Repeated Police Mental Health Act Detentions in England and Wales: Trauma and Recurrent Suicidality

Int J Environ Res Public Health. 2019 Nov 29;16(23):4786. doi: 10.3390/ijerph16234786.

Abstract

Most police Mental Health Act (Section 136) detentions in England and Wales relate to suicide prevention. Despite attempts to reduce detention rates, numbers have risen almost continually. Although Section 136 has been subject to much academic and public policy scrutiny, the topic of individuals being detained on multiple occasions remains under-researched and thus poorly understood. A mixed methods study combined six in-depth interviews with people who had experienced numerous suicidal crises and police intervention, with detailed police and mental health records. A national police survey provided wider context. Consultants with lived experience of complex mental health problems jointly analysed interviews. Repeated detention is a nationally recognised issue. In South East England, it almost exclusively relates to suicide or self-harm and accounts for a third of all detentions. Females are detained with the highest frequencies. The qualitative accounts revealed complex histories of unresolved trauma that had catastrophically damaged interviewee's relational foundations, rendering them disenfranchised from services and consigned to relying on police intervention in repeated suicidal crises. A model is proposed that offers a way to conceptualise the phenomenon of repeated detention, highlighting that long-term solutions to sustain change are imperative, as reactive-only responses can perpetuate crisis cycles.

Keywords: Section 136; lived experience; personality disorder; police Mental Health Act; repeated detention; suicide and suicide prevention; trauma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Commitment of Mentally Ill / statistics & numerical data*
  • England
  • Female
  • Humans
  • Male
  • Mental Health Services / legislation & jurisprudence*
  • Middle Aged
  • Police / statistics & numerical data*
  • Self-Injurious Behavior / epidemiology*
  • Suicide, Attempted / statistics & numerical data*
  • Wales
  • Young Adult