Mental Health Act 1983

Dan Poulter Excerpts

Tuesday 11th July 2017 Commons Chamber

[Sir Paul Beresford]

The other four officers stood on tip-toes waiting to catch the young woman on each occasion when she looked as if she was going to dive through the window. Fortunately, they managed to stop any action. In the meantime, contact was made with St George’s Hospital’s psychiatric unit to seek urgent hospital psychiatric assistance. After some considerable time, the appropriate psychiatric individual arrived with an ambulance and crew. This immediately inspired further alarm, rejection and, ultimately, a huge struggle. In due course, a sad young lady was transported to the hospital as the designated place of safety, and we had prevented the suicide.

The whole pantomime had occupied five officers and three NHS staff, and took about four hours to sort out. It was obvious from the very beginning that the police themselves could have taken care of the young lady quickly, as indeed they did after instruction from the NHS staff. Immediate action by the police would have taken the lady into care quickly, thus reducing the continuing risk over those four hours, and saving the police and NHS staff a large number of man hours. Under section 136 of the Mental Health Act, the police would have been able to act promptly if this pantomime had taken place in a public place. However, the incident took place at the young lady’s mother’s home. That was deemed, correctly, to be a private place, which meant that no direct police action was legally possible. I have had discussions with officers in the Met, and I have found that this was not an unusual case.

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 at home, having been made aware, and then seeing for themselves, that Mr Middleton was making serious preparations for committing suicide. The officers incorrectly believed that they could arrest Mr Middleton and take him from his home 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 home. The officers were therefore required by the custody sergeant to return Mr Middleton to a relative’s home, hoping that that was some form of safety. Sadly, Mr Middleton still managed to hang himself there.

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 provision under the 1983 Act. Subsequent to raising the issue, I have heard from many frontline police officers, including those who have campaigned on the issue, and I have also had extensive conversations with Professor Keith Rix, who is an academic psychiatrist and an expert in this area. I am reliably informed that the Garda in the Republic of Ireland have a clear operational advantage over our police because, under section 12 of the Irish Mental Health Act 2001, they can act promptly, even in a private residence.

As the all-seeing Minister will be aware, over the 10 years between 1997 and 2007, admissions to hospital as a place of safety went up from 2,237 to 7,035—those are the latest figures that I have been able to get. The Minister is quick with arithmetic, so she will be able to note that that is a threefold increase. The difficulty facing the police is that the powers on which they can act are limited to persons found by the police in a public place. There is ample anecdotal—and perhaps stronger—evidence that the police in desperation sometimes persuade a person to leave their home, or contrive to remove them to a public place so that they can use the section 136 powers of arrest. In fact, one London-based social services authority’s audited figures estimated that 30% of section 136 arrests were recorded as having been made at or just outside the detainee’s home. The police do that in sheer desperation to save the individual’s life, which would be lost unless they acted. Put bluntly, a tiny adjustment to the legislation would allow the police to act in a private home, as they can in a public place. That would save an enormous amount of time and, potentially, a considerable number of lives.

In my discussions about this, it has been suggested that the police already have sufficient powers—they do not. The second argument is that an amendment would extend the right of the police to enter private properties—yes, it would. There are many legal reasons for the police to enter a private property; perhaps the most obvious and linked one is that if the mentally ill person was threatening, or in the process of murdering, somebody in that private place, rather than killing themselves, the police could act immediately.

There is a simple solution to this: amend section 136 by simply removing the words

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

When I raised this issue in the Adjournment debate about a year ago, the Minister’s predecessor gave a clear indication that change was being considered. He gave me a commitment that if the Government could not get this right using the measures they were considering, an amendment to section 136 might be exactly what was required.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

My hon. Friend is making an important and thoughtful speech. Does he agree that it is possible at the moment for a mental health professional who wants to put someone under section 2 or section 3 of the Mental Health Act to gain entry to their house with the police and a locksmith? It therefore seems strange that the police do not have powers to deal with a very similar situation when they have concerns about someone’s mental health and believe they need to exercise section 136 powers.

[Sir Paul Beresford]

I thank my hon. Friend, who is, of course, on his way, with a bit of luck, to being a very senior academic psychiatrist in a couple of years. He is right. In situations such as this, no one rings up St George’s Hospital in Tooting and says, “Please could I have a psychiatrist?” They ring the Met police, who then have the difficulty of dealing with the situation, and who stand there holding the detainee in the private home while the psychiatrist is brought in from the hospital.

I shall be grateful if my hon. Friend the Minister will at least be prepared to meet me and Professor Rix to discuss how this difficulty can be sorted out. If necessary, I am prepared to resort, as I have in the past, to the ten-minute rule Bill procedure to bring about this tiny change.

--- Later in debate ---

[Sarah Newton]

My hon. Friend makes a very good point and he will be pleased with recent legislation that has reduced that timeframe from 72 to 24 hours. That is a big step forward. Whether an incident happens in a public place or in someone’s home, we are working towards a situation where a mental health professional will be with the police when they attend. That means that there will be no delay similar to that described so vividly by my hon. Friend. I think that some of the examples he gave happened some time ago. As a result of investment, particularly in the work of the crisis care concordat, which has created the framework for police forces to work with mental health services in their community, all kinds of innovative measures have been introduced to ensure that resources, including mental health nurses routinely working with police officers on the beat and specialist back-up to deal with situations similar to those we have heard about this evening, are planned and delivered locally. That is how we want things to happen.

As I have said, we are putting the resources in place. Although these services are working in most of the country, additional investment is being provided where that is not the case. There is also support through the crisis care concordat to fill those gaps and to ensure that everyone everywhere has the same experience.

[Dr Poulter]

My hon. Friend is making some thoughtful and good points about the extra resources that are going in to support people with a mental illness. On section 136 powers, the mental health professional who accompanies the police is often a nurse, and they do not have powers to section people. A section 12-approved doctor who accompanies the police, however, does have powers to section people, and the same is true under sections 2 and 3 of the Mental Health Act. I think that is where my hon. Friend the Member for Mole Valley (Sir Paul Beresford) is coming from.

[Sarah Newton]

I thank my hon. Friend for his contribution. The point I was trying to make is that a range of health professionals are working alongside the police in different settings to make sure that their response is appropriate. Sometimes it is mental health nurses who will be on the beat with police officers. My hon. Friend the Member for Mole Valley said that the police were called because somebody was in a very aggravated and stressful situation and they might have been prepared to take their own life. A call handler at the emergency centre would triage that situation, understand its severity and send the appropriately qualified medical professional so that they can make those decisions.

I think we are largely in agreement on the progress we have made. I want to focus on my hon. Friend’s key point, which is that he does not think that the police have sufficient powers to act quickly in relation to people in private homes who are mentally distressed. I have read through his previous contributions and I am sympathetic to his point. I appreciate how utterly frustrating it must be for police officers who find themselves in a situation where they feel helpless to take action in a reasonable amount of time when they would have those powers if they were in a public place. Having read previous debates and contributions, however, I think it is right that we consider somebody’s home differently from a public place. For most people, their home is their refuge. It is a special place. We allow people to do all sorts of things in their homes that we do not allow them to do in a public place. We have to reflect carefully before taking more powers on the state to allow us to intervene in people’s private space. We seek to strike the right balance so that we can intervene to keep people safe and ensure that they get access to services without violating their privacy. We have consulted quite widely on the matter, and we considered it when we were looking at a review of the legislation. There was a lot of discussion about it, and the view was that we had struck the right balance and did not need to take the extra step that my hon. Friend wants us to take.

New powers have been introduced, as I mentioned, in the Policing and Crime Act 2017, and we are monitoring how they are working. I reassure my hon. Friend that if that monitoring suggests that we can or should do more, we will take further action. We expect to see a lot more data from the police this autumn about how sections 135 and 136 are implemented on the ground. We will be analysing the results of a new annual data return to establish whether there are any new trends or patterns that need further response. We will have the opportunity to consider the whole issue in the round as we look, as promised, at the Mental Health Act.

I am happy to meet my hon. Friend and any other colleagues who have a close interest in this policy area, along with Professor Rix and officials from the Department of Health and the Home Office, to make sure that we have this absolutely right. We want to join up mental health professionals and police professionals appropriately to prevent the sorts of situations that we have heard about this evening. I look forward to building on the good progress that we have made, and I will continue to work well with my hon. Friend to make sure that that happens.

Question put and agreed to.