It is absurd that today a child who has committed no crime can end up in a prison cell because the right mental health service isn’t available to them. Where other medical emergencies, such as heart attacks, warrant an ambulance to A&E, a patient suffering a mental health crisis can find themselves in the back of a police car and detained for up to 72 hours in a prison cell.
Today the long-overdue Policing and Crime Bill has its second reading. The bill has the potential to ban treatment for people with mental health problems that would never be thought acceptable for those with physical illnesses.
It will ensure that a child in a crisis cannot be held in a police cell and that cells will be used only in exceptional circumstances for adults. It will also guarantee that a person in crisis cannot be held against their will for more than 24 hours without an assessment by a professional.
The Royal College of Psychiatrists has long called for these changes, but laws don’t come with magic wands attached. Saying that no child having a mental health crisis should end up in a police cell is the easy bit. According to the Care Quality Commission there is not a single A&E department or mental health trust in Devon, Norfolk, Lincolnshire, Kent or Bath to which a patient under 16 can go as a place of safety to be assessed.
The difficulty in finding psychiatric beds will make it difficult to ensure that everyone gets an assessment within 24 hours. Under existing guidance a professional can only complete an assessment under the Mental Health Act if they are sure there is an bed available in a secure acute psychiatric hospital.
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The independent commission, led by Lord Crisp and supported by the college, found that patients were being sent to hospitals up to 95 miles (150km) away. Sometimes beds just aren’t available anywhere. How can a professional complete their assessment? Either the assessment is delayed and people are held too long, or the patient is released.
The NHS staff who provide community-based crisis mental healthcare are terrific, but there is only so much they can do. Too often people who should be sent to secure wards are left with community teams because there are no beds available.
I hope this bill is passed, but I also hope the government does not think that changing the law will magically make these problems disappear.
Professor Simon Wessely is president of the Royal College of Psychiatrists