NHS London has issued proposals aimed at reducing the number of patients detained under the Mental Health Act
“Police involvement may sometimes lead to worse outcomes and increase disproportionality in our policing, especially amongst our Black communities. We are determined to change this and the announcement of this concordat is a really important step that will help further transform our approach to mental health care in London.” Commander Kevin Southworth, head of public protection, Metropolitan Police
Metropolitan Police offers will be able to consult a medical professional before they detain a patient under the Mental Health Act, under a new plan issued by NHS London.
The plan states that the NHS will provide a bespoke service, staffed by mental health clinicians, whom police can ask for advice on the best treatment pathway for a patient in a crisis.
The aim of the plan is to reduce the number detained by police under Section 136 (S136) of the Mental Health Act, which has been rising steadily. The goal is a 20% year-on-year reduction over three years in the number of people placed on S136.
A pilot scheme will be launched next year to determine the effectiveness of the policy at reducing the use of S136. It is likely to be integrated into an NHS 111 service offering mental health support to patients in a crisis. The service will be launched nationally in April 2024.
NHS London said that police will only detain a patient under the Mental Health Act as a “last resort”.
The new service for police is part of a concordat released by NHS London earlier this week, which sets out several commitments to improve mental health services in the capital.
Six mental health joint response cars (MHJRC), containing a paramedic and mental health professional, will respond to mental health calls seven days a week to reduce the number of patients making an unnecessary trip to A&E. Paramedics will be able to carry out a physical assessment at the scene, while mental health professionals will conduct a risk assessment and deliver psychological interventions to reduce the patient’s distress.
In London, 60% of patients are taken to A&E as a first port of call – twice the national average. Once there, they may face a long wait for care.
Evidence from an initial pilot and evaluation of the MHJRC found that four out of five people attended by the joint team of mental health professional and paramedic were seen, treated, and discharged at the scene, enabling them to avoid a trip to A&E.
The former minister and Liberal Democrat MP Sir Norman Lamb, who was involved in creating the plans, told the Standard: “The rising number of S136 detainments is concerning, and it puts an enormous amount of pressure on A&E departments. You then have police staying with people for many hours. It is not appropriate for us to expect police to perform a central role in treating people with complex mental health needs who are in a crisis.”
Lamb said that NHS London was working with black-led community organisations to help provide “culturally appropriate” support, stressing that reducing the number of young black men detained under S136 was a priority for the health service. NHS figures show that black people are nearly five times more likely to be detained under the Mental Health Act than white people.
He added: “The system is failing communities and we have a responsibility to fix that. For black men to be disproportionately affected by S136 is not acceptable in this day and age.”
Commander Kevin Southworth, head of public protection at the Metropolitan Police, said: “We know police involvement is not always what people suffering from acute mental health illness will want, nor are police officers and staff always best-placed to help in such situations.
“Police involvement may sometimes lead to worse outcomes and increase disproportionality in our policing, especially amongst our Black communities. We are determined to change this and the announcement of this concordat is a really important step that will help further transform our approach to mental health care in London.”
The proposal to offer direct support and advice to Metropolitan Police officers about mental health, which aim to reduce the numbers of people detained under the Mental Health Act, is welcome. Too many people are currently sectioned under the Act, causing distress to them and putting additional pressure on NHS services. The plan to introduce mental health response cars to enable people in mental health crisis to be assessed and helped directly at the scene has been shown to be successful in a pilot, and it makes sense to roll it out more widely. If it continues to work well, the model is one that could be emulated in the rest of the country.