Place of safety orders in England: changes in use and outcome, 1984/5 to 2010/11

Keown, Patrick

doi:10.1192/pb.bp.111.034348

Cited by 15 publications

(15 citation statements)

References 8 publications

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“…This reduction is in contrast to the steady increase in the use of section 136 nationally. 16 The Norwich site with support based solely in the police control room, by contrast, showed no significant change in overall numbers of section 136 detentions. The data provide some possible explanations for this observed difference between the sites.…”

Section: Discussionmentioning

confidence: 97%

Police liaison and section 136: Comparison of two different approaches

et al. 2017

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Aims and method Two police liaison and section 136 schemes were developed alongside police services at different sites within the same NHS trust. In one, a mental health nurse worked with frontline police attending incidents related to mental health. The other involved nurses providing advice from the police control room. Section 136 detentions were measured over two 6-month periods (6 months apart) before and after practice change. Data analysed included total numbers of section 136 assessments, outcomes following subsequent assessment, and relevant diagnostic and demographic factors. Association of any change in section 136 total numbers and proportion subsequently admitted was investigated in both sites.Results The model involving a nurse alongside frontline police showed significant reduction in section 136 numbers (38%, P < 0.01) as well as greater admission rates (P = 0.01). The scheme involving support within the police control room did not show any change in section 136 detention but showed a non-significant (P = 0.16) decrease in subsequent admission.Clinical implications Mental health nurses working alongside frontline police officers can help improve section 136 numbers and outcomes.

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Section: Discussionmentioning

confidence: 97%

Police liaison and section 136: Comparison of two different approaches

et al. 2017

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“…Since its inception, the frequency with which the Mental Health Act is used has followed an upward trend, 6,12 with a considerably greater rise in the use of s.136. 13 The Department of Health's recent Review of Operations of s.136 suggested that its growing use was in part explained by more people being taken to hospital-based places of safety and fewer taken to police cells where historically its recording has been patchy. 6 In addition, the rise was thought to be partly due to improved quality of data.…”

Section: Current Evidencementioning

confidence: 99%

Detention under section 136: Why is it increasing?

Loughran

2018

Med Sci Law

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There has been a significant increase in the use of section 136 of the Mental Health Act 1983 in England and Wales, particularly over the past 10 years, but the reasons for this increase remain unclear. This paper presents a history of English mental-health legislation and the current evidence relating to the use of section 136. It suggests that changing police attitudes, socio-economic factors and diminished resources amongst both the police and mental-health services may have contributed towards its increase. The strain placed on health services may have also resulted in a greater reliance on the police force as an access point to NHS care and could result in the inappropriate use of section 136. With the principle of the 'least restrictive option' at the heart of the Mental Health Act, this advocates the need for reform.

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“…Across England and Wales in 2012/13, a total of 21,814 individuals were detained and assessed under S136 with 14,053 assessed in a hospital setting (64%) and 7,761 in a police cell (36%) with 82% not progressing after their clinical assessment to any further Section of the Mental Health Act [75]. The inappropriate S136 detentions were not only the result of a lack of awareness of available options and of the need to use the least restrictive option, but also of deliberate use of this option to ensure urgent access to mental health services or in situations where a person is voluntarily seeking help [68]. Research also acknowledged that detention in a police cell as place of safety can be highly distressing [76].These inappropriate S136 detentions caused unnecessary financial burden on NHS [31,65,68].…”

Section: Key Policy Reports Recommend Ever-closer Partnership Betweenmentioning

confidence: 99%

“…The inappropriate S136 detentions were not only the result of a lack of awareness of available options and of the need to use the least restrictive option, but also of deliberate use of this option to ensure urgent access to mental health services or in situations where a person is voluntarily seeking help [68]. Research also acknowledged that detention in a police cell as place of safety can be highly distressing [76].These inappropriate S136 detentions caused unnecessary financial burden on NHS [31,65,68].…”

Section: Key Policy Reports Recommend Ever-closer Partnership Betweenmentioning

confidence: 99%

A Review of Quality Improvement [QI] Specialised Interventions in the USA and England to Reduce the Number of Police Mental Health Crisis Detentions and Provide Support to High Intensity Utilisers [HIUs]

Matheson-Monnet¹,

Jennings²

2017

MEDJ

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Background:Key issues in both the USA and England have been how to deal appropriately and effectively with the increasing number of mental health related incidents, in particular 1) the rising number of people with mental health issues detained in police custody until they can be clinically assessed and 2) the negative impact on public safety of the high intensity service users [HIUs] who draw a disproportionate amount of emergency and crisis services and are well known to both police and mental health services.Aims and objectives:To provide an overview of what is known about current quality improvement interventions undertaken to address these two key issuesi.e.reducing both the number of police mental health crisis detention and the disproportionate amount of emergency and crisis service usage [police, ambulance, ED] from HIUs with complex mental health problems to help inform policy and practice decisions in a context of lack of best evidence and lack of evidence based studies.Methods:PubMed and Google Scholar were searched to undertake a narrative synthesis of what is known of the various quality improvement interventions that have been introduced in both the USA and England to address these two key issues. Authors’ knowledge was also used to describe two quality improvement interventions not included/not yet listed in Google Scholar or PubMed.Results:In the USA, the dominant approach to reduce mental health police detentions is the CIT model, first introduced in 1988, now increasingly implemented with the addition of the older model of police and mental health co-responder (which go back several decades earlier) to increase its effectiveness. The CIT model has been adopted and spread worldwide despite methodological shortcomings in evaluations. Although a best evidence model with increasing data being gathered on effectiveness, it has yet to become an evidence based model. The Street Triage models introduced in England in 2012 were inspired by the older police and mental health co-responder model. Despite a primarily descriptive approach and methodological shortcomings in evaluations and only a handful of studies published, ST has also been widely adopted and spread within England. Only a handful of interventions have focussed on supporting HIUs with the implementation in England of a unique model but evolving model of integrating a police officer within a multi-disciplinary mentoring style intervention which has now adopted by other English police forces and could usefully be adopted by USA police forces.Conclusion:More data need to be systematically gathered on effectiveness and analysed against a range of clear success criteria, including a cost benefit analysis of the relative merits of their different variations before and in order that they can be called evidence-based models.

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Place of safety orders in England: changes in use and outcome, 1984/5 to 2010/11

Cited by 15 publications

References 8 publications

Police liaison and section 136: Comparison of two different approaches

Police liaison and section 136: Comparison of two different approaches

Detention under section 136: Why is it increasing?

A Review of Quality Improvement [QI] Specialised Interventions in the USA and England to Reduce the Number of Police Mental Health Crisis Detentions and Provide Support to High Intensity Utilisers [HIUs]

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