Detained under the Mental Health Act

The call came out on the radio requesting 'fast raps' to be taken to the hospital, as a female who had earlier been detained by police under s136 of the Mental Heath Act, was becoming agitated and posing a risk to herself, officers and nursing staff.  The radio controller asked for the urgency, with the officer responding “sooner rather than later”.  We found a set in the car so went to assist.

Upon arrival we found officers in a side room in A&E with the detained person, Andrea.  Two officers had detained Andrea, the other two, like us, were delivering fast raps for restraint.  Andrea was sitting on the floor and her face and forearms covered in blood.  I couldn't at first see any injuries as I remained outside the room, passing a couple of  new pairs of medical gloves inside to officers as theirs split whilst wrangling with Andrea.  For a small lady, Andrea could kick around quite a bit and before too long I was inside helping to restrain her and apply the restraints.

Fast raps are restraint straps, measuring about 8cm wide and a metre or more in length and are essentially double sided Velcro straps, furry on one side, sticky on the other.  If applied correctly, they are pretty effective.  Sometimes it's not possible to apply them perfectly as the detainee is usually kicking and wriggling around, which is of course why the straps tend are used.  Straps are not applied as a matter of routine, and they are reserved for the exceptional situations where the detainee is a serious risk of harming themselves, officers or others.  We are trained to use them.

A strap was applied to Andrea’s lower calf area, thighs and a final one across her chest, encompassing arms so that she could not access the two gaping lateral lacerations on her left wrist.  One cut was deep for that part of the body; the deepest I had seen.  It had to be half a centimeter deep by about 5cm wide, with the second, less serious being the same width but maybe only 1-2 mm deep.  The main cut itself was no longer bleeding but can imagine it releasing a fair amount of blood earlier, which is no doubt where the blood on her face and arms came from.

Andrea was distressed.  She wanted a cigarette and kept asking for such.  Clearly she was in no fit state to leave the hospital, and she couldn’t have one where she was.  Maybe that would have calmed her down, but it’s not something that could have been considered.  Whilst I was outside the room, I heard an officer exclaim “she’s fitting”, and I observed a few seconds of what appeared to be an epileptic seizure.  Officers took the correct steps and did not restrain during her few seconds of fitting.  Nursing staff attended.

Section 136 of the Mental Health Act allows police to detain someone where they: are in public; would appear to have a mental illness; need to be removed to a place of safety for protection of themselves, officers or other people.  The DirectGov website has some good info in this respecthttp://www.direct.gov.uk/en/DisabledPeople/RightsAndObligations/Police/DG_4018603. 

Between moments of being calm, Andrea kicked and wriggled, but to little avail as she was now securely restrained.  We calmed her as best we could and sat her up so that she was as comfortable as possible.  She remained upset and she kept saying “I’ve done nothing wrong, why are police here?”  That made me think of the public perception of the police and perhaps how we are thought of as just arresting people or dealing with public order situations.  Maybe the uniform is synonymous with law and order, but in this situation the wellbeing of Andrea was our only concern.  Police have duty of care to preserve life and limb, and take an oath for such when becoming a constable.  Andrea was detained because she was, in the opinion of attending officers, about to harm herself.  The reality police TV shows these days concentrate all too much on the ‘action’ side of policing, and not the side that we were dealing with.  That’s another story through…

During her pleading for a cigarette, Andrea told us that she was bi-polar and couldn’t help how she was.  Her forearms arms were littered with scars of historic self harm injuries; there must have been hundreds of healed razor cuts.  A nurse attended, who addressed Andrea by her first name and told us that she had dealt with her before.  The nurse clearly had many years of experience, as she dealt with Andrea so well.  Andrea refused a local anesthetic and requested the use of steri strips to close the wound.  Even I could see that steri strips would be of little use keeping it closed, and the nurse advised such, with the only option being to stitch it closed.  I’ve never seen the act of stitching skin together.  The nurse again demonstrated her expertise and within a few minutes had closed the wound with five stitches, with Andrea’s hand and forearm being held steady by one of the attending officers.  What a skill. I was mesmerized. The final patching-up was to apply a dressing to the wound.

By this time a van had been called for to transport Andrea from A&E to another hospital, in which is the official place of safety for people detained under mental health legislation once appropriate A&E input is completed.  It arrived after a few minutes and we walked Andrea to the waiting van, and after a small bout of reluctance, she got in for onward transportation to the place of safety and further assessment.

That was the end of the input from myself and crewmate, so we became available for the next job…

I would say that detaining someone under 136 is one of the least liked jobs for officers.  I’ve been involved with a few and most are not in as bad a way as Andrea.  However, once detained two officers have to stay with the detained person until they have been assessed by a mental health professional, social worker and the police doctor.  At night, that process can take hours to complete, meaning that there are two fewer officers ‘on the street’ than there would have been normally.  Despite officers not being fans of the slow process, which involves doing very little for a long time, they are professional and know that the detained person is vulnerable and requires help, whether they reaslise that or not.  Putting the TV cameras in most s136 situations would make for dull viewing, but this is one of the important unseen roles of the police.


PS Andrea was not her real name

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