A criminal case last year in Hampshire led to a court finding that a mentally ill man stabbed a police officer during execution of a s135(1) Mental Health Act warrant for a statutory assessment. The man’s parents had raised concerns about his wellbeing and this led to an Approved Mental Health Professional and Doctors attending to assess the support he might need. For reasons that weren’t explained, they obtained a warrant under the MHA which requires police officer attendance, to execute it.
For those who aren’t sure, this kind of warrant from a Magistrate’s court is for police officers to enter someone’s home in order that they may either be assessed there by the professionals, or be removed to a Place of Safety if necessary. I say “for reasons that weren’t explained” because there are wide variety of reasons and circumstances that may lead an AMHP to seek a warrant and the police officers must be accompanied by an AMHP and a registered medical practitioner when they execute the warrant and it allows entry to be forced, if necessary. On this occasion, officers attended and first attempted to persuade the man to allow access but this was unsuccessful. Whilst waiting for other officers to attend with method of entry (MoE) kit, the man opened the door and attacked the officer with a knife.
It is thought the only reason the injured officer wasn’t killed was the protection afforded by his stab vest – I’m sure we all hope he’s recovering from his injuries and wish him well.
Having been arrested and then prosecuted for attempted murder in relation to the attack, the man obviously remained very unwell, given he was detained in a secure mental health unit and found unfit to plead. This means the court he is not capable of understanding legal proceedings or instructing his legal representation so the court are required to determine whether he “did the act” alleged, in order to determine whether civil or criminal law should govern any ongoing detention in hospital. The jury found he did stab the officer, therefore criminal courts have the duty to consider the broader risk which may be posed to the public and they have decided to impose a hospital order under s37 MHA. (I can find no confirmation either way about whether this order will be a restricted hospital order, under s41 MHA.)
PLANNING AND PREPARATION
This incident is far from the first to end with serious injury (or worse) around the planning of MHA assessments, either with or without the availability of a s135(1) warrant to force entry. Indeed, some delays and disputes about conduct and planning can centre on whether or not the professionals believe a s135(1) warrant should be obtained. In this case, there was delay after alerting the man to police presence, in order to secure equipment to force entry; in other cases, there have been delays in convening the organisations together because police have been unable to offer up officers to execute the warrants when they AMHP and DRs are ready to go. In other cases, the police have been ready and willing but the mental health professionals unable or reluctant to proceed for a number of different reasons. And I haven’t even mentioned the ambulance service yet, to secure the conveyance to hospital if it’s known it will be needed.
This is an extremely complex endeavour to organise – lots of moving parts!
In other incidents, AMHPs and DRs have informed police there will be a delay in executing the warrant because there is no hospital bed in to which the patient can be admitted if they are detained after assessment – there has always been an issue about beds for MHA admissions and s135 processes should see a bed identified before the assessment. That having been said it’s not a strict legal requirement and because we know of untoward incidents occurring before the beds becomes available, it’s worth thinking about whether the risk of delay when there is no bed, is greater than the risk of proceeding without one. I’m aware of incidents where the police have suggested executing the warrant anyway only for the AMHP to decline and an untoward event occuring which was arguably preventable. Immediate concerns about risk can be mitigated because a s135(1) MHA warrant allows someone to be removed to a Place of Safety for 24hrs whilst a bed is sourced — this should link to effective arrangements under s140 MHA and obligations under s6 HRA to ensure the ECHR rights of patients and the public.
I have to wonder whether the number of disputes, debates and difficulties we see about s135 processes are mostly a product of things not always being planned and / or governed correctly, along with the wider issue about bed availability and received cultures about things have always been done. The sheer number of factors which can cause a collision between all those moving parts are incredible but what we do know, is Coroners have felt justified in highlighting the quality, content or the lack of existence of joint protocols on s135(1) MHA as being something which could give rise to a future death and PFD issues have been issued. (We know they have done likewise on joint policies for s136 MHA and AWOL patients, as well.) Plenty of these things are available on the internet to read and when I’ve chosen to do so, I’m often left wondering about claims made that lessons are learned.
Winner of the President’s Medal,
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All views expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2023
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – www.legislation.gov.uk
Mental Health Cop 