I’ve never had this one before, but rare and obscure questions about arcane aspects of UK mental health law are welcomed by email! – always helps add spice to my day.
A patient who had been ‘sectioned’ on the Isle of Man has failed to return from authorised leave in hospital and is now thought to have taken a ferry to the UK mainland as a foot passenger. They think he may have gone to an address in either Liverpool or Manchester where he has connections and the question was raised, do English police officers have a power to re-detain a Manx mental health patient if he’s found at that location in order to arrange return them to the Isle of Man?
Yes, they do – section 89 of the Mental Health Act 1983 covers this and for future reference, this also covers patients who are missing from the Channel Islands and it is a power equally open in Wales had the patient swerved off to north Wales instead a northern English city (and why wouldn’t you?) –
- As long as the patient is missing from the kind of MH order which, in England or Wales, would have seen them liable to re-detention under either s18 or s138 MHA, they can be re-detained under s89 and returned.
- The Isle of Man, Jersey and Guernsey each have their own mental health laws, entirely separate from the four countries of the UK as they are not a part of the UK, they are Crown Dependencies so it’s always going to be worth understanding the kind of order from which the patient is absconded. If it’s detention for weeks or months for assessment or treatment, then it’s like s2 or s3 MHA ’83 and therefore, s89 applies.
- It may be of note to observe as well, this power of re-detention is also open to Approved Mental Health Professionals in England and Wales and the Act and the Codes of Practice in both countries are silent on the subject of who should do it – either type of professional can and it would have to be argued out if there is disagreement.
It may well come down to urgency, risk and threat. As it always does.
CERTAIN PRACTICALITIES
It will be worth discussing how the patient is returned to the place of origin when contemplationg is started about re-detaining someone in these circumstances because it’s not going to be a quick process to return them. There is obvious potential for disagreement about who should do what and ultimately, the two groups of professionals involved are governed by separate legislation which may be silent or contradictory on the subject. I could easily imagine a police force on the UK mainland saying, “we’re not travelling to the Isle of Man” for example, but it then means they will have some responsibility for looking after the person until such time as Isle of Man NHS can get over the water and in to the relevant city where their patient has been found.
It would also be interesting to see if the local, English NHS would support those police in doing so? I once recall a patient going missing from the Isle of Wight, which is a part of England so the need for obscure knowledge of the arcane wasn’t involved but the practicalities would be similar. He was located in Birmingham and had to be looked after until such time as Isle of Wight NHS staff could get over the water on a ferry and travel north. The local NHS Place of Safety in Birmingham agreed he could be accommodated there, where at least he could access food, drinks and a shower until such time as his escort arrived to take him back to the island. Normally, a health-based Place of Safety is for those detained under s135 or s136 MHA but in this case he was detained under s18 MHA for return to the island. No reason why detention under s89 for return to a different island couldn’t also be the basis of him being looked after whilst people travel.
So our Manx friend could be helped by the NHS in Liverpool or Manchester if it’s going to take a day or so to get staff over for an escort? – you’d have to hope it would happen, wouldn’t you, otherwise he’ll be sat in an Emergency Department which won’t do anybody any good. Although the Isle of Man is not a part of the UK’s National Health Service, there is a reciprocal healthcare agreement in place that allows the NHS to offer services to Manx residents (and vice versa if you ever visit the lovely island – I intend to cycle all the way around it one day, I think that would be a lovely day out on the bike).
There are similar reciprocal arrangements in place in the Channel Islands as well.
EXAM QUESTION
So there you are: section 89 allows an Approved Mental Health Professional in England or in Wales, to re-detain someone who has absconded from a mental health order on the Isle of Man or the Channel islands, as long as the order was the kind of thing which would have allowed re-detention in England under s18 or s138 MHA. That most usually will mean, missing from something like s2 or s3 MHA but it would also include missing from ‘criminal’ sections of the MHA, like a s37 or s37/41 hospital order and some others. Check the detail carefully and get the professionals in those jurisdictions to describe the order carefully so you can judge whether it’s the kind of thing on which someone in England / Wales would be re-detained.
If you’re interested in this more obscure kind of stuff, you could also go and read sections 87 and 88 – that all relates to very similar stuff about powers in England / Wales to return patients missing from Northern Ireland (section 87 MHA) and the reverse (section 88 MHA). If you want to get really nerdy and wrap your head around the Scottish provisions – which are so much more infinitely complicated! – you need to read a whole other post of mine.
Happy cross border pondering! – it’s a minefield only because it doesn’t come up that often. Except the Scottish stuff, that’s just a minefield, full stop – it always involves the use of a hundred words where ten would do. Good job I love Scotland – I’m happy to work with their overly wordy mental health legislation in order to have ongoing access to the full Scottish breakfast at the Coffee Pot in Aviemore.
Winner of the President’s Medal, the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions expressed are my own – they do not represent the views of any organisation. (c) Michael Brown, 2024
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 