Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-14T13:25:11.729Z Has data issue: false hasContentIssue false

RE: In the liminal spaces of mental health law – what to do when section 136 expires?

Published online by Cambridge University Press:  28 May 2024

Rafiq Ahmed Memon*
Affiliation:
Consultant Forensic Psychiatrist, Birmingham and Solihull Mental Health NHS Foundation Trust, UK. Email: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Type
Correspondence
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use and/or adaptation of the article.
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

Beyond the limit of section 136

As a forensic psychiatrist, I read with interest the paper by Hassanally et al about what to do when section 136 expires.Reference Hassanally, Laing and Kishore1 Section 136 of the Mental Health Act 1983 lasts up to 24 h. What was the intent of Parliament in setting that limit? A literal reading means 24 h and no longer. The logical consequence is that after 24 h, the patient must be released from detention and their liberty restored. In terms of practical management of the clinical scenario, the doctors should complete medical recommendations for a section 2, as this is within their power. Police should confiscate the large knife. The patient should be released at the 24 h mark as no bed is available and the brother who historically brought the patient to hospital notified if possible. This is an unpalatable outcome, and it needs little imagination to foresee what disaster may ensue in the community. Yet it must have been foreseeable to Parliament, as the scenario described is both credible and realistic. Escalation to the director on-call for the NHS trust and the medical director should also be done. There will be moral injury and moral distress to the doctors involved, in addition to the lack of bed and lack of care for the patient. Alternatively, continuing to detain the patient past the 24 h mark would intentionally break the law via false imprisonment and unlawful deprivation of liberty. This is unethical and would require the complicity of several people, who would be opening themselves up to legal jeopardy. Citing public protection would be insufficient. No common law citizen's arrest is possible, as the patient was already under police arrest using section 136. Another alternative could be to criminalise the patient for possession of an offensive weapon and have him charged and taken to the magistrates’ court. But that would be unjust, as the patient clearly requires diversion to in-patient services. Four sections along from 136, we find 140. This basically says that health authorities have a duty to notify local social services authorities, specifying the hospitals in which arrangements are in force for the reception of patients in cases of special urgency. And so, going forward, it would be useful for psychiatrists on call to have knowledge of such arrangements at the start of their shifts. I would be interested to read other arguments about this worrying situation. I agree that the care of the patient is the first concern for medical professionals, but this must be within the confines of the law of the land.

Declaration of interest

None.

References

Hassanally, K, Laing, J, Kishore, A. In the liminal spaces of mental health law – what to do when section 136 expires? BJPsych Bulletin 2024; 47(6): 342346.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.