Changes to procedure for detained mental health patients

Changes to section 136 of the national Mental Health Act protocol came into force on Tuesday (April 1) at EEAST, meaning the ambulance procedure has changed for patients detained by police under the Mental Health Act.

The National Ambulance Mental Health Group has published a national standard protocol to follow, which can be found online, but a summary of the process can be found below:

1.       If a police officer detains someone under the Mental Health Act, they will contact us. If there is an immediate threat to the individual’s life, the call can be made via 999.

2.       We will initially respond to the call under emergency blue light conditions. Where possible this response will be an ambulance, but a rapid response vehicle can be used where needed.

3.       When with the patient, the most senior ambulance clinician will decide whether or not the patient’s issues are mental or physical, and whether they need to be conveyed to A&E. Appendices 1 and 2 in the protocol document can help you with this.

4.       Once a decision has been made, we will then convey the patient (i.e. to A&E or a place of safety etc.) within 30 minutes where possible (dependant on operational demand). A risk assessment will be undertaken with police at this stage – more help and information on this is available in appendix 3. The police will remain with the patient during conveyance, and will contact the relevant health care professional before you arrive.

5.       If during the risk assessment it’s decided the patient needs to be conveyed in a police vehicle, it may be necessary for the highest qualified member of the ambulance crew to also travel in that vehicle (with any appropriate equipment). In these cases, the ambulance should follow behind to provide further support if needed.

For patients who are being actively restrained, an ambulance must be dispatched as an immediate, high-priority response. Although patients who are restrained do not necessarily require hospital treatment, this must be a clinically-led decision taken by us.

If whilst on scene there are any disputes within the framework between yourselves and police officers, on-call police supervisors and Trust managers should be contacted to ensure a quick and effective resolution at the time.

Nationally, all ambulance service chief executives have signed up to this new protocol. 

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