E0506 Procedure – Custody Mental Health Assessments
Number: E0506 Date Published: 22 July 2020 Version 1 – July 2020
1.0 Summary of Changes
This is a new procedure which will give guidance regarding detained persons arrested for criminal offences and who, whilst they are in custody, appear to be suffering from a mental disorder.
2.0 What this Procedure is about
The purpose of this new procedure is:
To provide guidance in respect of detained persons (DP) who have been arrested for a criminal offence and whilst in police custody, appear to be suffering a mental disorder and require an assessment under the Mental Health Act 1983 (MHA);
To ensure a DP who appears to be in mental health crisis receive timely mental health assessments at the most appropriate Place of Safety (POS);
To ensure if there is consideration for the use of Section 136 MHA (S136) for a DP in custody that this power is used appropriately in-line with E 0501 – Section 136 Mental Health Act 1983;
To prevent situations where a DP is held unlawfully because their detention clock as per the Police and Criminal Evidence Act 1984 (PACE) has expired but the application to section them under the MHA cannot be completed;
Following on from the above point to ensure when concerns arise there is the potential for a DP detention to become unlawful the National Police Chiefs Council Escalation Protocol is enacted. Compliance with this procedure and any governing policy is mandatory.
3.0 Detail the Procedure
ED Emergency Department (formerly called A&E) AMHP Approved Mental Health Professional DP Detained Person HBPOS Health Based Place of Safety HCP Health Care Professional PACA Policing and Crime Act 2017 PACE Police and Criminal Evidence Act 1984 POS Place of Safety MHA Mental Health Act 1983 MHP Mental Health Professional MSE Mental State Examination S136 Section 136 Mental Health Act 1983
A process flowchart has been produced to act as a reference guide to accompany this procedure.
3.1 Initial Identification of Concerns for the Detained Person’s Mental Health
Concerns regarding the mental health of a DP can be identified at any point during their period in custody. As detailed in procedure E 0101 Procedure – Detainee Reception the Custody Sergeant has a responsibility to ensure that any detainee is fit to be detained in custody. This will commence from when the DP is first brought before them to authorise their detention. It is then a continuing duty throughout the DP detention in custody and prior to their release the Custody Sergeant must complete a risk assessment as per E 0107 Procedure – Pre Release Risk Assessment.
3.1.1 Initial Mental State Examination Completed by a Health Care Professional
On the identification of concerns for the mental health of the DP, the Custody Sergeant may determine than a Mental State Examination (MSE) is required before a decision can be made as to whether a DP is fit to be detained. A Health Care Professional (HCP) will be called to complete this examination as soon as possible. Following this examination the HCP will decide whether a formal MHA assessment is required and communicate this decision to the Custody Officer. If an MHA assessment is not required, the HCP will advise the Custody Officer on fitness for detention / interview, and the investigative process continues.
If the HCP recommends a formal MHA assessment is required they will also be consulted by the Custody Sergeant as to their advice on the use of S136. As a result of Policing and Crime Act (PACA) a requirement now exists to consult a Health Professional where practicable prior to the use of S136. Although there is a requirement to seek advice (provided it is practicable to do so) and it should be used to inform decision making, police are not bound or required to follow any advice provided. This is fully detailed in E 0501 – Section 136 Mental Health Act 1983.
3.1.2 Where it is not possible to await a Health Care Professional
There may be cases where the Custody Sergeant identifies urgent concerns for the mental health of the DP. The urgent nature of these concerns will mean the Custody Sergeant forms the view the DP is not fit to be detained and either they cannot await the attendance of an HCP or one has been requested but is not available within a reasonable timescale. At this point the DP will be released from custody with consideration of the appropriate tactical options as detailed in section 3.3.1. If one of these options will be to consider the use of S136 then as detailed in section 3.1.1 if it is a practicable a Health Professional must be consulted. Advice could be obtained from:
Suitable medical professional in custody: Section 3.4 of E 0501 – Section 136 Mental Health Act 1983 lists the Health Professionals who can provide advice to fulfil the consultation requirement and include paramedics;
Between 10:00 - 02:00 hours: Request Street Triage via FCR to attend the incident or provide telephone advice. It will attend for adults and children;
Adults, between 02:00 - 10:00 hours: Essex Partnership university trust (EPUT) contact centre on 0300 123 0808.
Anyone under 18, between 02:00 - 10:00 hours: Phone the Emotional Wellbeing and Mental Health Service (EWMHS formerly CAMHS) for advice.
The contact details for the Central Management Hub and the EWMHS service are on the S136 mental health Connexions page.
3.2 Mental Health Assessment process
Once it has been decided that a MHA assessment is required an Approved Mental Health Professional (AMHP) needs to be contacted to arrange a MHA assessment:
Between 09:00 – 17:00 hours contact the AMHP Hub which covers the area in which they were detained. The daytime AMHP Hubs can be contacted via calling the EPUT Central Management Hub;
Between 17:00 – 09:00 hours there will be AMHPs on duty within Social Care's Emergency Duty Teams (EDT);
In order to complete a full MHA assessment, the AMHP will have to source 2 Doctors to assess the DP (who, where possible, should be approved under Section 12 MHA). The AMHP should continue to liaise with Custody and provide:
An approximate time in which they believe they should be able to attend to complete the MHA assessment;
The current availability of hospitals to receive the person if they are deemed to require detection under the MHA, the relevance of this is explained below.
Once the MHA assessment has been completed the potential outcomes are:
Detention under Section 2 MHA for up to 28 days to be assessed. This might suggest the DP did not have capacity at the relevant time. Even if they are found not to have had capacity, if the offence is sufficiently serious or there are significant risks identified linked to their offending, the person can potentially still go through the criminal justice system;
Detention under Section 3 MHA for up to 6 months (although this can be extended) for treatment. This might suggest they did not have capacity at the relevant time. Even if they are found not to have had capacity, if the offence is sufficiently serious or there are significant risks identified linked to their offending, the person can potentially still go through the criminal justice system;
Informal admittance, if suitable and they agree. They are, however, not detained under the MHA and so free to leave at any time and the guidance below must be followed;
Discharge (release), if they are deemed not to have a mental disorder regardless of wider risks they may pose. They may be referred for support from community mental health or other services. Their release could be within hours of being detained and must be considered as part of any safeguarding.
When does a DP PACE clock stop – If a person is assessed as requiring detention under the MHA they are not sectioned at this point and their PACE clock continues. In order for the AMHP to complete the application a hospital with an available bed who is willing to receive the patient needs to be identified. When one has been identified the AMHP can complete the application and at this point the DP is legally sectioned and their PACE clock stops. Until this point is reached regardless of how unwell the DP is, if their PACE clock expires their detention will become unlawful.
Recommendation for Informal admission – No DP must ever be held past the point their PACE clock expires, to wait for an informal admission. It can never be justified unlawfully holding a DP to achieve the goal of taking them to a hospital, which they would be legally entitled to immediately leave.
3.3.1 Tactical options to consider
The correct process within PACE for a DP who is identified as requiring a MHA assessment and is fit to be detained should be for the assessment to be expediently conducted in custody. Detailed in section 3.4.1 is guidance about when in the MHA assessment process a PACE Superintendent could grant an extension.
There are potential blockers which may prevent an expedient MHA assessment:
Time at which the need for a MHA assessment is identified – Concerns for the mental health of a DP are not always immediately identifiable and could be identified at any point whilst they are in custody;
Delays in the completion of the Mental State Examination – Due to delays in the attendance of the HCP to do the MSE;
If the detained person is intoxicated or under the influence of drugs – A DP cannot have their MHA completed in such a condition, the same as how their PACE suspect interview could not be completed;
Delay in the MHA assessment being arranged – Due to problems in the availability of an AMHP and/or the two doctors required. This problem can especially occur out of hours and at weekends;
Availability of a hospital to receive the DP – Locating a hospital which is willing to receive the DP can be an involved and prolonged process especially in respect of children or those with specialist needs.
If these blockers do arise there is the potential that the DP PACE clock will not be sufficient for the MHA assessment/application to be completed and their detention will become unlawful. A significant period in custody will also mean the DP will go for a prolonged period without receiving treatment and support from appropriate mental health professionals which there is no current provision to provide in custody. The changes to MHA made by PACA have now expanded the scope of where S136 can be used and it can now be used for persons in a police station/custody suite. If the criteria is met to use S136 this now provides 3 tactical options to be considered:
(1) Not to be detained under S136 – DP remains in custody for their MHA assessment to be completed; (2) Detained under S136 but DP remains under arrest – DP would be taken to a HBPOS or to ED as a contingency POS for their MHA assessment. Whilst outside of custody their PACE Clock would be frozen; (3) Detained under S136 but DP does not remain under arrest – DP is disposed of from custody (on bail, released under investigation or no further action taken) in relation to the matter they are under arrest for.
3.3.2 Factors to Consider as Part of the Decision Making Process
The option which is suitable will be dependent on a number of factors. It is not possible to produce a definitive list and professional judgement will have to be applied by the Custody Sergeant but within the rationale recorded on the custody record consideration should be given to:
188.8.131.52 Information Gathering about the DP:
Anticipated fitness to continue to detain the DP in custody;
Advice of health professional regarding the use of S136, if it was practicable to consult them as per the requirement under PACA;
Can the HCP or other health professional who has been consulted access the DP health records and is there any relevant information contained within them? Specifically any current diagnosis of physical health or mental health conditions and whether they have they been detained under S135/S136 before, if so how recently and the outcome. This may give an indication of whether once assessed they will be sectioned or not and fit to continue to be dealt with for the offence they have been arrested for.
184.108.40.206 Ascertaining viability of completing the MHA assessment in custody:
Information provided by the AMHP on when they can attend to commence the MHA assessment and the availability of any hospital to receive the DP should they be sectioned;
Taking into account the above, is it believed the MHA assessment can be completed and any subsequent application made within the time remaining on the DP’s PACE clock?
220.127.116.11 Suitability to take the DP out of the Custody Setting to a Health Establishment
The severity of offence, which would inform decisions around whether bail or releasing them under investigation is appropriate;
From contacting the Central Management Hub (contact details on the S136 mental health Connexions page) is there an available HBPOS to receive the DP;
Are there risks associated with the DP where there will be consideration for an RIC, which would require either the DP to stay in custody or if detained under S136 remain under arrest?
If they are to remain under arrest, a minimum of 2 police officers would be required to remain with them at the POS, are there these resources available?
Risk assessment of the DP, would it be safe to take the DP to a HBPOS especially if the DP will remain under arrest. If there is no HBPOS available and ED would be used as a contingency POS, given its insecure nature would this be suitable?
If there is consideration for the use of ED as a contingency POS how long it is believed to be until a HBPOS would become available and is this an acceptable period of time to wait? If taken to ED can the MHA assessment be completed there and if so how long would it be before it could be commenced?
The use as ED as a contingency POS for a DP who will remain under arrest should only be considered in the most exceptional of circumstances. As ED is not a secure environment nor does it have staff specifically allocated to care for S136 detainees.
3.4 Option 1 – DP not detained under S136 and to remain in custody
If this option is chosen the Custody Sergeant must ensure that they act in accordance with the National Police Chiefs Council Escalation Protocol. This protocol is designed to ensure when issues are identified with the MHA assessment process they are escalated if they give rise to concerns they may lead to an unlawful detention, so appropriate action can be taken.
This document outlines when and to whom an incident needs to be escalated.
The following persons will assume the responsibilities for their respective rank:
Inspector – Fulfilled by PACE Inspector;
Superintendent – Fulfilled by PACE Superintendent;
Gold – Fulfilled by the Chief Constable or Deputy Chief Constable only.
3.4.1 When can a Superintendents Extension be Considered
A Superintendent’s extension can be granted if, the DP is awaiting their MHA assessment and if the intention at that time is to continue to pursue the criminal investigation, then an extension can be granted. If following the completion of the MHA assessment if the DP is deemed fit for detention/interview, the intention will be to interview them and complete other necessary enquiries to continue to the investigation of the offence in question.
A Superintendent’s extension cannot be granted if, however, it has already been decided given the relevant facts of the case that whatever the result of the MHA assessment no further action will be taken in relation to the offence. In such a case under Section 34(2) PACE the grounds for the detention would have ceased to apply. So, an extension could not be considered as the purpose of it would be to enable a MHA assessment to be completed for the welfare of the suspect not in pursuance of any criminal investigation.
A Superintendent’s extension cannot be granted if, the DP MHA assessment has been completed but they have not been sectioned because a mental health unit willing to receive them has not been found.
3.4.2 Use of Section 136 in Police Custody
Following the December 2017 amendments to the Mental Health Act 1983, it is now lawful to consider the use of section 136 in police custody in respect of those who have been arrested. This section covers when, a suspect should be released from detention, whilst under investigation, in order to be diverted to the mental health system. There are two possible scenarios where this might occur:
Safeguarding someone who suddenly and unexpectedly indicates an intention to end their life or injure themselves, just as they are being released from custody – this would apply whether the person is released with or without charge;
Where PACE grounds to hold someone have expired (see s34 and s37) but where there is an ongoing need for mental health services – in this context, either an MHA assessment by an AMHP and DR; or where someone is awaiting admission. This scenario may vary depending on when the decision is taken to suspend PACE and implement s136, which can add a layer of complexity.
The majority of people, who are taken to police custody and are then identified as having some kind of mental health condition, are not then assessed under the MHA for potential admission to hospital.
The fact that someone is thought to have some kind of mental health condition should not mean the police suddenly bring detention to an end, by use of pre charge bail or release under investigation. The grounds for using s136 in these circumstances would usually not be met, because for most their condition will not be acute, giving rise to a need for ‘care or control’.
The proportion of people assessed under s136 who are then identified as requiring specialist mental health services (which would include any admission to hospital), vary by force area, but it is often less than 50%. Most people assessed under the MHA are not admitted to hospital, any mental health care they require can be organised by Liaison and Diversion Services (LaDS) in custody. LaDS can usually ensure the healthcare needs of people under arrest are met, unless the person needs to be ‘sectioned, in which case they would need to call upon an AMHP and a doctor to undertake the statutory MHA assessment.
Police services must ensure their use of s136 is appropriate: in the custody context this means ensuring s136 is considered only where the original PACE grounds for detention do not exist or where someone’s poor mental health is so acute they are unfit for detention. Nothing in law prevents the arrest, investigation and prosecution of criminal suspects even where they have a serious mental illness and all cases should be treated on their individual merits without assumption or presumption about the relationship between any offence committed and someone’s mental state.
18.104.22.168 The Decision to Use s136
Before considering use of section 136 the custody sergeant should ask:
1) Are there ongoing grounds under PACE to keep the person detained? Where PACE grounds continue to exist, nothing prevents an FME assessment, a LaDS assessment or even a statutory MHA assessment occurring in police custody. So, where investigators are securing and preserving evidence, seeking to obtain evidence by questioning and/or have not yet reached a view about whether immediate prosecution will be required, custody officers should not be thinking about ending detention unless someone’s health is so bad that they are unfit for detention in custody. Nothing prevents the two processes running alongside one another; 2) Are the grounds for use of s136 actually satisfied? The important question to ask is whether the person appears to be suffering from a mental disorder and to be in immediate need of care or control, in their best interests or for the protection of others? If the grounds for detention under s136 are not met, the power cannot be used. If the kind of assessment, referral or care that someone needs is available in custody whilst someone remains lawfully under arrest, what value is added by use of s136? It will usually be necessary to have a collision of these two circumstances to proceed via 136: genuine difficulty in further justifying detention under PACE; and a healthcare situation believed to be sufficiently serious in its own right to justify the use of the MHA. The exception to this, of course, is where someone is so ill, it is a medical emergency, they are unfit for detention in police custody and need to be urgently transferred to A&E.
The boundaries between mental health and criminality are blurred. Whilst neither are easy to define and some behaviours can overlap, it is common to be presented in custody with behaviour demonstrative of a serious mental health condition and a contravention of our criminal law. Public policy suggests (Home Office Circular 66/90 and 12/94) how we should approach the overlaps and in the UK this is by criminalising people for more serious offences only where broader public safety is at stake.
The police have an important role to ensure balance in the application of that policy:
We don’t want the police to fail to bring to justice those who have offended where a mild or moderate mental health condition has, in no significant way, affected their liability for their conduct;
We don’t want the police to criminalise the seriously unwell and other vulnerable people for minor crimes which were situationally related to their condition and the context of a crisis incident;
We do want the police to protect the public from those who pose a much more significant risk, in order to allow the criminal courts to make a thorough assessment of how we balance the patient’s right to treatment with legal frameworks which ensure public protection.
We need to think carefully about the potential for us to take premature decisions: if officers do not facilitate immediate access to the mental health system because of the alleged offence, is that a proportionate response and could this be detrimental to the individual’s health? If we are diverting someone from the criminal justice system because they have a mental health condition, is it one which is sufficiently serious to require urgent assessment ahead of any other consideration about the offence they are alleged to have committed and what risk does this pose to the wider public and the individual themselves? All cases turn on their individual merits and need to be discussed with healthcare professionals involved.
Consideration of using s136 in police custody should occur and should only occur where there is genuine difficulty in further justifying detention under PACE for someone who was originally arrested for an offence; and where their mental health problems are believed to be sufficiently serious in their own right to justify the use of s136 if they had been encountered outside of custody. The exception to this is where someone is so ill, it is a medical emergency and they are unfit for detention in police custody, in need of urgent transfer to A&E regardless of the PACE conditions around the investigation.
3.4.3 Consideration for a RIC for DP who has been assessed under the MHA and it deemed an application should be made to section them
When a person is sectioned in custody they will be transported to a mental health hospital with a locked ward or low secure mental health unit. Barring the exceptional circumstances covered at the end of this section they will not be able to be admitted to a medium or high secure unit. This is because the NHS pathway into a medium and high secure units are as the result of a hospital order which is issued by the criminal courts, either a Crown Court (from their first appearance) or a Magistrates Court (following a finding of fact against the defendant).
The circumstances of some cases and the risk posed by the DP accordingly may mean that a RIC should be considered in cases where:
The normal grounds to refuse bail would not be removed by the DP being sectioned, when taking into consideration it will not be possible to guarantee how long someone will be sectioned for. If detained under Section 2 for assessment, this is for up to 28 days to allow them to be assessed. At any point within that period if it deemed they are not suffering from a mental disorder they will be released. If detained under Section 3 for treatment and it is assessed they have sufficient recovered, they will be released;
In addition to the above, it is deemed by the police and the assessing mental health team that a locked ward or low secure unit is not sufficient to mitigate the risk posed by the DP and a medium or high secure unit is required.
If a RIC is to be sought and the grounds are the same as they would for any custody case and the below process should be followed:
Suspect interview – If the person cannot be interviewed the CPS will require that either the health professionals who completed the MSE or MHA assessment have stated they are not fit to be interviewed;
MG 3 – Then once there is then sufficient evidence to meet the threshold test the CPS can be approached for a charging decision. In the MG 3 the case should then be outlined as normal with how the facts of the case (applying the threshold test) meets both the evidential and public interest test;
Question of the suspect’s capacity – The CPS lawyer approached for a charging decision may question the fact that the capacity of the suspect will not have been confirmed. This is not by itself, however, a barrier to charges being authorised. Cases where a RIC would be sought in such circumstances will be those where the alleged offences are so serious that regardless of their capacity it would be sought for the suspect to go through the criminal justice system. As even if they were found unfit to stand trial, only the criminal courts can make someone subject of a hospital order;
MG 7 – The facts concerning why a locked ward or low secure unit is not suitable should be outlined in the MG7;
Once charged and bail is refused – The defendant would then appear before the next magistrates court as normal;
If a RIC is not possible – If there is not the evidence to approach the CPS or the CPS will not authorise charges (and if applicable once any process to appeal the decision has been exhausted) then as part of continual dialog with the AMHP they should be updated accordingly. They will then have to make arrangements with the appropriate bed manager for plans to be put in place to manage the patient accordingly. There should then be consideration to expedite the investigation and potentially for a short bail date to be set. At which point if it is still applicable a RIC can be considered when they answer bail.
22.214.171.124 Exceptional Circumstances for Direct Admittance to a Medium Secure Unit
Access to a medium secure unit only via a hospital order is not a legal requirement, it is simply the pathway designed by the NHS to access these units. EPUT would be legally able to admit a patient detained under Section 2/3 into their medium secure unit at Brockfield House. They would not, however, be funded for this patient (who are normally paid for by NHS England) and have to absorb the high associated financial cost. As such if an exceptional incident occurred (i.e. a murder) where the circumstances meant the DP could not be RIC, but they were deemed by EPUT to pose an unacceptable risk to staff at a low secure unit, they could potentially consider this as an option. Ultimately in such exceptional circumstances this would be a matter for EPUT senior management to consider and what type of mental unit they will place the patient.
3.5 Option 2 – Detained under S136 but remains under arrest
Once the DP/patient leaves custody their PACE clock will be frozen but on arrival at a POS their clock to be assessed under the MHA will commence. The DP/patient remains under arrest exactly the same as if they had been taken to ED for treatment. As such officers retain responsibility for taking action to ensure the DP/patient remains in their lawful custody and does not come to harm or harm anyone else.
The process to use S136 is outlined in E 0501 – Section 136 Mental Health Act 1983 although there will be some variation from it. Once S136 is used the restrictions to use a police station as a POS must be adhered to. These are fully detailed in the S136 procedure but crucially:
No-one under 18 can be held in a police station;
For anyone 18 or over they must pose an imminent risk of serious injury or death to anyone and because of that risk no other POS in Essex can reasonably be expected to detain them.
As a result, the use of S136 in custody must be planned with the below arrangements in place to take the person straight out of custody once S136 is used. Should the DP/patient behaviour become unmanageable to the point even with police support that they pose an imminent risk of serious injury or death to anyone then consideration should be given to returning them to custody.
3.5.1 Arrangements required prior to the use of S136:
The requirement where practicable to consult a healthcare professional for advice still applies and if it is practicable they must be consulted;
A POS has been identified as willing to accept the DP/patient;
Officers have been identified and are ready to escort the DP/patient to a POS;
Transport which should be an EEAST ambulance should have been requested and has arrived and is ready to transport the DP/patient;
The Custody Sergeant is ready to process the DP/patient out of custody.
3.5.2 Detention of the Patient at a HBPOS:
On arrival at the HBPOS the A287 risk assessment form will be completed and given to health staff, who will be made aware the DP/patient is detained under S136 but also under arrest for a criminal offence. The health staff will provide the DP/patient with a notice of their legal rights under the MHA;
The health staff will then assume responsibility for the clinical care and monitoring. They should continue to monitor and supervise the DP/patient with exactly the same duty of care as anyone detained under S136. The officers are not there to assume this role and the DP/patient is not to be left solely in the care of officers;
The DP/patient will be held in a secure suite within the HBPOS, so there is no requirement for officers to remain in the room them. As they will be in a secure and sterile environment. The DP/patient must remain, however, under the constant observation of officers at all times;
In the event restraint is required if possible this should be undertaken by staff at the HBPOS but if it reaches a level which is not manageable assistance should be provided by officers. Health staff will ensure the monitoring of the DP/patient vital signs throughout any restraint and alert officers to any concerns as to the DP/patient’s welfare;
If the behaviour and actions of the DP/patient give rise to concern that additional police resources are required the duty LPT Sergeant should be contacted.
3.5.3 Detention of the Patient at ED
Within E 0501 – Section 136 Mental Health Act 1983 there is an ED process flowchart for S136 patients taken to ED.
This process should be followed with the exception that as the DP/patient is under arrest for a criminal offence as well, there can be no consideration of any kind of handover to ED staff.
On arrival at the HBPOS health staff will be made aware the DP/patient is detained under S136 but also under arrest for a criminal offence. They will advise them of the circumstances and any known medical risks;
Unlike a HBPOS ED is not a secure environment and ED do not have staff specifically to care for a S136 detainee. Officers will be responsible for the safety, security of the DP/patient and the safety of everyone else in ED. A room isolated from the rest of the ED department should be used if possible;
Although ED does not have staff specifically allocated to monitor S136 detainees they have a duty of care to ensure the DP/patient receives the correct level of clinical monitoring and medical attention. They should draw upon assistance from the liaison psychiatry team in ED as required;
In the event restraint is required this will be undertaken by officers but with health staff ensuring the monitoring of the DP/patient vital signs. Health staff will alert officers to any concerns as to the patient’s welfare throughout any period of restraint;
If the behaviour and actions of the DP/patient give rise to concern that additional police resources are required the duty LPT Sergeant should be contacted.
3.5.4 Outcome of MHA assessment
Once the DP/Patient has had their MHA assessment completed if a decision has been made to:
Discharge them they will be returned to custody to be dealt with for the outstanding criminal offence;
If they a decision is made they should be sectioned a decision will have to be made whether to bail, release them under investigation, take no further action or return them to custody to be dealt with for the outstanding criminal offence. Returning the DP to custody would most likely be for those cases detailed in 3.4.3 where a RIC would be sought.
3.6 Option 3 – Detained under S136 but DP does not remain under arrest
With this option the DP will be disposed of for the offences they are under arrest for and consideration will be given to a short bail date, if applicable. The normal S136 pathway should then be followed but as detailed in 3.5, once S136 is used the restrictions to use a police station as a POS must be adhered to. As part of the arrangements this will include the Athena process being completed to process the person out of custody prior to the DP being detained under S136.
3.7 Transportation out of custody
Patient detained under Section 2/3 MHA – The AMHP will arrange transport via a secure ambulance to the hospital which will be receiving the patient. Patient detained under S136 – EEAST should be contacted to provide an ambulance as detailed in E 0501 Procedure - Section 136 Mental Health Act 1983,
3.8 Staff Welfare
The distressing nature of some mental health incidents could potentially give rise to issues of staff welfare. The publication, engagement and use of staff welfare services are encouraged. Within Essex Police this means services provided by Occupational Health. Managers and supervisors should familiarise themselves with C 0201 Protocol - Trauma Risk Management (TRiM).
Further guidance around staff welfare and health is available from the TRiM webpage and Health Services webpages. There is also helpful advice contained on the Blue Light Programme – support for emergency services.
4.0 Equality Impact Assessment
EIA - pending
5.0 Risk Assessment
Police officers and police staff will consider real time risks in a dynamic manner in accordance with their individual roles and take all reasonable steps to reduce these as far as possible.
The following have been consulted during the formulation of this document:
Essex Diversity and Inclusion Manager
Health & Safety
Strategic Change Team
Strategic Force Crime & Incident Registrar
Custody Chief Inspector
Personal Safety Team Leader
Policy author of the Body Worn Video Procedure
Women’s Leadership Development Forum
Work Life Balance
Christian Police Association
Author to initiate contact with the below:
British Transport Police
Section 135 and 136 System Preparedness Plan leads
Essex Partnership University Trust (EPUT)
East England Ambulance Service Trust (EEAST)
Local Authority Leads:
North AMHP Lead
South AMHP Lead
Thurrock AMHP Lead
EDS AMHP Lead
Emergency Department Leads:
Colchester Hospital University Foundation Trust
Princess Alexandra Hospital
Southend University Foundation Trust Hospital
Basildon and Thurrock University Hospital
7.0 Monitoring and Review
This procedure will be reviewed by, on or behalf of, the Head of Crime and Public Protection in consultation every 12 months.
8.0 Governing Force policy. Related Force policies or related procedures
E 0500 Policy – Mental Ill Health
E 0501 Procedure - Section 136 Mental Health Act 1983
E 0505 Procedure – Acute Behavioural Disturbance (ABD) and Excited Delirium (ED)
B 1400 Policy - Protecting Vulnerable People
B 1407 Procedure - Safeguarding Vulnerable Adults
E 0100 Policy - Custody
E 0104 Procedure – Post Reception Detainee Care
8.1 Data Security
Essex Police have measures in place to protect the security of your data in accordance with our Information Management Policy – W 1000 Policy – Information Management.
8.2 Retention & Disposal of Records
Essex Police will hold data in accordance with our Records Review, Retention & Disposal Policy – W 1012 Procedure/SOP - Records Review, Retention and Disposal.
We will only hold data for as long as necessary for the purposes for which we collected. Victims/public should be reminded that Essex Police take the protection of personal data seriously as described in the privacy notice.
9.0 Other source documents, e.g., legislation, Authorised Professional Practice (APP), Force forms, partnership agreements, (if applicable)
College of Policing mental health Authorised Professional Practice (APP).
Department of Health and Home Office guidance for the implementation of changes to police powers and places of safety provision in the Mental Health Act 1983.
College of Policing briefing document, Mental Health Act Amendments 2017.
A Joint Policy Relating To Section 136 Mental Health Act (1983) Agreed by – Essex Police, Essex County Council, North Essex Partnership Foundation NHS Trust and South Essex Partnership NHS Foundation Trust but has not yet been updated in-line with legislation.
Royal College of Psychiatrists, Guidance for commissioners: service provision for Section 136 of the Mental Health Act 1983
Royal College of Emergency Medicine, brief guide to Section 136 for Emergency Departments.
National Ambulance protocol for the conveyance of persons detained under Section 136
Essex Police and Essex Partnership University Trust Triage Operational Policy.