Operational partnerships - Mental health - missing and escapee patients (O18h)

O18h Missing and Escapee Mental Health Patients
Governing Policy - O18 Policing Mental Health

1. Security protective marking

1.1 Not protectively marked.

2. Summary of changes

2.1 This Standard Operating Procedure (SOP) has been reviewed in October 2024 – minor amendments made in line with Right Care, Right Person.

3. Application

3.1 This standard operating procedure (SOP) is published to provide operational officers with clear guidance on how to manage missing and escapee mental health patients.
Compliance with this SOP and any governing policy is mandatory.

4. Detail the Procedure

4.1 Introduction

4.1.1 ‘Missing’ mental health patients are patients who are absent from a hospital where they were detained under a civil order and escapees are patients who have escaped from the custody of a hospital imposed by a court.

4.2 Missing or AWOL Mental Health Patients

4.2.1 Absent without leave (AWOL) can apply to anyone detained under the Mental Health Act 1983 if they escape / abscond from hospital, or where they fail to return following a period of authorised leave – this will include restricted patients.
Call handlers should be aware of any differences in response to restricted missing or AWOL patients.

4.2.2 A person who has been compulsorily admitted to hospital for treatment or assessment as above, may be granted leave of absence for any period of time authorised by certain members of the hospital staff under Section 17 Mental Health Act. If the person fails to return to hospital on time, or for some reason the leave has been terminated early by a responsible clinician, then they become a missing or AWOL patient.

4.2.3 Section 18 Mental Health Act provides police officers with the power to return a missing mental health patient to the hospital. However, Section 18 does not provide a power of entry. Entry to premises to enact the Section 18 arrest power is only provided by Section 17(1)(d) PACE where the officer is in pursuit of the patient. This is a limited and unlikely eventuality.

4.2.4 Hospitals are responsible for locating patients who are AWOL, and they maintain a duty of care, but they may request police assistance to search for the patient, especially where they are particularly vulnerable or dangerous.

4.2.5 Where a patient is missing or AWOL from a hospital and cannot be located or it is likely the patient will refuse to return to the hospital, the hospital staff may request police assistance to find and escort the patient back to hospital.

4.2.6 The Force Control Room must decide on the merits of any request, the risks involved to the patient, mental health workers and the public, and the prospect of offences being committed (which the police will be obliged to investigate), when deciding whether or not to deploy resources.
Call takers should be encouraged to ask questions when a person is reported as being AWOL to:

• confirm that they are AWOL

• establish if they are a restricted patient

Police should consider whether it is more appropriate to record the patient as AWOL, as a Wanted Person, or as a Missing Person.
Recording an AWOL patient as a Missing Person may be justified, in certain circumstances, for example, if:

• there are any suspicious circumstances

• the patient is vulnerable

4.2.7 Receiving calls about restricted patients –

'Restricted patients' are offenders detained in hospital for treatment who are subject to special controls by the Secretary of State for Justice. They include offenders who are:
• diverted from the courts to the hospital system

• transferred to a secure hospital from prison and made subject to a restriction order or direction

The restrictions in place are dependent on their sentence.

4.2.8 Call takers should ask questions to establish if the patient is currently subject to restrictions.

4.2.9 Police should be informed immediately if a missing patient is subject to restrictions under Part 3 of the Act, according to the Code of Practice: Mental Health Act 1983 (chapter 28.15).

4.2.10 Restricted patients who have escaped from a hospital ward or failed to return to the ward following leave may be described to call takers as:

• Part 3 Patients

• Absconders

• Section 37/41 Patients

4.2.11 Following every incident, the log must be tagged for the Force Mental Health Team, as subject matter experts, to review the preventative measures / patient response required for each case.

5. Equality Impact Assessment

5.1. 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 in those with other protected characteristics (E.g., higher morbidity in BAME 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.

6. Risk Assessment

6.1. This SOP has been subject of extensive consultation with senior representatives from the AMHP Service, Clinical Commissioning Groups, Kent and Medway Partnership Trust over the past years.

7. Monitoring and Review

7.1. 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.

7.2 This SOP will next be reviewed in October 2025.

8. Security

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

9. Retention and Disposal of Records

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