Vulnerable children detained in police cells as ‘substitute’ for health and social care

Police officers are too often being left with “no option” but to detain vulnerable adults and children in custody, sometimes for long periods, because they are unable to get help from NHS and social services, a review has found.

Home secretary Theresa May ordered Her Majesty’s Inspectorate of Constabulary (HMIC) to look at the treatment of children, people with mental health problems and black and minority ethnic groups. The review inspected five police forces and three Metropolitan police service boroughs and also took findings from child protection inspections into account.

HMIC found that custody is being used as a substitute for health and social care support and expressed concerns that local authorities are failing to meet key statutory duties to accommodate vulnerable children detained by police. Police officers are also being forced to respond to mental health crises and children in an environment and with techniques that “are wholly unsuited to the task”, the review found.

The report makes 18 recommendations, including a call for local children’s safeguarding boards to hold police forces and local authority children’s services to account for the provision of services that can divert children away from custody.

The home secretary said she would review the HMIC recommendations and respond in due course.

Avoidable detentions

HMIC found that many detentions to custody could have been avoided if alternatives were available but said that efforts from police officers to refer into health and social care services were often hindered by eligibility criteria. In some cases the only power the police had to remove and keep a person safe was to arrest them, usually for minor offences, and then put them in custody, the review found. This meant a number of vulnerable adults and children had been “criminalised unnecessarily”, it added.

“While health, social care and children’s services can and do refuse to admit vulnerable people into their care, the police do not have this option. The police seek to avoid taking an individual into custody if there is no security reason to do so; but it is difficult for them to divert vulnerable people away from custody if the right alternative services are not available,” the report said.

“Thresholds and/or waiting times for access to healthcare and local authority social services often leave the police isolated when it comes to finding solutions for people with complex needs who do not fit easily into the categories of service offered by those agencies.”

Failing children

Under the Children Act 1989 local authorities have a duty to provide suitable accommodation for children in police detention. However, HMIC found that local authorities routinely failed to meet this duty and this was “a major factor” in children being detained in cells overnight. In one example, a 15-year-old boy was detained for over 39 hours after being arrested for criminal damage. Despite numerous attempts by custody staff, no alternative accommodation was found by the local authority.

One factor adding to the problem was the fact that police often requested secure accommodation when other types of accommodation such as residential or foster care might be more appropriate, HMIC found. This meant a request by the police for secure accommodation may be met with the response that none was available, it added.

Mental health responses

The review also found a series of issues with the response police forces received from NHS and social services in cases involving adults and young people having mental health crises.

Under section 136 of the Mental Health Act, police officers have the power to detain people to a place of safety for the safety of the person or others and so that they can be assessed by a health professional. Places of safety should ideally be NHS units (known as ‘section 136 suites’) and police custody should only be used as a last resort. But the HMIC review found that there were difficulty accessing section 136 suites at all the forces inspected, often due to staffing issues at the units.

“In these cases, if the A&E department refused admission, mentally ill and distressed people were detained in police cells, because the police had no other option open to them,” the review found.

HMIC found that when people in mental distress were detained to custody people could spend long times waiting for a mental health bed to become available for them to be transferred to, despite repeated efforts by custody staff to request one. Response times from doctors and Approved Mental Health Professionals (AMHP) also varied from 90 minutes to 10 hours. Custody staff in all forces inspected reported delays in setting up Mental Health Act assessments out of hours.

The review found that training that would support police officers to identify and respond appropriately to the needs of vulnerable people was limited and custody officers were overlooked for specialist child protection and safeguarding.