On Saturday night, I spent the evening with out-of-hours mental health services in Halifax to see how services cope when someone requires urgent support and care, outside of the normal service hours.
In my experience, the late and early hours of the weekend are when front line services are under the greatest pressure, and you really see what is going on.
I’ve done a series of shifts with front line services in my constituency now and seeing the problems they face has been like turning over a stone, and you can’t quite believe what you’ve uncovered.
The first thing to say is that everyone I met, from the ‘Approved Mental Health Professional’ or AMHP who I was shadowing, to the police officers, the psychiatrists, and NHS staff who I came into contact with that evening were some of the most compassionate and dedicated people. Yet their efforts to do their best for those in a crisis were undermined by the failings in the system and more specifically a lack of appropriate beds.
Especially at night, the police are called as first responders to mental distress and under Section 136 of the Mental Health Act, they may detain someone they believe may cause harm to others or themselves, and bring them to a place of safety in order to be assessed and to establish what the most appropriate course of action.
There are just two ‘136 suites’ in the whole of West Yorkshire, with each suite able to accommodate one patient. One suite is at The Dales facility at Calderdale Royal and the other is in Wakefield.
Despite the lack of beds there is increasing pressure on our mental health services. This was evident during my shift when in Halifax alone two people were detained under the Mental Health Act, and there was no place of safety available for the second person.
Staff explained to me that this wasn’t unusual as there are frequent incidents where some of the most vulnerable people remain in the back of police cars, until an appropriate 136 suite becomes available – sometimes hours later.
A further problem arises once an assessment in a 136 suite has taken place and a decision has been taken to detain a person for further treatment. There is such pressure for beds in NHS mental health units that there are often none available anywhere in the country. A person can then wait in the 136 suite for hours.
When a bed becomes available a patient can be taken anywhere in the country and lengthy journeys can all compound what could already be a difficult experience for someone who is at crisis point.
A shortage of beds is also putting increasing pressure on the Police. As was the case on Saturday night, the police officers who brought the patient to the 136 suite could not leave until the patient had been released by the one staff nurse on duty at the suite.
The nurse may be uncertain exactly how serious the patient’s condition is, so it becomes almost impossible for the lone nurse to be left with a patient without a police presence, meaning officers have to stay.
In addition if the 136 suites are full officers must stay with anyone who is detained until a suite becomes available. Over the Halloween weekend, I saw how this placed serious pressure on the numbers of officers available to respond to 999 calls.
We have to do better than this. I will be pulling together all of the agencies involved in the situations I witnessed on Saturday night to establish what changes we can bring about locally. However a durable solution ultimately requires more funding from the Government and more beds to be available nationally.
I will be sharing my experiences with the Government, who have a duty to offer treatment, with dignity and care, without delay, for those who need it. I fear we have a long way to go.