Detention under section 136 of the Mental Health Act: A multi-agency panel review of practice and communication between police officers and mental health professionals

Abstract

A critical part of police involvement in incidents involving mental ill health in the UK, is the section 136 (S136) of the Mental Health Act 1983. This power allows police officers to detain an individual and take them to a place of safety in order for them to have a mental health assessment. The decision (or not) to use this power is a collaborative multi-agency process. It involves communication and information sharing between police officers, mental health professionals (MHPS), paramedics and the person in crisis. By working closely with people with lived experience we explore how detention under S136 is negotiated and decided between police officers, mental health professionals and paramedics. Methods: A multi-agency panel that examines selected S136 cases (police video footage), has been in place since 2021 and convenes quarterly. It is chaired by a senior police officer and attended by professionals from the Devon and Cornwall Police and Devon and Cornwall Mental Health NHS Trust, e.g., Psychiatry Liaison, Quality Lead, Crisis Team service manager, and Manager of the Mental Health helpline. This pilot study involves the analysis of S136 panel meetings, including meeting minutes and observations of police video footage. Results: Initial findings show disagreements between police and MHPs arise from the confusion over what constitutes a mental-health crisis; instances where MHPs think police may be too quick to exercise S136, disagreements between different professionals sometimes in front of the person in crisis; and lack of ambulance support. Further analysis on verbal and non-verbal communication techniques that are associated with critical actions (e.g., reasoning for detention, de-escalation) that can be targeted in training, will be presented. Conclusions: Understanding what is really happening during multi-agency decision-making we can improve the response, so that it is empathetic yet safe and effective, without resulting to detention unless the risk of harm is substantial.