Patients face ‘unacceptable waits’ of up to 48 hours for Mental Health Act assessments

Inspection report warns of 'unacceptable' waits for social workers and other approved mental health professionals to assess people detained under section 136 of the Mental Health Act.

People detained by police under the Mental Health Act have faced “unacceptable waits” of up to 48 hours before being assessed by approved mental health professionals (AMHPs), the chief inspector of prisons has warned.


Officers “frequently” reported waits of up to eight hours for patients detained under section 136 of the Act to be assessed at NHS units, an inspection report into eight Merseyside police custody suites found. There had been one case of a “wait of 48 hours”.

“The police were considering their options to deal with these unacceptable waits,” the report said.


Section 136 of the Mental Health Act gives police powers to take a person to a “place of safety” – ideally an NHS unit – for their own protection or the protection of others so that their needs can be assessed.


A person can be legally held in a place of safety for up to 72 hours. But one multi-agency policy agreed with Merseyside police and hosted on the Mersey Care NHS Trust website states that “a maximum waiting time of two hours” is good practice.


Steve Chamberlain, chair of The College of Social Work’s AMHP community of interest, said that the length of waits for Mental Health Act assessments “varies widely across the country”.


“But reports of eight hour waits, and one reported case of a 48 hour delay, are clearly totally unacceptable – most of all to the detained person but also to the police who are having to manage them for such a long time,” he said.


The College’s AMHP network is involved in several projects looking at the issue of section 136 responses nationally.


“Increased mental health resources are needed, both to improve the availability of AMHPs out of hours and staff in mental health units to speedily receive patients from the police,” said Chamberlain.


Three NHS trusts provide mental health services to the inspected custody suites on Merseyside: 5 Boroughs Partnership NHS Trust in St Helens; Cheshire and Wirral Partnership NHS Foundation Trust and Mersey Care NHS Trust.


Dr David Fearnley, medical director at Mersey Care, said the police had informed all of the agencies involved that “from 31st March they’ll be using a risk assessment process in conjunction with nursing staff at the place of safety to direct how long they remain with patients”.


“Mersey Care has been working in partnership with all key stakeholders who are involved in the care of people detained on a section 136 to reduce waiting times,” Fearnley said.


A Cheshire and Wirral Partnership (CWP) NHS Trust spokesperson said: “’CWP is aware of this issue and is liaising with all partners locally via the clinical commissioning group to work collaboratively to a resolution. CWP has never been made aware of unacceptably long waiting times.”


A 5 Boroughs Partnership NHS Trust spokesperson said it aimed to “assess all patients within four hours” of their arrival.


“Our police colleagues regularly attend bi-monthly mental health forums across our footprint at which we welcome the opportunity to discuss any areas of concern.”


A Merseyside police spokesperson said partnership work to improve section 136 waiting times “has been on-going for some time and we are introducing a risk assessment process to ensure effective management of the patients in future.”

Overall the inspections found that mental health services in the Merseyside custody suites were “performing well”.


The majority of custody officers had received mental health training in 2012. Most staff felt confident referring people to mental health practitioners appropriately and were “generally happy” with out-of-hour arrangements.


Every custody suite had access to criminal justice mental health teams during office hours and mental health practitioners visited daily to offer support, the report added.

is Community Care’s community editor

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