Operational partnerships - Mental health - execution of warrants under Section 135 (O18b)

O18b Execution of Warrants under Section 135 Mental Health Act

1. Summary of changes

1.1. This Standard Operating Procedure (SOP) has been reviewed in August 2024 - no amendments to content made.

2. What this procedure is about

2.1. This standard operating procedure (SOP) is published to provide operational officers with clear guidance when considering executing warrants or obtaining warrants under Section 135, Mental Health Act 1983.

Compliance with this SOP and any governing policy is mandatory.

3. Detail the Procedure

3.1 Introduction

3.1.1 Section 135 Mental Health Act 1983 provides a mechanism for two routes to secure access to private premises to resolve a person believed to be suffering from a mental disorder.

3.1.2 Section 135(1) allows an Approved Mental Health Professional (AMHP) to lay information on oath before a justice of the peace, that there is reasonable cause to suspect that a person believed to be suffering from mental disorder either, (a) has been, or is being, ill-treated, neglected or kept otherwise than under proper control, in any place within the jurisdiction of the justice, or (b) being unable to care for himself, is living alone in any such place.

3.1.3 The warrant authorises any constable to enter, if need be by force, any premises specified in the warrant in which a person is believed to be and if thought fit, to remove that person to a place of safety.

3.1.4 Section 135(2) allows a constable or another person authorised under the Mental Health Act (such as a doctor) to lay information on oath before a justice of the peace, to request a warrant to take a patient to any place, or take into custody or retake a patient who is liable under the Act (such as a patient who was on Section 17 leave and is now AWOL) and (a) there is reasonable cause to believe that the person is to be found on premises within the jurisdiction of the justice, and (b) that admission to the premises has been refused or that a refusal of such admission is apprehended.

3.1.5 The warrant authorises any constable to enter, if need be by force, the premises to remove the patient.

3.1.6 In the execution of a warrant issued under Section 135(1) the constable shall be accompanied by an Approved Mental Health Professional and by a registered medical practitioner. However, if the warrant is issued under Section 135(2) the constable may be accompanied by a registered medical practitioner and/or by a person authorised under the Mental Health Act.

3.1.7 If the warrant states the name of a specific mental health professional or a doctor then that person must be present for the execution of the warrant to be useful.

3.2 Role of the Approved Mental Health Professional

3.2.1 An Approved Mental Health Professional (AMHP) is an independent agent employed by Kent and Medway Partnership Trust, Kent County Council or Medway Council. They have a duty of care to the patient, are responsible to preserve the rights of the patient and to organise the attending professionals and logistics for the warrant. The AMHP is responsible for seeking a warrant under Section 135(1), securing the attendance of the registered medical practitioners, arranging for an ambulance or other conveyance for the patient and the attendance of Police Officers.

3.3 Requests for Section 135(1) Warrants

3.3.1 All requests to execute a Section 135(1) warrant should be directed to the Force Control Room for consideration. Requests for urgent warrant executions should be directed to the FCR for allocation to a patrol. The force will not entertain requests from the AMHP Service or other agencies to conduct a preliminary visit to a premises for the purpose of determining whether or not the occupant is willing to receive mental health professionals, as a precursor to an AMHP seeking a warrant on the grounds that entry is otherwise likely to be refused.

3.3.2 The warrant directs the ‘constables of Kent’ to execute warrant and the role of the Police is to secure entry and fulfil the directions of the warrant. While the AMHP is responsible for the coordination of personnel for the warrant, its execution must be led by a Police Officer.

3.3.3 The Force Control Room will carry out the following actions before allocating the warrant:
Contact the lead professional to confirm:

• the identity of participating professionals;
• details of the warrant;
• anticipated outcomes for the patient and alternative contingencies;
• any risk factors associated with the patient and the premises;
• the identity and contact telephone numbers of carers or relatives of the patient who may be able to secure the patient's co-operation and provide insight into the patient;
• who owns the premises;
• that the lead professional has secured transport arrangements and made arrangements to care for dependant relatives and pets, and
• negotiate a realistic time window.

3.3.4 The police will not transport patients detained via the warrant unless they are so violent that they cannot be safely managed by health professionals and ambulance personnel alone.

3.3.5 Kent Police will:

• nominate specific officers to execute the warrant;
• conduct searches on PNC and Athena and identify any risks posed by the patient; an
• if the call is passed to Tasking, they will ensure the lead officer involved in the S135 compiles a briefing document to accompany the warrant including the information and intelligence obtained.

3.3.6 The nominated officers will be briefed by their supervisor or their nominee who will be the lead officer and command execution of the warrant. The tactics to be employed will be dependent on the character and level of the risk posed by the patient.

3.3.7 The lead officer should conduct additional checks on PNC and revise risk information if there is any indication that circumstances have changed.

3.3.8 The lead officer will identify themselves to the other parties to the warrant at the earliest opportunity to establish threat and risk and also to confirm their respective roles and responsibilities. The LPT supervisor and AMHP must have direct and open dialogue to negate any confusion, make best use of resources available and ensure any risk to the vulnerable person is minimised. The on duty LPT sergeant must take command of the incident and manage the attendance of resources at the appropriate time. This can then be passed between shifts and direct liaison with AMHP. Officers should consider use of Body Worn Video with reference to policy O47.

3.3.9 Having secured entry to the premises, the lead officer will confirm when it is safe for the other parties to enter and remain to prevent a breach of the peace.

3.4 Protective Search Power

3.4.1 Section 136C allows a police officer to search a person subject to section 135, 136(2) or 136(4) if the officer has reasonable grounds to believe that the person may be a danger to themselves or others and is concealing something on them which could be used to physically injure themselves or others.

3.4.2 The search power is designed to ensure the safety of all involved and should be used appropriately to support policing and health agencies to effectively care for and support the person. The new power does not include any restrictions around age or any other characteristic of the person to be searched. However, the power does not require a person to be searched. Any search conducted by the officer under Section 136C is limited to actions reasonably required to discover an item that the officer believes that the person has or may be concealing. The officer may only remove outer clothing. The officer may search the person’s mouth, but the new power does not permit the officer to conduct an intimate search.

3.4.3 Section 136C power does not affect the applicability of other existing search powers – including powers under sections 32 and 54 of the Police and Criminal Evidence Act 1984, and powers of health professionals to search patients detained in hospitals in some circumstances.

3.4.4 A 'bed' does not need to be identified for the warrant to be executed, however an AMHP and a doctor need to be present legally for a warrant to be executed. In situations where there is a refusal by the AMHP or the doctor to be present and in the absence of any other legal powers to allow for the safe detention, assessment and mitigation of risk, officers should escalate the matter to supervisors or the duty manager and document any conversations around the matter.

3.5 Transportation

3.5.1 Police should consider unmarked cars to travel to a property to enforce a warrant under section 135 of the act. This is to reduce the impact of executing such a warrant on the patient.

3.5.2 While the patient should always be transported by an AMPH arranged ambulance, it remains the police responsibility as set out in the warrant to remove the patient to the place of safety. This is best achieved by escorting the ambulance or having a Police Officer escorting the patient in the ambulance.

3.5.3 When ambulances are stationary their doors cannot be locked to prevent egress from inside the vehicle. This may affect police containment preparations when police officers are escorting individuals for the purposes of Section 136 or 135 of the Mental Health Act. Officers must ensure the supervision, containment and if unavoidable, restraint of those detained where ambulances are used to convey patients to a Place of Safety. In law, conveyance by ambulance does not imply agreement to convey and detain unless expressly agreed otherwise and police officers remain responsible for the security of the detained person until handed over, usually at the Place of Safety.

3.5.4 A patient may only be transported in a police vehicle with the permission of an Inspector. Ambulance transportation provides continuous medical monitoring, immediate medical intervention if the patient deteriorates and protects the dignity of the patient. A patient may only be transported in a police vehicle with the permission of an Inspector, unless paragraph 3.5.5 applies. The Inspector must be satisfied that transportation in a police vehicle is necessary and appropriate in the circumstances and document their decision on the STORM record.

3.5.5 Where a patient is so violent that it is unsafe for them to be transported in an ambulance, they should be conveyed in a police vehicle containing an equipped paramedic and followed by an ambulance. These circumstances do not require the prior approval of an inspector and must be decided by the detaining officer.

3.5.6 In the event that the paramedic concludes that the patient needs urgent medical attention, the patient will be conveyed to an Emergency Department. Some medical conditions evidence symptoms that can be easily mistaken for symptoms of mental disorder. At the Emergency Department the paramedic will inform the clinician of their medical observations. If any officer present has any concerns that an individual may be experiencing excited delirium / acute behavioural disorder which can be present with or without any restraint having been employed. Or positional asphyxia which is a separate condition involving restraint. All would need to be communicated at the earliest opportunity to health professionals, treated as a medical emergency, and taken at face value until ruled out by a doctor at A&E and not by a paramedic.

3.5.7 The officer has a duty of care to the clinician to communicate any known risks and concerns about excited delirium / acute behavioural disorder and positional asphyxia presented by the detainee and ensure these are ruled out by a doctor. At the Emergency Department the clinicians will concurrently stabilise and treat the patient’s medical condition and notify the hospital’s Psychiatric Team. Once the patient is medically safe the Psychiatric Team will begin their assessment. The officer’s supervisor must decide whether it is appropriate for the officer to remain with the patient or risk the patient absenting themselves from hospital and being reported as a high risk missing person.

3.6 Periods of detention

3.6.1 The permitted period of detention, during which a person can be detained at a place of safety, under section 135 or 136, is 24 hours (reduced from a maximum of 72 hours).
The responsible medical practitioner can extend that period by up to 12 hours if a Mental Health Act assessment cannot be completed within the permitted period due to the person’s mental or physical condition. Where the person is being detained in a police station, a police officer of the rank of Superintendent or above must also approve the extension.

3.6.2 Calculation of the detention period. The detention period for those detained under section 135 or 136 begins:-
(i) where a person is removed to a place of safety under section 135 or 136 – at the point when the person physically enters a place of safety. Time spent travelling to a place of safety or spent outside awaiting opening of the facility does not count;
(ii) where the person is kept at the address specified in the warrant under section 135 - the time at which the police officer first enters the premises; and
(iii) where a person is kept at a place under section 136 – at the point the police officer takes the decision to keep them at that place. The clock continues to run during any transfer (if this is necessary) of a person between one place of safety and another.
If a person subject to section 135 or 136 is taken first to an Emergency Department of a hospital for treatment of an illness or injury (before being removed to another place of safety) the detention period begins at the point when the person arrived at the Emergency Department (because a hospital is a place of safety).

3.7 Post Warrant Execution

3.7.1 At the conclusion of the matter, the lead officer will ensure that a 3x5x2 is submitted so that future officers will benefit from any intelligence obtained and also the S135 mental health eform which is used to collect data for a Home Office data requirement.

4. Equality Impact Assessment

4.1 An Equality Impact Assessment has been carried out and the potential for differential impact has been carefully considered. It is noted that the morbidity of mental illness is greater in those with a learning and / or physical disability and also in those with other protected characteristics. (E.g. higher morbidity in ethnic minorities and LGBT+ communities and higher incidence of suicide in males.) For this reason officers enacting this policy / standard operating procedure are reminded to be particularly careful to ensure their decision making is evidence based and without cultural bias.

5. Risk Assessment

5.1 This SOP has been subject of extensive consultation with senior representatives from the AMHP Service, Integrate Care Board, Kent and Medway Partnership Trust and North East London Foundation Trust and with health and police officer practitioners over the past year.

6. Monitoring and Review

6.1 The Force Mental Health Liaison officer will monitor this standard operating procedure and conduct an annual review to ensure it is fit for purpose, reflecting changes in legislation, national police practice, the NICE Guidelines and developments in local partner practice.

6.2 This SOP will next be reviewed in August 2025.

7. Security

7.1. Kent Police have measures in place to protect the security of your data in accordance with our Information Management Policy (Policy W1000 – Information Management).

8. Retention and Disposal of Records

8.1. Kent Police will hold data in accordance with our Records Review, Retention and Disposal Policy (Policy W1012 – Records Review, Retention and Disposal).