Scandal of putting mentally ill children in police cells must end, says MP
Dr Sarah Wollaston condemns use of police stations for under-18s who are having a breakdown rather than taking them to specialist medical units
By: Denis Campbell
Sunday 17 Aug 2014
Ministers should end the “scandal” of vulnerable children and young people suffering a mental health crisis being assessed in a police cell because of a nationwide shortage of proper psychiatric facilities, an influential MP has demanded.
Dr Sarah Wollaston, the chair of the Commons health select committee, said it was “wholly unacceptable” for under-18s who are picked up by the police because they are having a breakdown to be taken into cells rather than to a specialist medical unit.
“It would be unthinkable for someone who had a broken leg, for whom there was no place to assess them in casualty, to be taken to a police cell. It should be unthinkable for someone who’s having an acute mental health crisis to be seen in a police cell. That’s inexcusable, but it’s happening,” Wollaston told the Guardian. “That’s wholly unacceptable for an adult, much less for a child.”
Wollaston, who was a GP for 24 years before becoming Conservative MP for Totnes in 2010, added: “We won’t have true parity of esteem [between mental and physical health in the NHS] unless we end the scandal of section 136 assessments”.
Anyone detained under section 136 of the Mental Health Act 1983, which often happens if someone appears mentally disturbed in a public place, should be assessed in a “place of safety”. That is meant to be a mental health unit, but a lack of them in many parts of England means one in three assessments takes place in a cell in a police station.
Figures from the Care Quality Commission, the NHS care regulator in England, show that 21,814 assessments of adults or children took place in 2012-13 under section 136, of which 7,761 involved the use of a police cell. According to the Association of Chief Police Officers, a disproportionate 45% of under-18s detained under section 136 that year were assessed in police cells.
Victoria Bleazard, director of communications and campaigns at the charity Rethink Mental Illness, said: “It’s disgraceful that so many people, especially children and young people, are being held in police cells under section 136. If you’re experiencing a mental health crisis, you should be brought to a ‘place of safety’ in a health facility. A police cell should only be used as an absolute last resort.”
However, she added, there are only 161 places of safety in England, many of which can only take one person. “That means that there simply aren’t enough facilities available to meet the needs of people in crisis. Even worse, more than a third (35%) of those facilities do not accept young people under the age of 16, which is why children in crisis are being taken to police cells,” said Bleazard.
The situation is compounded by the fact that the strict admission criteria enforced by many places of safety mean some do not accept people who show signs of drug or alcohol abuse. “That’s a big problem, because a high proportion of people going through a mental health crisis will also have related drug and alcohol issues,” she said.
Wollaston accused the NHS of treating mental health as “a Cinderella service” and seriously underfunding it. NHS bosses had failed so conspicuously to deliver the coalition’s landmark pledge of “parity of esteem” between mental and physical health that the health secretary, Jeremy Hunt, may be forced to intervene, she said.
Wollaston said the NHS had given mental healthcare low importance for decades.
“Mental health has always been a Cinderella service within the NHS, underfunded and given nowhere near enough priority. There’s never been a time when mental health services have been funded equitably with physical health and received a fair share of the cake, especially child and adolescent mental health services,” she said.
The last Labour government’s decision not to set maximum waiting times for patients to access mental health treatment, despite introducing them for key physical health services such as A&E units and planned operations, was an example of the inferior status psychological illness has received from Whitehall and the NHS, she added.
The coalition has pledged to rectify that imbalance by bringing in waiting times for mental health treatment from next April, though practicalities are still being discussed.
Mental health conditions, such as anxiety, depression and schizophrenia, make up 23% of all the conditions dealt with by the NHS. But the service in England spends just 13% of its annual £110bn budget on diagnosing and treating mental ill-health.
Fewer than a third of people with common mental health problems get any treatment at all, the new president of the Royal College of Psychiatrists, Prof Sir Simon Wessely, told the Guardian last week.
Calling for more money for mental health, Wollaston said: “It’s got a very small share of the funding, given the morbidity associated with mental health problems. We all know that the big challenge for mental health, especially for child and adolescent mental health services, is the funding issue. NHS England and Monitor [the NHS’s financial regulator] need to set out very clearly how the financial levers within the NHS are going to be changed … because the problem at the moment [is] the way that funding works across the NHS has always disadvantaged mental health treatments compared to physical health treatments.”
Higher spending would ultimately save the NHS money by helping keep people with mental health conditions healthier for longer and reduce early death, Wollaston believes.
Denis Campbell is health correspondent with the Guardian and the Observer. Since joining the Observer in 1999 he has covered sports news, social affairs and education. He previously worked for the Herald, Scotland on Sunday, Time Out and the Irish Times
Cedit: Guardian Newspaper Link: http://www.theguardian.com/society/2014/aug/17/mentally-ill-children-police-cells