A safer place to be

In January and February 2014 we carried out a survey of NHS mental health trusts and social enterprise providers of health-based places of safety in England.

The purpose of this survey was to examine the provision and use of health-based places of safety for people detained under section 136 of the Mental Health Act (the power that police officers have to detain people, believed to have a mental disorder, in a public place and to take them to a place of safety for assessment), especially as a means of understanding the availability and accessibility of the places of safety.

What we found

The survey focused on:

• The availability, in practice, of health-based places of safety.
• Accessibility, including any exclusion criteria.
• Staffing and training of those involved in operating places of safety.
• Target times and delays in carrying out MHA assessments after people have been taken to places of safety.
• Governance, reporting and multi-agency working.
• The role of police and ambulance services.

Overall we found that some places of safety are operating effectively, with innovative examples of positive practice and organisational developments. However, there was also evidence that recommended national standards are not being fully met in a range of areas.

There are four key findings that we believe need to be urgently addressed:

1. Too many places of safety are turning people away or requiring people to wait for long periods with the police, because they are already full or because there are staffing problems.
2. Too many providers operate policies that exclude young people, people who are intoxicated, and people with disturbed behaviour from all of their places of safety.
3. Too many commissioners are not adequately fulfilling their responsibilities for maintaining an oversight of the section 136 pathway.
4. Too many providers are not appropriately monitoring their own service provision. This makes it difficult for those providers and their commissioners to evaluate if provision is meeting the needs of people in their local area.

How the findings will be used

We have made recommendations aimed at providers, commissioners and other agencies, and have published the quantitative data collected through the survey. We have asked all involved agencies to review the findings, and to take appropriate action where there are shortfalls.

The data and findings will further be used to inform:

• Our wider Thematic review of mental health crisis care
• Our future inspections of Mental health services, and will help us to target areas for improvement.
• The Government’s Review of the operation of sections 135 and 136 of the Mental Health Act.