friend the Member for Mole Valley (Sir Paul Beresford) that it is a pleasure to respond to this debate. We have met to discuss his concerns before. I have received delegations on the subject and it was discussed extensively during the Committee stage of the Policing and Crime Bill.

To be fair, my hon. Friend does highlight an issue, and I am not going to run away from that. He is absolutely right to say that there are concerns about extending powers into a place of safety that is deemed to be someone’s abode. I have been on patrol with the police when they have encountered very similar situations to the first case that he mentioned. I have also heard people say, long before I got this position, “If only we could get this person outside their home, we could help them under the existing legislation.”

I am sure that all custody sergeants, who do a fantastic job, are as diligent as the one who my hon. Friend has met. I once heard a custody sergeant say that section 136 would not be appropriate when a person was in a public place. I do not think that that is right, either, but police officers are not mental health experts. One of the problems with section 136 is that it is specifically designed as a last resort when all other measures to help an individual have been exhausted. I will touch on other matters relating to the expertise that police officers do not always have, including the street triage initiative and resources for custody suites, and, importantly, the situation outwith officers.

Before we consider changing section 136, we need to ask whether it is being used correctly. We are concerned about the number of section 136 orders that are being used, and the data that I asked for show that forces in some parts of the country almost never use section 136, while others use it extensively.

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It would be interesting to compare and contrast those statistics with the suicide statistics. By law, anyone arrested under section 136 must be seen within 72 hours by a psychiatrist or a medical practitioner with psychiatric training, which represents an enormous safeguard.

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My hon. Friend is absolutely right. We will break down the analysis for information not just on suicides, but on criminal assaults, which are often carried out on loved ones. When I was out on patrol with the Metropolitan police in Camden, we went to what the neighbours described as a “domestic situation”; in other words, someone had allegedly been assaulted. When we arrived at and eventually got into the flat, the one thing that the person who had been assaulted desperately did not want was for their loved one to be arrested and taken to a prison cell, because they were ill. They were ill in a similar way to someone who had broken their leg or who had a medical illness. They were ill and they needed to go to a suitable place of safety.

All too often over the years, that person would have been arrested and ended up in a police cell. If they were not subject to section 136, they would not necessarily have the safeguard of being seen by a medical or psychiatric specialist. That is one of the reasons why the amount of time that someone with a mental illness can be kept in a police cell is massively restricted by legislation.

I would argue that this is a matter not just for the police, but for social services and the NHS in particular. It is not for a police officer to diagnose instantly whether someone having a mental health episode is drunk, has taken illegal drugs, or has had their medication go wrong. I may not be the Minister with responsibility for the police as the reshuffle goes on, but at the moment they are my police officers in England and Wales, and very often they have to make split-second decisions. However, I am desperate to make sure that they are not put in the difficult position of being the first port of stoppage rather than being, as they should be, the last resort for those in desperate need.

When I was fireman, I regularly attended incidents with the local police force. At about a quarter to five on a Friday, social services would phone the police and fire stations to say that they were going home for the weekend, but they had not seen Mary or Jonny—vulnerable people—during the week, so could we make sure that they were okay. Sometimes we had to break into the premises. I argued then and I argue now that that is not the role of the emergency services, and it is certainly not the role of the police. However, that has become the norm in all our constituencies.

My hon. Friend the Member for Mole Valley will be pleased to know that an inter-ministerial group is looking at this. When I was disabilities Minister, I sat on the group and argued my point about not just people with mental illnesses, but people with learning difficulties. The two are often confused in this area, because people with learning difficulties can also become very confused as we desperately try to look after them.

If someone has a mental illness, the place of safety that we take them to is not a police cell. We do exactly what it says on the tin and take them to a place of safety, which means a medical setting provided by the NHS or social services.

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I support my hon. Friend the Member for Mole Valley (Sir Paul Beresford) in everything that he is trying to do. Does the Minister agree that the time limit in the safeguards in section 136, which require an examination by a registered medical practitioner or an interview by an approved medical health professional within 72 hours, could be reduced to perhaps 12 hours? That would mean that the person in question would get more immediate help.

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My hon. Friend is absolutely right. That is exactly what will happen under the Policing and Crime Bill. The police will not be able to hold a person in a police cell for the length of time that they previously could while waiting for that medical examination to take place. However, to be honest, I think we can all agree that 12 hours is too long. Would we find it acceptable if someone with a broken leg had to wait in A&E for 72 hours? My hon. Friend the Member for Mole Valley is a qualified dentist. Would someone wait 72 hours if they had a huge abscess in their mouth that needed urgent treatment? Why is mental health treated so differently from other illnesses? That is something that my right hon. Friend the Member for North East Bedfordshire (Alistair Burt) has been working on extensively, although sadly he has decided to return to the Back Benches. When the coalition was in power, the right hon. Member for North Norfolk (Norman Lamb) accepted that the NHS was letting these people down, and that the men and women in our police forces were having to pick up the mess by dealing with those in desperate situations. That really is not the role of a police force.

Unless the Government come together to deal with this, my hon. Friend the Member for Mole Valley is right to be concerned about sections 136 and 135. I hope that he will take up my offer of our working together. I am sorry that I did not manage to be with him to meet the professor, although we did bump into him. If the concerns cannot be dealt with in the way that my officials and the three Departments that handle this suggest that they can, we will absolutely need to amend section 136, but let us first try to get to the right place. This will sound critical of other Departments, but I do not want the police to be seen, yet again, to be picking up something that another Department needs to address. That is what has happened over the years.

When I have said that we should restrict the length of time for which these very vulnerable people can be held in a police cell, one argument that has been put to me is: where will they go? How many specialist A&E facilities and places of safety are there, besides the cells in the local prison? The answer is that provision has to be made to ensure that the cells are not the first port of call.

Motion lapsed (Standing Order No. 9(3)).

Motion made, and Question proposed, That this House do now adjourn.—(George Hollingbery.)

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To conclude, it is absolutely right that this issue has been brought to the House, although I am aware of it. I was aware of it before I took on my portfolio and, to be fair, even before I came into the House, because my mother was a mental health nurse for more than 40 years. We are in a much better position today than we have been in the past, and we have a better understanding of mental health and learning difficulties—[Interruption.] The phone in my pocket is buzzing; it may well be someone trying to get hold of me urgently.

It is important that we work together. I give my hon. Friend a commitment that if we cannot get this right using the measures that we are working on, an amendment to section 136 might be exactly what we need.

Question put and agreed to.

House adjourned.