Detention under Mental Health Act

John Bercow Excerpts

Thursday 14th July 2016 Commons Chamber

[Sir Paul Beresford (Mole Valley) (Con)]

As an ethnic minority immigrant to this country, I am intrigued by the way the House works. We have had two days of a deeply serious international debate, and now an ethnic minority immigrant has an opportunity to put a point on a small but important issue that is almost local by comparison. I am referring to the possibility of a small change in the Mental Health Act 1983 to enable our policemen and women to act somewhat more promptly in the care of any person they find to be in need of mental health assessment and immediate care.

I raised this issue in a ten-minute rule Bill in 2014. I did not proceed, as I was informed that there was an ongoing review. That review has come and gone, and I have read it, but this small point was not referred to in it. However, there will possibly be a negative change—from my point of view—in the Policing and Crime Bill as it progresses through the other place.

I was initially prompted to seek changes having seen the need for them first hand. I was on a police parliamentary scheme in 2014, as part of which I went round Wandsworth on foot or by car. I joined two young uniformed police officers in their response car. The first call was a dash to a flat on the 14th floor of a council residential tower block. The mother of the household nervously let the officers in to see her daughter—aged 22—who was standing on the window ledge and threatening to jump.

It was quickly established that the daughter had a short history of suicide attempts. With the back-up of two plainclothes officers, and with great expertise, the young woman was persuaded to come down. A young female officer sat on the bed beside her, and they calmly discussed the problem. The police officer suggested the young woman might want to go to a place of safety for psychiatric and medical help. That was refused, and when the woman was pressed a little further, it was followed by agitation and threats to jump out of the window.

Meanwhile, police officers outside the flat had contacted the psychiatric unit at St George’s hospital for assistance. After a couple of hours, an individual from the hospital arrived with an ambulance and crew. There was further alarm and rejection, and a struggle ensued, but in due course this sad lady was transported to the hospital as a designated place of safety.

The whole pantomime had occupied five police officers and three NHS staff, and it had taken about three to four hours to sort out. It was obvious from the beginning that the police themselves could have taken care of the young lady very quickly, therefore reducing the police and NHS manpower hours needed and the risk of the young lady leaping out of the window.

I have a second personal case, which involves a Mole Valley resident. A lady in a block of flats has been threatening neighbours with bizarre and often aggressive behaviour to such a degree that some other residents actually fear for their lives, let alone obtain any peace at any hour of the day. Contact between the mental health team and the police has not coincided until very recently. I asked the police officer in charge about section 136. Predictably, I was told the lady’s home was a private place, so no police action was legally possible. From discussions with Met police officers, I have found that that situation is far from unusual.

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 in his home and noted his serious preparations for committing suicide. The police officers believed they had arrested Mr Middleton 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 private residence. The police officers therefore had to take him to what they hoped was some form of safety—a relative’s home. Sadly, later that day or the following day, he hanged himself.

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 appropriate provision under the Act. Subsequent to raising this issue, I have heard from many front-line police officers and again from Professor Keith Rix, who is an academic psychiatrist and an expert in this area. I still have no doubt that the Act needs amending fully to protect the police and, of course, those suffering a mental illness crisis.

I am reliably informed that in the Republic of Ireland, the Garda Siochana have a clear operational advantage in that, under section 12 of Ireland’s Mental Health Act 2001, where there is

“a serious likelihood of the person causing immediate and serious harm to himself or herself or to other persons”,

a garda can

“enter…any dwelling or other premises or any place if he or she has reasonable grounds for believing that the person is to be found there.”

There are instances recorded in England where the police have had to act outside the boundaries of the law out of concern for the safety of the individual. There are also recognised incidences of the desperate police persuading the person out of their home, and therefore into a public place, to effect an arrest under section 136 and take the person for proper and appropriate care, thus preventing a suicide. Over the 10 years between 1997-98 and 2007-08, admissions to hospital as a place of safety increased from 2,237 to 7,035. The Minister is noted for his quick arithmetic, and he will recognise that that is a threefold increase.

It was calculated that 17,417 people were detained under section 136 in 2005-06. By 2011-12, the overall number of incidences of its use was recorded as 23,500. As I have indicated, although the powers under section 136 are limited to persons who are found by the police in a public place, there is evidence that the powers are sometimes used to remove an affected person from their home. In fact, one London-based social services authority’s audited figures indicated that some 30% of section 136 arrests were recorded as having been made at or just outside the detainee’s home. In other words, in desperation, the police have had to manoeuvre the individual outside their private residence. This is an indication of the desperation of the police to obtain care for disturbed individuals, and hence it supports my desire for a change in the legislation.

Put bluntly, on a strict interpretation of section 136, the admission to hospital of hundreds, if not thousands, of potential suicides is delayed or denied, thus risking their suicide or self-harm, merely because the police, who sometimes have to just observe the situation, cannot act because it is happening in the person’s home or someone else’s home. In many instances, as I found in Wandsworth, the police have to spend considerable time waiting until they can obtain a medical practitioner or a health official to give them the nod to transport the patient to care.

One argument against the amendment that I am suggesting is that the police already have sufficient powers. It is quite clear, from my own observation, that that is basically incorrect. The second argument is that it would extend the right of the police to enter people’s private properties. Clearly, in those circumstances, that is appropriate because somebody is in need of mental health care, and that is the whole point of the change I am seeking. It is already possible for the police to enter an individual’s private home to investigate a possible breach of the peace, assuming that the police would be utilising that eventuality to enter the property. Often, they have to help someone who is clearly suffering mental disorder. In many cases, other residents in the property can allow the police in, but having done so, as in the first case I cited, they are then still unable to act.

In my belief, and in my experience, the police are acting only in the very best interests of the individuals concerned and of the safety of the public, and we should give them the legal mechanism to do so. Doing nothing is not an option. I suggest that a simple solution would be to amend section 136 by simply removing the words

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

I am hopeful of a positive answer from the Minister; I know that he is extremely flexible. I would be happy to work with him to seek a ten-minute rule Bill, or take a different direction through a tiny change to the Policing and Crime Bill in another place. If he has a problem with my suggestion, I would be grateful if he met me and Professor Rix to discuss a solution to help the police to save lives and injuries, and not, as the Department appear to be doing, produce exactly the opposite effect.

[Mr Speaker]

I call the Minister of State for Policing, Crime, Criminal Justice and Victims, at the Home Office and at the Ministry of Justice, to reply to the debate.