Operational partnerships - Mental health - patients in custody and Allied Matters (O18c)

O18c Mental Health Patients in Custody and Allied Matters

Governing Policy - O18 Policing Mental Health

1. Summary of changes

1.1. This Standard Operating Procedure (SOP) has been reviewed in October 2024 – minor amends throughout.

2. What this Procedure is About

2.1. This standard operating procedure (SOP) is published to provide operational officers with clear guidance managing mental health patients in police custody suites.
Compliance with this SOP and any governing policy is mandatory.

3. Introduction

3.1. Mental health patients can reach Police Custody Suites via several routes:

• A person has been detained under Section 136 Mental Health Act 1983 and there are exceptional circumstances which dictate the detainee is taken to a Police Station (as a place of safety). These exceptional circumstances include:
  • the decision-maker is satisfied that the behaviour poses an imminent risk of serious injury or death, to that person or another person.
  • because of that risk, no place of safety other than a police station can reasonably be expected to detain that adult, and
  • where the decision-maker is not an officer of the rank of inspector or above, an officer of that rank or above authorises that adults’ removal to police station.
• A person has been arrested on warrant or for a criminal offence and they appear to be suffering from a mental disorder, or
• If a person is detained and appears to be in mental health crisis, officers should seek to address any mental health concerns prior to arrest and conveyance to a custody suite in conjunction with 836 clinicians. If the person is arrested (due to the exceptional circumstances, as defined in the Mental Health Act (Place of Safety) Regulations 2017 – as outlined in 3.1.1), then the arresting officer must communicate this to the Custody Sergeant as soon as they arrive in the custody suite.
• If an individual has been arrested for the above, then any mental health assessment will take place in custody and must be through CJLDS and will not require the use of S.136 MHA powers. CJLADS must not suggest the use of 136 rather than assessment in custody.
• In cases where a remand is sought, provided the threshold for remand is met, any mental health assessment will take place post remand as a forensic inpatient assessment.
• Investigators should consider as a reasonable line of enquiry, linking in with Mental Health Policing team for tactical advice and liaison with health and social care partners.

3.2 Procedure in Custody

3.2.1. Where detention has been authorised, and the mental health of a detainee raises concern, then the CJLDS team within the custody suite, or relevant Crisis Team via 836, must be contacted and requested to make the necessary arrangements to conduct a full Mental Health Act Assessment. An Approved Mental Health Professional (AMHP) must be asked to attend the Custody suite by the CJLDS or 836 team for this purpose.
It should be noted that CJLDS can initially assess the Detainee’s mental health and wellbeing and will advise (and divert) accordingly, where it is necessary to refer to the appropriate Mental Health Clinician / Clinical Team, e.g., to arrange a full Mental Health Act Assessment.
CJLDS do not assess suitability for interview, or other investigative procedures – which are to be carried out as part of the wider evidence gathering.

3.2.2. If the AMHP is delayed beyond 3 hours of initial contact to 836, the escalation Process should be commenced (Kent Police, KMPT and NELFT Trust Problem Escalation Process). The Force Custody Manager or, if not on duty, the LPT Duty Inspector should be notified a detainee is requiring a full Mental Health Assessment in Custody. The Custody Sergeant is responsible for requesting assistance from relevant persons on the escalation procedure.

3.2.3. After 3 hours has elapsed, the matter should be immediately escalated to the Force MH Lead Superintendent (between 0800-1600 hours) OR, where they are unavailable, or the requirement to escalate has occurred out of hours, then the Duty Superintendent should be contacted.

3.2.4. On arrival of the AMHP, the responsibility for progressing the assessment will pass to them, although the Custody Sergeant will retain overarching responsibility for the detained person’s general care and welfare. The AMHP and at least one Section 12 Mental Health Act Approved Doctor will conduct the assessment.

3.2.5. The AMHP will inform the Custody Officer of the outcome of the assessment. This information will be recorded on the custody record.

3.2.6. When there are no longer any grounds to lawfully detain the person in custody the individual should be released.

3.2.7. Following a full Mental Health Act Assessment and where the person is likely to be detained under section 2 / 3 / 4 of the Mental Health Act but no ‘in-patient bed’ has yet been identified for them, bed managers should be contacted to resolve this immediately. Mental health Assessments must not be delayed due to uncertainty regarding the availability of a suitable bed.
Should an appropriate bed not be identified, the AHMP should be contacted to discuss releasing the detained person back into the community whilst waiting for their bed.

3.2.8. Should an individual require a Mental Health Assessment and there are outstanding PACE matters that require them to remain in custody, the PACE clock will continue to run down.

The PACE clock is there to progress the investigation, and not for a medical or mental health assessment process, each case is subjective, and the Custody Sergeant will have the final say regarding the individual’s further detention.

The Custody Sergeant’s decision is final in relation to detention and care of the detainee. Any decision must be fully documented on the custody record.

4. Equality Impact Assessment

4.1. An Equality Impact Assessment has been conducted 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 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.

5. Risk Assessment

5.1. This SOP has been subject of extensive consultation with senior representatives from the AMHP Service, Clinical Commissioning Groups, Kent and Medway Partnership 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. The next review of this SOP will take place in October 2025.

7. Other Source Documents

• Mental Health APP
• Mental Health Act 1983
• Mental Capacity Act 2005
• Mental Health Code of Practice
• Information Sharing Protocol

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).