“The first survey to focus specifically on the use of section 136 detentions under the Mental Health Act by police forces in England and Wales has revealed significant disparities in the way the powers are used – including the number of people detained, the use of police vehicles to transfer detainees, handover times, and the use of custody.”
So says a new article in Policing Insight(£) – as it’s subscription only, I can’t access the article but thankfully, their LinkedIn post about this is substantial, so we’ll use that instead.
Before I get in to it, though, I have to admit, this post is born of frustration so do bear with me. It’s made me wonder if I’ve just literally wasted years of my life.
Regular readers know this blog has been running for the best part of 14 years and I was involved in policy and practice work on these topics for approximately seven years before I decided to start writing. When I read this LinkedIn post, I must admit to wondering what the hell I must have spent my time doing and why I’d bothered to write the 1,165 published articles, currently totalling over a million words of text and two versions of national guidelines on this stuff.
So strap in!
ANALYSIS
“Although the survey data has yet to be fully analysed, it has already revealed a wide disparity between forces in terms of the number of people detained, whether police vehicles are used to convey detainees to a place of safety, handover times, and use of custody while waiting for a s136 bed, alongside gaps where forces were unable to supply any data.”
This isn’t new and it isn’t the first time attention has been drawn to disparities. There are posts on this blog which make loads of passing references to difference, my early favourite example being that around 2009/2010, just before this blog was born, West Midlands Police were using s136 MHA around the same amount as Nottinghamshire Police. This might not trouble you until you realise the West Midlands and its police force was around three times the size of Nottinghamshire. So why were (then) 7,500 officers using the power as frequently as 2,500 officers on a population of 3-million people rather than just over 1-million people?
Were West Midlands under-using it or Nottinghamshire over-using it? – a bit of both or something else besides?! Who knows! … what is the “right” amount, after all? That something the survey analysts will have to wrestle with and it’s something I pointed out in countless presentations over the years, including at the National Mental Health Forum meetings when forces met to discuss policing and mental health issues.
You could keep looking – why did Thames Valley Police use s136 far more than West Midlands Police when its officer establishment and population were smaller? I was involved in a number of conversations about ambulance service support to s136: very long (and fairly boring) story made short, the ability of a particular ambulance service to offer timely support seemed correlated to their overall efficiency rating as a service meaning for years, West Midlands Ambulance Service and Yorkshire Ambulance Service were undertaking a lot of conveyance. East Midlands Ambulance Service and North-East Ambulance Service (sorry, guys!) were not.
POLICE CUSTODY
“One significant shift revealed in the survey is that fewer people detained under s136 are being taken to police custody; 36 forces reported this practice had ended, a positive step given that police stations will no longer be a place of safety under amendments in the new MHA [Mental Health Act].”
Of course police stations are used less now than before – it could hardly be otherwise if the bloody law changed in 2017 to introduce massive restriction which more or less banned use of custody except in circumstances which are almost never justified. If you can use police stations at one point whenever you like or whenever you have no other option, it shouldn’t be a surprise to find use of custody reduces when you can almost never justify it against new, more restrictive laws.
“They don’t have the space – and they might not have the staff – but it’s a serious issue for policing in that we are keeping people in an ED [emergency department] and we have to stay with them because we can’t hand them over.”
– John Thirkettle MBE, Mental Health Operations Manager, Humberside Police.
Starting whilst I was at the College of Policing, the Home Office have been publishing annual data on use of section 136 MHA and on many occasions, including the last few years and I’ve blogged about this. One the primary highlights which I predicted in 2017 when this legal change occurred and which I’ve emphasised when blogging, is the use of Emergency Departments is rising, often for people who have no requirement for ED-specific treatment and who are there, purely because the police have no option to use a MH-specific Place of Safety and no justification for use of the cells. I’m only aware of one police force who has analysed how many of the people who are taken to ED actually require an ED-specific service and it’s 50% of those removed there. And somewhat obviously, the rise in reliance on ED is closely correlated with the inability to use police custody because of the legal change – both are symptoms of MH-specific Places of Safety not having sufficient capacity, something made worse by capacity often not changing since 2010, when use of the power by the police has risen by well over 50%.
“I don’t think we’ve really thought at a national level about what is the right process. We need to delve into it at a granular level to understand exactly what it’s telling us, and understand the difference between the best and the worst and why.”
– John Thirkettle, Humberside Police.
Of course we thought of it! – more than thought, discussed at massive length, over and over and over again. It was the main subject of conversation during 2009/11 when the (then) National Policing Improvement Agency, a predecessor organisation to the College of Policing, produced the first national guidelines on policing and mental health in 2010 and then arranged workshops all around the country for every police force in England, including Humberside. I know this because I was seconded to NPIA a couple of days a week to run those workshops and I drove to Sheffield to delivery the Yorkshire event with emphasis at that time specifically on s136, mental health specific places of safety, circumstances and pathways to ED and the circumstances and caveats of when police custody might have to be relied upon.
It’s also worth noting, NPIA produced template protocols for forces to use for s136, s135(1), AWOL patients and conveyance (the MHA Code of Practice topics) if they didn’t know what should be in a decent protocol and all of these things were formally badged by the NHS and Department of Health. This meant a huge amount of time sitting with those managers to secure their agreement for the suggested processes which some think were never discussed precisely so their badge could be used so forces could go to local NHS organisation and if they met with resistance, they could show them it was also coming from the Department of Health and NHS England.
I even remember an annual leave day having to be cancelled because just as NPIA were about to start the print run for the hardcopies of the 2010 guidance, the DoH popped up with some new issues which required correcting before the guidance could be finalised and printed – and I remember being entitled to TWO annual leaves in return for this one day off being cancelled at zero notice to sort the issue!
If only most forces hadn’t just ignored that and then complained later that it was never done, eh?!
Then, in 2017, when the Policing and Crime Bill 2017 amended the MHA to restrict the use of custody, various channels of communication emphasised that areas would need to sit down with the NHS partners – both MH and ED as well as ambulance – to make sure local pathways were properly developed and the restrictions on use of custody understood. This was done at a time when many forces had effectively ignored the 2010/11 work to ensure proper s136 pathways. I subsequently had to give evidence as an expert witness in at least two inquests I can recall to outline certain forces hadn’t taken sufficient steps to ensure proper protocols and pathways for s136 detainees and these omissions had contributed to police contact death outcomes.
NEW SURVEYS
So whatever this new survey has done or is doing: it’s welcome because it’s always a good idea to look at the latest data and circumstances and keep reflecting. But let’s not pretend their haven’t been entire PhDs looking at s136 use, that there haven’t been various informal analyses of annual data with messages of emphasis about over-reliance on ED, under-requesting of the ambulance service and officers’ occasional ignorance in proceeding to transport people in police vehicles, seemingly without attempting to secure an ambulance. Discussion about variation in use also took place in the context of “street triage” co-responder programmes, because of the fact they weren’t having similar impacts in all parts of England.
All of that happened – and I could go in to more detail about this and make other points but the main one is done. I was there to see or do it when it happened and I was also there whilst at the College of Policing wondering why the hell much of it was being ignored by Chief Constables and mental health leads in the second part of the last decade as the inquests continued to stack up for things where we really should have absorbed the lessons learned stuff. Quite honestly, I’m still here now wondering that as the inquests continue to stack up and all of this is a part of my PhD topic:
Why, precisely – and despite the law, the tragedies and the statutory and non-statutory guidance which shouldn’t be ignored – are we still in a position where these materials are not being used by forces to make sure policy, protocols and training are sufficient to ensure that when adverse outcomes do occur, the force and its officers are consistently in entirely defendable positions? Why are partnerships still not structured correctly, fifteen years after that NPIA work and all the stuff we’ve learned since after yet more police contact deaths?
If the argument is that this stuff didn’t happen, that CPD events emphasising all of this weren’t held, that seminars weren’t brought to forces to have it explained and with contact deaths and officer wellbeing during adverse investigations being emphasised, that we still need to do these obvious and overdue things, then I’m afraid I have to admit somebody wasn’t paying enough attention. I will admit: I read this LinkedIn post and I just laughed a frustrated and annoyed laugh and took the dog for a walk to calm down and wonder just how much of my time I’d wasted.
Not the first time I’ve had to wonder these things.
Awarded the President’s Medal, by 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, 2025
I am not a police officer.
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 