Today I’m reproducing an article I wrote for my family column in the weekly newspaper, The Gazette & Herald, which covers much of the county of Wiltshire. It was published on Thursday August 29 2013 and I’m reproducing it here at the request of one of my Twitter followers, an organisation which I much admire, Wiltshire Mind. To follow me on Twitter, you’d be most welcome at @mum3fi, and you can find the Gazette & Herald @wiltsgazette.
Some time ago, I wrote about an Ofsted report into the safeguarding of vulnerable children in Wiltshire and the fact that the county’s local authority had been found wanting.
I also reported on the fact that the 2012 report had prompted action to be taken and went through some of the measures to improve the situation for vulnerable and looked-after children in the county. I should point out that the report didn’t suggest any children had come to harm as a result of failings.
However, buried within that 2012 report was a comment which really stood out for me – and which I’ve been trying to get to the bottom of ever since.
It said ‘the established practice by police of using section 136 of the Mental Health Act 1983 to hold some children or young person in custody where they have committed an offence is inappropriate’.
It goes on to say ‘this practice is under review given that there is now a dedicated CAMHS (Children and Adolescent Mental Health Services) out-of-hours service that can provide more timely and potentially more appropriate assessments’.
This prompted me to find out about Section 136 of the Mental Health Act 1983. It’s headed ‘mentally disordered persons found in public places’. It allows that a constable can remove and detain someone for up to 72 hours until he, or she, is examined by a registered practitioner or mental health professional.
What does this mean? Have the police in Wiltshire – or anywhere else for that matter – been holding young people and children, in custody for up to 72 hours when it’s suspected they might have mental health issues?
Since raising questions around two months ago, I’ve been on a journey of epic proportions around the ‘system’. But the answer to my key question is – yes.
A number of children each year have been arrested and held, usually when they’ve committed an offence, and the police believe mental health issues have contributed in some way.
Several times the term ‘Freedom of Information’ was used by various voices but last week I finally got some figures from Wiltshire Constabulary. They are:
2009 – four children (under-18s) were held under Section 136.
2010 – six.
2011 – four.
2012 – three.
But to confuse matters even further these are not the definitive figures. The police have recorded ‘pure’ cases – those where a child clearly has, at first point of contact, mental health issues. However, there have also been a number of cases where an arrest has been made and police officers have subsequently sought help as they’ve suspected mental health issues.
Taking these cases into account as well, the total number of children between the end of 2010 and the end of 2012 who were held under Section 136 was 23.
So what has been done about it? The Wiltshire Safeguarding Children Board (WSCB – partnership between Wiltshire Council, Wiltshire Police and Oxford Health NHS Foundation Trust) insists much has been done.
In December 2012, mental health services for under-18s was taken over by Oxford Health NHS Foundation Trust, known as Oxford Health. It immediately introduced the Child & Adolescent Mental Health Services (CAMHS) Protocol.
To cut through the jargon this means when police officers respond to a young person in ‘significant mental health distress or crisis’, the officer contacts CAMHS from the scene by phone. They can do this 24 hours a day, seven days a week. Emergency mental health assessments can then be offered or an appointment within 24 hours.
The officer provides information including:
* Presentation – how is the young person behaving?
* Need for medical attention – is the young person hurt?
* Circumstances of the incident
* Concerns regarding safeguarding or welfare
The CAMHS worker checks the electronic health record system to see if that young person is known. If so, the worker may speak directly with the young person and propose a safety plan or speak to parents or carers.
If distress can be reduced through a phone conversation, the young person is normally offered an urgent assessment on the morning of the next working day. If concerns remain, an emergency assessment can be offered in a safe location such as a CAMHS clinic or police station within two hours.
If the young person is not known, there may be unknown risks and an urgent mental health assessment can be offered.
The options are discussed with the officer at the scene who always reserves the right to use a 136 detention or other police powers.
In a statement WSCB said:
“It’s a system which enables officers to gain a mental health perspective to inform their decision-making and consider alternative options. It also ensures CAMHS are alerted to mental health concerns at an early stage stage and can offer an urgent assessment whether the young person is detained or not.
“The benefits of this collaboration between mental health services and the police, is that distressed young people who require urgent mental health support can receive this quickly, in the least restrictive manner which ensures their immediate needs and risks are reduced.”
The Board says that so far, the new system is working.
“We are pleased to report as result of this protocol there has been a dramatic reduction in the number of 136 detentions under the Mental Health Act of young people under 18 years.
“In the last two years, prior to the introduction of the protocol, there were 23 ‘136’ detentions – this has reduced to three since December 2012.”
We’re not talking about many children, of course, but we are talking about children. Children suspected of having some kind of mental health issue. Children who could, quite legally, be held for up to three days. Let’s hope this new support system keeps on working.