Supplementary written evidence submitted by the
Home Office and the Department of Health

Letter from Rt Hon Norman Lamb MP, Minister of State for Care and Support, Department for Health; Rt Hon Mike Penning MP, Minister of State for Policing, Home Office, to the Chair of the Committee, 18 December 2014
 

REVIEW OF THE OPERATION OF SECTIONS 135 AND 136

OF THE MENTAL HEALTH ACT 1983

Having recently appeared before your inquiry into policing and mental health, we are writing to draw your attention to the publication of the joint Department of Health and Home Office review of Sections 135 and 136 of the Mental Health Act 1983. We hope you will welcome the recommendations, which are summarised below. The review has been able to draw upon the oral and written evidence submitted to your inquiry. Unfortunately timescales did not allow us to taken into account your final report, once it is published, but this will of course form part of our ongoing thinking in this area.

The review report, and supporting evidence base, is now available online at:

https://www.gov.uk/government/consultations/review-of-the-operation-of-sections-135-and-136-of-the-mental-health-act

The review gathered a wide range of evidence, including from service users. The accompanying reports include the summary of the responses to the online survey, which received more than 1100 responses between April and June 2014. The review makes a number of recommendations including proposals for possible future legislative change. These will be consulted on in more detail prior to any Bill being brought forward, after the next General Election.

The review aimed to address what was widely perceived as an excessive use of police cells to detain people under section136, and in particular to ensure that children and young people are not being held in police cells when experiencing a mental health crisis. The review makes a number of legislative and non-legislative recommendations. The key recommendations are:

1. Amending legislation so that children and young people aged under 18 are never taken to police cells if detained under S135 or S136, and ensuring that police cells can only be used as a place of safety for adults experiencing a mental health crisis if the person’s behaviour is so extreme they cannot otherwise be safely managed elsewhere;
2. Reducing the maximum length of detention under S135 and S136 to 24 hours from 72 hours, with the possibility of an extension if necessary;
3. Encouraging  innovation in identifying places of safety so that alternative places can be found;
4. Expanding the remit of section136 to apply anywhere except for private homes – thus addressing concerns that in some situations the police did not have the ability to act promptly to assist someone within the existing legal framework
5. For private homes, retaining the need to obtain a S135 warrant in order to provide the appropriate safeguards and oversight; and
6. Reducing inappropriate S136 detentions by requiring the police to consult a suitable health professional prior to making the detention, wherever feasible (supporting the approach taken in street triage pilots).

The review in addition made a number of non-legislative recommendations which are in keeping with progress already being made as a result of the Crisis Care Concordat, and reflecting the findings of the recent Care Quality Commission report, ‘A Safer Place to Be’ – a survey of health-based places of safety in England. The report recommends that NHS commissioners and providers of health-based places of safety and should work together to map demand levels and ensure that adequate capacity and staffing is available to support people in mental health crisis, especially children and young people, and that contingency plans should be in place to cope with periods of peak demand. The report also recommended that they should also review their local section 136 protocol, particularly with regard to any criteria for excluding people, and ensure that the protocol is consistent with the Code of Practice in England (once the revised version is available in spring 2015, subject to parliamentary approval).

In seeking to identify areas of best practice, the review has found that in some areas multi-agency groups were very active in meeting regularly, reviewing data and specific cases, and identifying repeat cases and putting in place appropriate multi-agency care plans. This should be best practice everywhere.

We hope you will find the review of interest and look forward to receiving the report of your inquiry.

Rt Hon Mike Penning MP and Rt Hon Norman Lamb MP

2