Mental illness and handcuffed

[dottycat123]

I am hoping someone with legal knowledge can help me with a work situation. I am a mental health liaison nurse in a general hospital. Many people who I assess are in a highly distressed state and can be aggressive. The police frequently bring people into the A&E department who have been removed from risky situations. There is a huge move to reduce the number of people detained by police under section 136 of the mental health act, therefore the consent of people arriving with the police in A&E is questionable at times. A few weeks ago the police brought a young woman in after an episode of self harm, she was aggressive and trying to leave. It was suggested to the police they utilise a section 136 they declined and handcuffed her . Eventually she calmed down after sedation and the handcuffs removed. Is it legal to handcuff in this situation when not arrested or detained under the MHA ? I have complained to the local police representative for vulnerable people but my question about handcuffing has been ignored in the complaint.

What's the alternative?

It's not that I think there is an alternative it's if there is a legal requirement for a person who is handcuffed to be detained under the Mental health act or under arrest, can someone not arrested be handcuffed?

Sounds like a lawful use of force to prevent harm to others and damage to property, but if you have a problem complain to your local force and they ought to investigate, or alternatively arrange a meeting with the force's Mental Health officer.

I have contacted the police vulnerable adult worker about it but am struggling to understand if the law allows for people to be handcuffed in this situation. I just thought that by utilizing a 136 detention it would have been within a recognized legal framework and somehow 'better'.

The police are entitled to use reasonable force where appropriate. That includes the use of handcuffs. If the police reasonably believe that someone is likely to become violent they can handcuff the individual concerned. So yes, they are allowed to use handcuffs in this situation provided it is reasonable to do so.

Thanks for clarifying this.

Surely if the person is in an ED you could apply a section 4, 5(2) or 5(3)

But I agree that there should be clarity regarding consent.

Why are you seeking clarification on MNet rather than through your Trust's Safeguarding/legal team?

Of course they can. She was being aggressive so the police handcuffed her, sounds like for their own protection. She calmed down so they took them off. What’s the issue? Why should the police get hurt?

Would they have been able to sedate her without the handcuffs? Had she attempted to assault the police or staff or self harm in the ED?

Yes it's fine for them to handcuff her. The police are so often left to deal with mental health issues when people trained in mental health issues won't. What they need is support from mental health workers, not complaints. Please stop making their already difficult job more difficult

Surely sedating someone is a form of restraint. Shouldn't that also only be used as a form of last resort? I see it as not much different to handcuffing someone.

You are taking away their right to move independently.

The police are protecting themselves from potential assault. It was a short term measure and they were removed as soon as the situation was assessed and the patient calmed down.

Yes lets waste hours of police time hanging about in A&E.

If the person was drunk to the point of collapsing you would bring them in to A&E do you expect police to hang about while they sober up.

In the case of the young vulnerable woman they brought her to a place of safety most appropriate for her needs.

Have you sought advice from the RCN legal team or your safeguarding lead.

How are you able to sedate them if they aren't detained under the mental heath act? Don't they have to consent to medical treatment? For that matter if they aren't detained or sections can't they just leave the hospital?

I'm not doubting that the sedation etc isn't in their best interests, but surely it's all part of the same legal process / situation?

Could you have used a rmn holding power for a few hours until the psychiatrist arrived instead of a 136 to take charge. Or can you use a DOLS in these circumstances.