The police arrest someone in Area A and remove them to custody, the police station being in Area B. Once there, the suspect is assessed by someone from custody healthcare or the NHS Liaison and Diversion service and deemed to be in need of Mental Health Act assessment.
Whose Approved Mental Health Professional service should consider the need for and potentially undertake the MHA assessment which the FME or L&D have requested?
In this little vignette, “area” means local authority area where the council runs the AMHP service. In the West Midlands, there are seven local authorities, each with their own AMHP service but the configuration of West Midlands Police means there are a number of reasons why officers may have to go “cross border” with someone they’ve arrested. Indeed, it can also happen with someone who has been detained under s136 Mental Health Act 1983.
VARIOUS CIRCUMSTANCES
For example, the local authority area of Dudley does not contain a police station with a functioning custody block, so people who are arrested will most usually be taken to the block in Oldbury, in the Sandwell LA area. People detained by the police in Solihull under s136 will often be removed to the Place of Safety service in Edgbaston, Birmingham because the local authorities of Birmingham and Solihull share a mental health trust who only has one Place of Safety location, in Birmingham.
There are loads of examples and some other circumstances even within that one police force area where we can end up with cross-border considerations. A new one since I left West Midlands Police is the opening of a new hospital in Smethwick with a major Emergency Department which replaces the ED in City Hospital, Birmingham – the area where I began my policing career. I felt like a lived in City Hospital at one point in my mid-twenties.
But if you are shot or stabbed in inner-city, west Birmingham in 2026 you will be ambulanced across the local authority border in to Sandwell to the shiny new hospital. In any kind of healthcare situation then giving rise to a need for a MHA assessment, we can again ask the question about who bears responsibility for the assessment and given over 50% of 136 detentions in the West Midlands go to ED, this situation must be happening quite a lot, not just in Birmingham / Sandwell but also for Wolverhampton / Walsall and Warwickshire / Coventry.
I wonder if areas ever developed a cross border protocol? – I’ll come back to this.
WHERE THE BODY IS
When these debates come up, the question often arises about responsibility and I was always amazed that it does because of how simple the answer actually is. The responsibility to consider the need for a Mental Health Act assessment sits with the Area B “where the body is” (awful terminology) at the point where the need for consideration arises.
- If the police in Area A arrested someone but removed them to custody in Area B, then Area B bear the responsibility.
- The same is true if the remove someone to a Place of Safety in Area B having used powers under s136 MHA.
- If someone is taken by ambulance from Area A to Area B and the need for consideration then arises, it sits with Area B to do it.
It’s not in the least bit ambiguous and this answer is grounded in law, which states –
Section 13(1) MHA –
“If a local social services authority have reason to think that an application for admission to hospital or a guardianship application may need to be made in respect of a patient within their area, they shall make arrangements for an approved mental health professional to consider the patient’s case on their behalf.”
[Bold is my emphasis. ]
“A patient within their area” – so much more dignified than “where the body is”, and also has the advantage of actually being the legal terminology from the Act.
LOCAL DISPUTES
These debates come up regularly – it’s amazing that the law has been stable on this point for 67 (yes, sixty seven) years because s13 MHA 1983 is the modernised version of s54 MHA 1959 which contains the phrase “a patient within the area of the local authority”.
This post comes from a social media discussion where Area B were refusing to assess someone under arrest in a police station, because the person had been initially arrested in Area A and an argument was attempted that Area A should provide an AMHP. This would be amusing if it didn’t leave the police in a difficult position so often – I won’t be the only officer to have had Area A telling me it’s Area B’s responsibility and vice versa.
Top Tip: when Area B, who have “a patient within their area” are busy putting this point across, it would be quite reasonable for officers (or Emergency Departments if they are caught up in this) to point out Area B have a legal duty under s13 and if they don’t start fulfilling it, the police or ED may take legal advice or action because they are caught in a catch-22 where the answer is obvious.
OVER THE BORDER
None of this means I’m not sympathetic to AMHP services. I remember many years ago telling West Midlands Police and the AMHP services in Sandwell, Birmingham and Dudley they may need to start talking to each other about future arrangements when custody infrastructure changed. The police were moving away from having one or two, small custody blocks for each local authority area by building to massive custody blocks which would cater instead.
A “super-block” was built in Oldbury, for Sandwell, Dudley and parts of Birmingham, another was being built in north Birmingham which could be used for the occasional Sandwell prisoner as well as those from Birmingham and potentially Walsall. Ultimately, there are various reasons to do with demand, maintenance or special operations why people from anywhere could go to any block in the force area and I did once know of a prisoner from Coventry, arrested on the border with Leicestershire, was taken to north Birmingham, around 25-miles away.
So this stuff can cause chaos and as police stations and Emergency departments can be significant generators of demand for AMHP services, I can see why one agency’s decision to re-arrange their affairs can then cause disquiet. When the shiny new Midland Met hospital was opened in Smethwick, a load of MHA assessments which previously sat with Birmigham now sat with Sandwell, a much smaller authority. I’m sure Sandwell would point out they were now being expected to take a significant uplift in MHA assessments, but I do wonder whether they would remember that quite a lot of their area’s patients in need of ED treatment would have been taken over the border from places like Smethwick and Bearwood, to the old City Hospital ED, in Birmingham.
LOCAL PROTOCOLS
One way around this is for Areas A and B to agree a local protocol for who will act and in which circumstances. To continue with my previous example, both City Hospital and the Midland Met are within 0.5 of the local authority border: it’s hardly more difficult for a Birmingham AMHP to travel to Smethwick than for a Sandwell AMHP to travel to Winson Green, so the areas’ AMHP services would be at liberty to agree a local protocol.
One such thing was put in place between Birmingham and Solihull when the 136 Place of Safety service opened in 2010, whereby Solihull agreed they would assess patients detained in their own area, wherever they could do so during office hours. The declined to offer that service overnight because being a smaller local authority, they only had on AMHP on duty overnight and that person had various functions to perform.
The rule always comes back to s13(1) and “A patient within their area” – unless or until another AMHP service agrees to act, the law says responsibility to consider the need for an assessment rests with the local authority where the patient IS, not the area from which they were removed by the emergency services.
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, 2026
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
