Government advises against cell use for children with mental health problems

The Mental Health Crisis Care Concordat says every local area should establish protocols that set out how police officers should use powers under the Mental Health Act to ensure that a person deemed in need of emergency mental health care receives an assessment and are taken to a health-based “place of safety” rather than a police cell.

The protocols, which should be agreed by NHS commissioners, the police, the ambulance service and social services, need to make specific arrangements for dealing with children and young people detained under the act.

The Concordat says that protocols should ensure police custody is never used as a place of safety for children and young people except in exceptional circumstances. It defines this as “where a police officer makes the decision that the immediate safety of a child or young person requires it”.

“Even in cases where police stations are used, the use of cells should be avoided, and alternatives considered wherever possible,” it adds.

In addition, the Concordat states that units attached to adult wards in mental health hospitals can be used as places of safety if child-dedicated facilities are unavailable – under the Mental Health Act 2007, hospitals should provide "age-appropriate" facilities that are separate from adult wards.

The new advice comes just weeks after the Care Quality Commission revealed that 41 children were held in police cells in the South West under the Mental Health Act because of a lack of age-appropriate places of safety at local hospitals.

Figures published last week showed that 350 children have been treated on adult psychiatric wards so far this year.

The Concordat also highlights the importance of staff in hospital adolescent inpatient units having the “appropriate skills, experience and resources” to support those aged 16 to 18 whose care may soon transfer to the adult system.

Schools and youth services should be fully involved in developing crisis strategies for children and young people as they will often be the first to identify the problems a young person is experiencing.

It recommends that services ensure groups with a higher prevalance of mental health problems, such as looked-after children, care leavers and those leaving youth custody, have good access to mental health crisis care.