Detention under section 136(1) of the Mental Health Act 1983 allows for the police to arrest a person from a public place and remove them to a ‘place of safety’, typically an emergency department or mental-health unit if it is ‘in the interests of that person or for the protection of other persons in immediate need of care or control’.
Aims/objective: The aim of this study was to describe the views and perceptions of the process for people with lived experience of mental distress who have been detained under section 136 of the Mental Health Act 1983.
Method
Semi-structured interviews were conducted with a non-probability sample of people with lived experience of mental distress who have been detained under section 136 across Greater London. Interviews were transcribed and thematically analysed using grounded theory. Fifty-eight people with lived experience of mental distress detained under section 136, including four carers, participated in this study.
Results
Three interwoven themes were identified: (a) process or procedural issues; (b) the professional–patient relationship; and (c) the importance of a supportive therapeutic environment.
Conclusion
The length of time, multiple assessment points and processes juxtapose against the need for a humane physical environment and supportive therapeutic interactions from all professional agencies. It is unclear how changes proposed in the Policing and Crime Act 2017 will address these patient needs.
AllisonSBastiampillaiTFullerDA.Should the Government change the Mental Health Act or fund more psychiatric beds?Lancet Psychiatry2017;
4:585–586.
3.
Department of Health.The Mental Health Act 1983.
London:
The Stationery Office, 1983.
4.
Department of Health. The Mental Health Act 1983.
London:
The Stationery Office, 1983, section 135, paragraph 3B, subsection 6.
5.
Section 136 and police custody – an unacceptable situation. Lancet 2013;381:2224.
6.
HM Inspectorate of Constabulary. A criminal use of police cells? The use of police custody as a place of safety for people with mental health needs. A joint review by Her Majesty’s Inspectorate of Constabulary, Her Majesty’s Inspectorate of Prisons, the Care Quality Commission and Healthcare Inspectorate Wales. London: HMIC, 2013.
7.
Department of Health.Mental Health Act 1983: Code of Practice.
London:
The Stationery Office, 2015.
8.
HM Inspectorate of Constabulary.Welfare of vulnerable people in police custody.
London:
HMIC, 2015.
BorschmannRDGillardSTurnerKet al.
Section 136 of the Mental Health Act: a new literature review.Med Sci Law2010;
50:34–39.
13.
LaidlawJPughDRileyGet al.
The use of section 136 (Mental Health Act 1983) in Gloucestershire.Med Sci Law2010;
50:29–33.
14.
JonesSMasonT.Quality of treatment following police detention of mentally disordered offenders.J Psychiatr Ment Health Nurs2002;
9:73–80.
15.
McGuinnessDDowlingMTrimbleT.Experiences of involuntary admission in an approved mental health centre.J Psychiatr Ment Health Nurs2013;
20:726–734.
16.
RileyGFreemanELaidlawJet al.
‘A frightening experience’: detainees’ and carers’ experiences of being detained under section 136 of the Mental Health Act.Med Sci Law2011;
51:164–169.
17.
DurcanG.Review of sections 135 and 136 of the Mental Health Act: the views of professionals, service users and carers on the codes of practice and legislation.
London:
Centre for Mental Health, 2014.
18.
WyderMBlandRBlytheAet al.
Therapeutic relationships and involuntary treatment orders: service users’ interactions with health‐care professionals on the ward.Int J Ment Health Nurs2015;
24:181–189.
19.
JaegerSPfiffnerCWeiserP.Long-term effects of involuntary hospitalization on medication adherence, treatment engagement and perception of coercion.Soc Psychiatry Psychiatr Epidemiol2013;
48:1787–1796.
20.
SadlerGRLeeHCLimRSHet al.
Recruitment of hard‐to‐reach population subgroups via adaptations of the snowball sampling strategy.Nurs Health Sci2010;
12:369–374.
21.
FaugierJSargeantM.Sampling hard to reach populations.J Adv Nurs1997;
26:790–797.
22.
GlaserBGStraussAL.The discovery of grounded theory; strategies for qualitative research.
Chicago, IL:
Aldine Publishing, 1967.
23.
GlaserBG.Theoretical sensitivity: advances in the methodology of grounded theory.
Mill Valley, CA:
Sociology Press, 1978.
24.
CorbinJStraussA.Grounded theory research: procedures, canons, and evaluative criteria.Qual Sociol1990;
13:3–21.
25.
CharmazK.Constructing grounded theory: a practical guide through qualitative analysis.
London:
Sage, 2006.
26.
BraunVClarkeV.Using thematic analysis in psychology.Qual Res Psychol2006;
3:77–101.
27.
MenkesDBBendelowGA.Diagnosing vulnerability and ‘dangerousness’: police use of section 136 in England and Wales.J Public Ment Health2014;
13:70–82.
28.
OpsalAKristensenØLarsenTKet al.
Factors associated with involuntary admissions among patients with substance use disorders and comorbidity: a cross-sectional study.BMC Health Serv Res2013;
13:57.
29.
KatsakouCBowersLAmosTet al.
Coercion and treatment satisfaction among involuntary patients.Psychiatr Serv2010;
61:286.
30.
RocheEMadiganKLyneJPet al.
The therapeutic relationship after psychiatric admission. J Nerv Ment Dis2014;
202:186–192.
31.
SmithDRocheEO’LoughlinKet al.
Satisfaction with services following voluntary and involuntary admission.J Ment Health2014;
23:38–45.
32.
StraussJLZervakisJBStechuchakKMet al.
Adverse impact of coercive treatments on psychiatric inpatients’ satisfaction with care.Community Ment Health J2013;
49:457–465.
33.
PriebeSKatsakouCYeelesKet al.
Predictors of clinical and social outcomes following involuntary hospital admission: a prospective observational study.Eur Arch Psychiatry Clin Neurosci2011;
261:377–386.
34.
KallertTWKatsakouCAdamowskiTet al.
Coerced hospital admission and symptom change – a prospective observational multi-centre study.PLoS One2011;
6:e28191.
35.
WyderMBlandRBlytheAet al.
Therapeutic relationships and involuntary treatment orders: service users’ interactions with health‐care professionals on the ward.Int J Ment Health Nurs2015;
24:181–189.
36.
BradburyJHutchinsonMHurleyJet al.
Lived experience of involuntary transport under mental health legislation.Int J Ment Health Nurs2017;
26:580–592.
37.
PughDLaidlawJ.Sections 135 and 136: running a health-based place of safety in Gloucestershire.Med Sci Law2016;
56:99–106.
38.
DockingM.The use of section 136 to detain people in police custody.J Ment Health Law2009;33–44.
39.
RixKJB.‘Alcohol intoxication’ or ‘drunkenness’: is there a difference?Med Sci Law1989;
29:100–106.
40.
NyttingnesORuudTRugkasaJ.‘It’s unbelievably humiliating’ – patients’ expressions of negative effects of coercion in mental health care.Int J Law Psychiatry2016;
49:147–153.
41.
KatsakouCPriebeS.Patient’s experiences of involuntary hospital admission and treatment: a review of qualitative studies.Epidemiol Psychiatr Sci2007;
16:172–178.
