The Approved Mental Health Professionals were busy chatting on X-Twitter last week about Right Care, Right Person and one of them commented their local police force had started ‘triaging’ warrants under s135 MHA. Another AMHP in the discussion quickly and correctly responded that 135 warrants are nothing to do with RCRP. For the avoidance of doubt in this post, when I refer to “s135 warrants”, I’m referring to both types: those under s135(1) MHA for assessment or removal to a Place of Safety (PoS); and s135(2) MHA or the return of patients who are AWOL or absconded.
And for those not yet aware, RCRP is a national initiative backed at the highest levels and it has four phases of implementation on four topics –
- Welfare checks – phase 1.
- Hospital walkouts, including AWOL patients – phase 2.
- Conveyance – phase 3.
- Section 136 and Place of Safety detentions – phase 4.
I’ve written before about how there could be more to it than this, but the fact is those leading the roll-out of the programme have chosen not to widen it further. I presume 135 is not a part of the RCRP programme because ultimately, the police must execute warrants under this legislation, there is no scope for anyone else to do it and therefore, regardless of whether anyone thinks it right or wrong, the police will be the ones forcing entry to people’s homes. But the reason I find non-inclusion of the topic interesting is because s135(1) warrants are not the only legal circumstances in which an AMHP may think the police are required at a Mental Health Act assessment in a home. Indeed, some AMHPs reading this may already have anticipated I’m about to mention the inquest after the death of Mr Nigel Abbott in Birmingham in 2018.
Mr ABBOTT’S INQUEST
Mr Abbott was killed on a Saturday afternoon in 2018 by a patient after a 48hrs period of the man’s concerning behaviour, involving his family making dozens of phone calls to the NHS whilst hiding knives in the home so he couldn’t access them and carry out threats he was making whilst acutely unwell. The patient had been seen by a psychiatrist on the Thursday evening before Mr Abbott died and declared by the doctor to be “a ticking time bomb” with a recommendation for an urgent MHA assessment and admission to hospital. Tragically, that didn’t occur before the tragic, unprovoked killing.
At the inquest, as well as delving in to precise details about what happened during Friday and Saturday to convene an assessment and in addition to exploring specifics about the inpatient bed situation, the Coroner examined the local joint protocol which existed on “Section 135 Warrants”. The document covered a topic I prefer to call “Mental Health Act assessments in private premises” specifically because not all MHA assessments in dwellings require a 135(1) warrant and the title of such a thing should reflect this reality, in my view. I realise it’s more of a moutful, but it passess the Ronseal Test – because that’s what’s “inside the tin”.
It may be there just isn’t time to get a warrant before needing to act urgently to safeguard someone; it could be the AMHP has tried to secure a warrant and been turned down by the authorising Magistrate – it happens, even if sometimes inexplicably. It can even be the grounds for such a warrant are simply not satisfied in law, so for all these reasons, if we think about the police role in private premises MHAAs only in terms of executing 135 warrants, we’re failing to countenance real and risky situations where warrants may not be possible, required or necessary. This is precisely the point discussed in the evidence at Mr Abbott’s inquest and which no doubt led to the Coroner’s Preventing Future Deaths reports requiring revision of local protocols on this.
TRIAGE
So what about this point on ‘triage’ for warrants? – I’ve literally no idea what this means without speculating it involves ignorance one someone’s part. Where a Magistrate has issued either kind of warrant, only the police can execute it – so discussion can occur about when the warrant may be executed, to what extent an AMHP or nurse may have planned for things like a locksmith, ambulance or other conveyance. But what can’t really be said is, “Do you actually need the police for this?” In all 135 situations, a Magistrate has issued a warrant which only the police can execute under the current legal framework.
There is no scope whatsoever for triaging out some of these warrants.
You can have a discussion about whether there is any kind of ‘policing purpose’ in a request for officers where there is no s135 warrant, but not where a warrant is involved – the policing purpose is the execution of a warrant that no-one else can do. This should all be covered in a good-quality, joint protocol on the topic – just one of five protocols which should exist in all areas of business, signed off by the police, local authority and NHS organisations involved. Thinking about 135 and MHA assessments after the AMHPs’ X-Twitter discussion is what got me wondering whether 135 is not an RCRP topic nationally because people are assuming the police role around MHA assessments in private premises is limited to situations where warrants have been granted. If so, it’s failing to learn lessons of history which are then to be learned, as there still is with Mr Abbott’s inquest.
It’s the old “no warrant, no police” thinking, which we know is flawed. So stop it, please: if an AMHP has sat all day in a court room to obtain a warrant, there’s no scope to triage it out – it needs executing and that means police officers.
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
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