IntroductionThis section of the Guidance sets out the legal responsibilities of police officers when in contact with persons with a mental disorder, and provides the general principles to inform local protocols between the Police Service of Northern Ireland (PSNI) and Health and Social Care Trusts and Board to ensure the appropriate management of persons detained for protection and assessment under the Mental Health (Northern Ireland) Order 1986 (MHO). Protocols are essential in ensuring that all parties are clear about the factors to be considered when deciding if police involvement is necessary in a particular situation. For example, agencies can agree criteria which indicate whether a situation is low, medium or high risk in terms of the likelihood of it resulting in violence and the nature of that violence.

The PSNI have a key role to play in providing an appropriate response to people with mental ill health and/or learning disabilities and facilitating access to a range of other agencies when required.

The PSNI is committed to equal access to services and social inclusion for all groups, particularly in relation to age, disability, gender, race, religion or belief and sexual orientation. This means that all police officers and police staff will be sensitive and responsive to people's differences and needs and will integrate this into the service they provide ensuring that nobody is disadvantaged as a result of their belonging to a specific social group.

The Police Service does not have primary responsibility for every task relating to people with mental ill health or learning disabilities and should not assume, directly or indirectly, responsibility for dealing with all related issues the public or other agencies may present them with. Other partner agencies are often better placed to deal with certain situations, and may in fact have statutory responsibility for them. The police, therefore, should always be ready to support, guide and assist, but not necessarily to lead. Taking on other agencies' responsibilities has a number of disadvantages for the police, including that it may mean the police are legally liable in the event of something going wrong, and it can set up risks for the police, for example, problems arising from not responding to other calls for which they have direct responsibility.

Although the police are expected to consider the Guide and the Code of Practice for the Mental Health (Northern Ireland) Order 1986, the Order does not place a statutory duty on them to have regard to it. Where the Code addresses areas that are relevant to policing police officers will continue to be governed by the primary legislation which provides the relevant power.

With this in mind, we fully accept that it is only by working effectively with other agencies that we can truly safeguard vulnerable people.

When supporting Health & Social Care agencies in the management of patients under the MHO, the police will consider their role under a number of other key pieces of legislation. Ultimately the PSNI will carry out their duties as outlined within Article 32 (1) of the Police (Northern Ireland) Act 2000. This outlines the general functions of the PSNI as follows:

(1) It shall be the general duty of police officers:

  • To protect life and property;
  • To preserve order;
  • To prevent the commission of offences;
  • Where an offence has been committed, to take measures to bring the offender to justice

Other key legislation includes:

  • The European Convention on Human Rights (ECHR). Article 5 (1) (e) provides for the 'lawful detention… of persons of unsound mind'.
  • Police and Criminal Evidence (NI) Order 1989 (PACE) and Common Law provide the legal basis for police actions and the appropriate procedures prescribed by law must be strictly followed.
    LINK TO Police and Criminal Evidence (NI) Order 1989 (PACE)
  • Section 75 Northern Ireland Act 1998 considerations

Article 65, PACE outlines that the Secretary of State (now the Department of Justice) shall issue codes of practice in connection with:

  • The exercise by police officers of statutory powers:
    • To search a person without first arresting him;
    • To search a vehicle without making an arrest; or
    • To arrest a person;
  • The detention, treatment, questioning and identification of persons by police officers;
  • Searches of premises by police officers
  • The seizure of property found by police officers on persons or premises.

The above is particularly important when Police are exercising Article19 PACE (NI) Order 1989 in entering premises if there is no time to obtain a warrant in an emergency situation. 1. Police Power to Remove a Person to a 'Place of Safety' Article 130 of the MHO empowers a police constable, who finds a person in 'a place to which the public have access' who appears to be mentally disordered and to require immediate care and control, to take that person to a place of safety The police officer who removed the person has a duty under Article 130 (3) of the Order to inform, where practicable, the nearest relative and a responsible person

If all elements of Article 130 MHO are present, and the person is not arrested for an offence, they should always be detained under the MHO and taken to a place of safety.

The power to detain a person, and remove them to a place of safety under Article 130 of the MHO is a preserved power of arrest by virtue of Schedule 2 of the Police & Criminal Evidence (NI) Order 1989 (PACE). The police officer should explain to the person that s/he is being detained under Article 130. It is important to recognise that although the Order uses the term "remove", it is deemed to be an "arrest" for the purposes of the PACE (NI) Order 1989.

There is no requirement to caution a person detained under Article 130 MHO and this need not be done, unless questions are put to them to obtain evidence that may be given in court or it is impracticable due to their condition or behaviour at the time.

Whilst a person detained under Article 130 MHO is entitled to know that their liberty is being temporarily restricted, formally telling them that they are 'under arrest' is likely to be counter-productive in that it may:

  • Cause the person to feel that their mental health needs are being criminalised thus contributing to stigma
  • Increase the person's agitation and possible resistance to help
  • Lead to an increased risk of having to use restraint. The police officer should ensure that an ambulance has been called.

2. Conveyance from Public Place The preferred option at all times is that a patient should be transported via an ambulance. Police should travel in the ambulance with the person, as police are unable to delegate the authority to convey. A person should only be transported in a police vehicle in exceptional circumstances. These exceptional circumstances might include when the person whose detention is sought, is behaving in a way that might cause serious harm to themselves, is extremely violent, is making threats against others involved in the conveyance process or is causing a serious breach of peace. On the rare occasions that this occurs, the police vehicle should be accompanied by an ambulance vehicle so that rapid assistance can be provided if a medical emergency arises.

Where an ambulance is requested, police have a responsibility to provide the Ambulance Control with appropriate information in respect of a detainee. Ambulance staff have responsibility for all decisions regarding the clinical treatment of a detainee following their arrival at the location of the detainee. 3. Place of Safety A place of safety is defined in the Order as "any hospital of which the managing Board or HSC Trust is willing temporarily to receive persons who may be taken there under this Order, any police station or any other suitable place the occupier is willing temporarily to receive such persons".

The Guide contains a list of hospitals that could be used as a place of safety. However this list is now out of date and police should continue to bring persons detained under Articles 129 and 130 to the local A&E department until further guidance in relation to which hospitals can be used to fulfil this function is provided by Health and Social Care Trusts.

It should not be automatically assumed that because a person is violent, that the police station is an appropriate place to detain them. Violent behaviour may be connected to conditions for which appropriate medical assessment and treatment is required.

A police station should only be used as a 'place of safety' in exceptional circumstances and for the minimum length of time possible. By design and functionality, police cells are not suitable for people suffering from a mental disorder and can exacerbate their conditions.

A person moved to a place of safety may be detained there for a period not exceeding 48 hours. Once suitable arrangements have been made, the person can no longer be detained at a police station under Article 130.

Where police convey a person to an A & E Department, it will be the responsibility of the relevant Trust to make the necessary arrangements for assessment under the MHO. A person is defined as 'arriving' at a place of safety when their care is formally accepted by a relevant healthcare professional managing that location. Police Officers bear legal responsibility for the health and safety of this person until a handover has taken place. During the 'handover' period the Trust staff should be able to co-ordinate their staff and obtain all relevant information from the police officer attending.

At the hospital premises, the doctor/medical staff are responsible for the assessment of the detainee and their physical and mental welfare.

For those who have committed an offence, Police will accompany and remain with a detained person during the period that they are removed from the custody unit and remain under arrest and in police custody. The number of police staff present will be determined by police following consultation with hospital healthcare and security staff, as appropriate, and will be sufficient to manage any identified risk to the detainee, police, hospital staff and members of the public.

Police may remain after the handover has taken place if they wish to consider an arrest once the mental health assessment has been completed or because the joint risk assessment has indicated the need for continual police presence due to a medium to high risk of violence or absconding or breach of the peace.

In an event of any disagreement concerning whether police officers shall remain in attendance, this should be resolved by the Hospital Staff and a Police Officer of at least Inspector rank. If issues cannot be resolved, then contact should be made with the Medical Director and appropriate Senior Representative within the PSNI.

Local protocols are required to be developed with the relevant Health Trust or Health & Social Care Board to specify the time period that an officer could reasonably be expected to remain there. These procedures should also specify police actions in respect of a person who is intoxicated and/or exhibiting signs of drug taking.

On police leaving hospital premises, responsibility for the security of the detainee will be retained by hospital security staff. Should a risk of violence by the individual subsequently escalate to a level requiring police intervention, police will be called via 999. 4. Target times for a Mental Health Assessment The assessment by the doctor and Approved Social Worker (ASW) should begin as soon as possible after the arrival of the individual at a place of safety. Where specific issues exist, for example the detained person is believed to have consumed alcohol and/or drugs the mental health assessment may be delayed until they are deemed fit to be assessed. A decision as to whether or not a mental health assessment is to be delayed should be made by the ASW in conjunction with the doctor and the police. Police should not remain with the individual unless a joint Risk Assessment states that the person is behaving in a way that might cause serious harm to themselves, is extremely violent, or is making threats against others involved.

If police officers are delayed from being released, this should be brought to the attention of a police officer of at least Inspector rank. 5. Police role in facilitating compulsory admission to hospital for assessment. There is no legal requirement for police to become involved in the routine management or movement of mentally ill persons. It should be borne in mind that the stigma associated with police involvement may prolong the symptoms of person's mental illness long after treatment interventions have been concluded. Furthermore the routine presence of police officers at such situations could be considered a breach of the person's right to privacy under Article 8 of the European Convention on Human Rights.

In most cases, police presence is requested where this process is taking place on private premises (typically the person's home address) and:

  • An application for compulsory admission to hospital for assessment has been made; or
  • The application process for compulsory admission to hospital for assessment has not yet taken place.

Local protocols should specify that an ASW or a GP should only request police presence at an application for assessment where they have carried out a risk assessment, and the result of that assessment is that the presence of the police is both proportionate and necessary. Police presence may be called where the ASW or GP identifies a significant risk of:

  • Violence or the threat of violence being used against those involved in the application for assessment or other persons present
  • Self harm by the individual to be assessed
  • Entry to the premises being refused and where it is necessary to obtain a warrant issued under Article 129 of the MHO, authorising a Constable, accompanied by a medical practitioner, to remove the patient to a place of safety

It is for the police to make the decision whether or not to provide a police presence. Where police presence is refused, the circumstances should be thoroughly documented. 6. Warrants There are additional powers under the MHO for an ASW to apply for a warrant, in order that access to premises is gained using force if necessary and, if necessary, remove that person to a place of safety with a view of detaining them under the MHO.

Where the risk assessment for a non-emergency event indicates that either entry will be refused, or that the process will be obstructed by the behaviour of the person, or other persons, police will require the ASW to apply for an Article 129 warrant. Where an ASW declines to make such an application in relation to a non-emergency event, police should decline to provide assistance. The need for and the use of such warrants are extremely rare, and is not a routine matter in every assessment.

Although in possession of a warrant, it is preferable to gain consent to enter the premises. Formally serving a warrant may have an adverse impact, given the sensitivities and public perceptions surrounding such situations, and given that the subject may be fearful and/or confused.

When a 129 warrant is executed, it shall be the responsibility of the endorsing police officer to deliver the warrant to Court Services. Unexecuted warrants will be delivered to Court Services by the ASW.

In emergency situations where there is no time to apply for a warrant, the circumstances may necessitate recourse to powers of entry to prevent a breach of the peace under Common Law or Article 19 PACE (NI) Order 1989.

There may be circumstances that delaying action to facilitate an ASW to seek an Article 129 warrant based upon a presumption of denial of access could leave the individual or others within the household at risk of violence or injury. Police Officers should therefore consider the need to protect others within the household, especially children or other vulnerable adults. 7. Police Response to an Assessment in Progress As well as pre-planned police involvement, unforeseen circumstances may occur whereby the ASW/GP/Ambulance personnel consider it necessary to call police to the scene of an assessment in progress. In all such cases, officers in attendance at the scene will be required to carry out a dynamic risk assessment and ensure that any action taken by police is legal, proportionate and necessary. Police will not attend in cases involving a difficult, but non-violent subject whose past history and present diagnosis gives no rise for concern for the safety of other agencies present. Before any police intervention, officers will have due regard for what other options were considered by the ASW/GP/Ambulance personnel in attendance, including the provision of adequate resources to manage the situation. 8. Request for Police to assist with hospital patients who present particular management problems Nothing contained in this section shall compromise the statutory and professional duty of a police officer to protect life and property, preserve order, and to prevent the commission of offences.

The MHO Code of Practice sets out how hospitals can prevent and respond to conduct presenting particular problems of management. It makes no mention of using police to assist in the controlling or restraining of patients. Whilst hospital staff have powers under the MHO to do so, this power does not extend to police officers.

However, healthcare staff should be afforded the same level of protection from violence as any other person, and therefore should feel able to report violence in whatever form it takes to the police, so that appropriate action can be taken. Whilst police may be called to assist hospital staff with in-patients who are receiving treatment or assessment, either as patients detained under the MHO or voluntary patients, they should not be routinely involved in patient management. Only in exceptional circumstances where it is beyond the capability of the hospital staff to manage the situation, and a serious breach of the peace has, or is likely to occur, will police respond to such situations. In all such cases, officers must ensure that any action taken by police is legal, necessary and proportionate, and that the rights of the patients are preserved.

9. Transportation and escort between Hospitals Nothing contained in this section shall compromise the statutory and professional duty of a police officer to protect life and property, preserve order, and to prevent the commission of offences.

There are no general powers under the MHO for police officers to transfer existing detained persons between hospitals.

Requests from Trusts for police involvement based solely upon patient history (e.g. is potentially violent) will be refused. Only in exceptional circumstances, it may be considered proportionate and necessary to provide a police escort during transportation. Such circumstances are cases where there is information to indicate that intervention by the public or other parties may occur, and that this intervention may present:

  • A significant danger to the public or Trust staff and/or
  • Risk of escape

10. Persons with a mental disorder who have absconded (AWOL) Persons who are liable to be detained under the MHO, and who are absent without leave, or fail to return within a prescribed period, may be arrested by the police without warrant, and returned to the relevant hospital. This power exists for 28 days, beginning with their first day of their absence without leave. The person should be informed in simple terms that the return to hospital is under the provisions of the MHO, and that a fuller explanation will be given at the hospital.

Where patients, who are for the time being subject to Guardianship, absent themselves without the leave of their Guardian from a place at which they are required by the Guardian to reside, they may be taken into custody and returned to that place by any constable or other authorised person.

Any person required to be conveyed, kept or detained by virtue of the MHO shall be deemed to be in legal custody. Such a person may be retaken by the person who had custody immediately before the escape, or by a constable, or ASW. A person who escapes while being taken to or detained in a place of safety under Article 129 or Article 130 shall not be retaken under this Article after the expiry of 48 hours, beginning from the time when they escape or the periods during whey they are liable to be so detained, whatever expires first.

If the person has absconded from Hospital after Police have left them in the care of Trust staff, then the Trusts bears the legal responsibility for the health and safety of this person. Persons subject to Part III of the Order A court may remand an accused person to a hospital for the purpose of reports or treatment. Where such a person absconds, they may be arrested without warrant and brought before the court that remanded them, as soon as practicable. In certain circumstances, a court may make an 'Interim Hospital Order' which commits a convicted person to hospital for treatment. If an offender absconds from a hospital in which they are detained in pursuance of an Interim Hospital Order, or whilst being conveyed to or from such a hospital, they may be arrested without warrant, and brought as soon as practicable before the court that made the Order. 11. Patient Restraint If persons are being transferred from a Public Place to a place of safety the Police have the power to use reasonable force, if necessary, in the exercise of powers under Article 130. The legal authority for the use of force in the exercise of this power is to be found in Section 3 of the Criminal Law (Act) 1967. Any use of force in these circumstances must be based upon a need to ensure the provision of 'immediate care and control' and must be necessary and proportionate.

If force and/or restraint have been used, the arresting officer should inform clinical staff upon arrival at the place of safety (which is not a police station) and the type of restraint used and for how long.

There is no power under the MHO for police to assist in the controlling or restraining of patients already within Hospital. There is power for Hospital Staff to do so for detained patients.

In circumstances where there is no obvious risk of harm to the patient or others, police officers will not restrain a patient unless they are carrying out an arrest for an offence, e.g. an assault on hospital staff or breach of the peace. There is also the issue in relation to restraint for 'voluntary' patients. Police officers do not have the powers to restrain under the MHO for voluntary patients. However Common law could allow them – but this is under special conditions.