Setting

This audit is applicable in all areas where detentions under section 136 of the Mental Health Act 1983 are carried out. The audit could be adapted to the legislation of the devolved nations, for example section 118 of the Mental Health (Care and Treatment) (Scotland) Act 2003.

Background

Section 136 of the Mental Health Act is a power that allows police officers to remove a person from a public place to a place of safety if the officer believes that the person is suffering from a mental disorder and is in immediate need of care or control. Police stations have routinely been used as a place of safety in many areas. The Royal College of Psychiatrists (2008) has proposed a national monitoring form for the use of section 136 orders, which has been developed further and has been successfully implemented in three sites and is incorporated in the form used by the Metropolitan Police. The advantage of using the same data-collection form nationally is that it will assist in benchmarking to enable more rapid service improvement.

Standards

Standards were obtained from the Royal College of Psychiatrists’ 2008 report on the use of section 136. Of particular relevance were the following:

ᐅ There should be routine local monitoring of the use of section 136, by a specific group.

ᐅ A mental healthcare setting should be used as a place of safety wherever possible and police custody should be used for this purpose only in exceptional circumstances.

ᐅ An ambulance should be used for conveyance from the public place wherever possible.

ᐅ The approved mental health practitioner should commence the assessment within 3 hours.

ᐅ The first doctor should be approved under section 12(2) of the Mental Health Act.

Method

Data collection

The national monitoring form was used to ensure that the data for the key standards could be compared at both local and national levels. For every section 136 detention, the monitoring form was completed by the detaining police officers and by either the approved mental health practitioner or an approved section 136 nurse.