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Mental Health: Section 136 Facilities

Volume 703: debated on Monday 30 June 2008

asked Her Majesty’s Government:

How many dedicated Section 136 suites in mental health trusts have been opened in England and Wales.

My Lords, we have good reason to believe that the extra resources that have been made available for investment in adult mental health services are being used to develop a growing number of dedicated Section 136 facilities. However, the Government do not hold information centrally for the total number of such facilities.

My Lords, I thank the noble Baroness for that reply. In Nottingham, all detained under Section 136 of the Mental Health Act, other than those requiring physical health needs urgently to be addressed in A&E units, are taken to a police station as a place of safety. I appreciate that Her Majesty's Government have allocated money to build suitable assessment units in psychiatric hospitals, but what assurance can the Minister give that facilities will not fail to open due to a lack of staff? How will Her Majesty's Government monitor the availability of these suites to help patients in need?

My Lords, I thank the right reverend Prelate for his questions, which are entirely reasonable. The capital funding allocated by the Department of Health in 2006 included £1.35 million for Nottinghamshire Healthcare NHS Trust to build a new eight-bed unit, including a Section 136 facility. Indeed, a condition of the funding was that Nottinghamshire met the revenue costs. There really is no reason why NHS bodies locally, in partnership with other relevant agencies, should not provide appropriate facilities and arrangements.

On the right reverend Prelate’s second question, we have given some thought to monitoring in respect of Section 136. The primary responsibility for ensuring effective and appropriate use of Section 136 lies with the responsible local agencies. However, our revised code of practice to the Mental Health Act makes it clear that locally agreed policies must include arrangements for effective monitoring of how, in what circumstances and with what outcome Section 136 is being used locally.

My Lords, the fact that severely mentally ill people still spend many hours languishing in police cells reflects a much wider failure to invest sufficient resources in in-patient units and services. The result is that the current risk is unacceptable. Will the Minister seek from strategic health authorities an assurance that they will review the levels of risk and the quality of services in in-patient units as well as the availability of Section 136 suites and that they will spend sufficient money to ensure that there is an acceptably low risk?

My Lords, I am very happy to revisit this question, but we have made it clear in our revised code of conduct that police stations should be used only exceptionally as a place of safety under the Act. There is clearly much to do, as they are used much too often. The code stresses that it is preferable for people to be detained in a hospital or other healthcare setting where mental health services are provided.

My Lords, does the noble Baroness realise how encouraging it is to hear that she is aware of this as a problem that the Government must tackle earnestly? Does she also realise how much that pleases me, given that, when I was a Minister in the Department of Health and Social Security in 1982 and, later, when I had responsibility for the Prison Service, I was faced with exactly the same cries about insufficient secure beds in NHS services for the number of people who needed them? The result is treatment that is not acceptable.

My Lords, the noble Lord is correct: we are driven by a desire to prevent and minimise people with mental disorders coming into contact with police and being detained by them. He is absolutely right that we need to improve access to healthcare.

My Lords, I shall expand a little on what the noble Baroness, Lady Meacher, asked because I think she was trying to get a rather broader response. What are the Government doing to ensure that mentally ill people can and want to access emergency and in-patient services, with confidence that they are of such a quality that they do not have to deteriorate to the point where a Section 136 is necessary—so they can get in early? What are the Government doing to ensure that services are of an acceptable quality that people want to use?

My Lords, the noble Baroness will be aware from experience that the Government have made the provision of services to those with mental illness a priority, which has included an additional £130 million capital funding to the NHS in England to assist with the development of dedicated healthcare-based facilities, including for people detained under Section 136, but not only for them.

My Lords, will strategic health authorities monitor the provision of acute mental health services in rural areas? It is evident that in some rural areas police stations are overused as places of safety because of a lack of facilities.

My Lords, I need to repeat what I said earlier: monitoring is a local responsibility. However, the Independent Police Complaints Commission is expected shortly to publish findings on the use of police stations under Section 136, which will include rural facilities. The Royal College of Psychiatrists working group is developing an agreed approach to recording information about the use of Section 136. Both those things will help to take this forward.

My Lords, will the future Care Quality Commission have a role in setting and monitoring standards in this area?

My Lords, the noble Earl is aware that it will. I hope that the CQC will take this up very seriously.