This week a Radio 4 investigation exposed that large numbers of children are being detained in police stations in an emergency under Sections 135 and 136 of the Mental Health Act because of a lack of alternative ‘places of safety’ in a crisis. The investigation, which followed a Freedom of Information request, found that children as young as 11 were being detained, many for more than 20 hours at a time.
This shocking finding shows that emergency care and support in a mental health crisis remains a major problem. This is despite considerable effort since the 2007 Mental Health Act to reduce the use of police stations as ‘places of safety’ and to ensure children are never placed inappropriately in adult psychiatric wards.
There are wide variations in 136 arrangements from one locality to another. Most now have dedicated health-based places of safety (for example in hospital sites) and clear protocols with the police for how to use them. Others might have suites available but are unable to staff them reliably or police officers don’t know how to make use of them. It’s often the relationships between health services and police forces that make the difference. And in all cases arrangements for children and young people will need to bear in mind their particular needs and vulnerabilities.
There are, however, a number of developments in train that should help to reduce the number of children held in police custody as a place of safety. Data about the use of Section 136 is now published alongside other Mental Health Act data by the Health and Social Care Information Centre. This should raise awareness of the use of these provisions and prompt areas that are lagging behind to take action to invest in better places of safety for people of all ages and improved protocols with the police for using them.
The national expansion of liaison and diversion services, for children and adults, can also help to prevent crises from emerging and to ensure that children who are detained get much quicker access to the support they need. Liaison and diversion teams can both respond to individual cases and, over time, raise the awareness and confidence of police officers in dealing with difficult situations.
It is vital, therefore, that we make diversion services available to police forces across the country. In every locality, the NHS and the police need to work in partnership to agree local arrangements for places of safety for children and adults, which staff in both services understand and know how to implement. And with data about the use of Section 136 now being published regularly, it is crucial that local health commissioners are made accountable for achieving improvements through the NHS Outcomes Framework.