Clarity – NSIMHN express concern at the lack of a place of safety in North Somerset.
There is currently no designated place of safety within North Somerset, the nearest ones are Bridgwater police station, or Southmead hospital in north Bristol. This then means a traumatic ride in the back of a police car/van to one of these places, and an expensive and anxiety inducing journey back on public transport where the person concerned may not even know the route. It’s difficult to see how this constitutes safety when someone is struggling. More than this, often the prospect of being taken so far away can push someone who is struggling and just needs someone to talk to – into crisis.
What is a designated place of safety?
The term “place of safety” is used in the Mental Health Act 1983, section 136 of the Act gives police officers the power to remove an apparently mentally disordered person who is in a public place and is apparently a danger to them-self or to other people, to a “place of safety” where they may be assessed by a doctor.
In practice, agreements between local authorities, NHS Trusts and police constabularies are in place, designating certain establishments as places of safety. The owners or managers of an establishment acting as a place of safety have a legal obligation to ensure that a detained person cannot leave the premises until he or she has been fully assessed, which may take up to 36 hours. Invariably, therefore, to ensure safeguarding of both the detained person and the public, places of safety are typically restricted to psychiatric hospitals and police custody suites, and tend to exclude open general hospital wards and accident and emergency departments. For the same reason, it is most unusual for friends’ or relatives’ homes to be designated places of safety.
Why is this a problem in North Somerset?
Often people who present as being in mental distress are not in full crisis, and can be helped by something as simple as a friendly face with a trained listening ear so they can talk through their distress. Rarely do emergency service staff have the training and skills required to tell the difference between this and someone who is in full mental health crisis, leading them to err on the side of caution and resort to Section 136 of the Mental Health Act to detain the person and take them to the nearest designated places of safety in Bristol or Bridgwater, It’s worth noting that the use of either still incurs a cost to North Somerset. Often the prospect of being taken far away can push people over the edge, and we’ve heard many stories of people resisting detention and often having to be forcibly restrained, not because they don’t want help, but because the idea of being so far from home with no idea how to get back, is a frightening and traumatic prospect.
This doesn’t work on any level. It’s unnecessarily traumatic for the person in distress, it puts extra pressure on the police and their duty to keep people safe, people are in even more distress than they might otherwise have been when they reach the place of safety, and unnecessary expense and anxiety is generated to get people home again. It is not a kind and compassionate approach to people in distress, and it is not acceptable.
What’s the solution?
The obvious solution is to have a designated place of safety at an accessible place within North Somerset. Further this also presents the possibility to incorporate prevention and recovery work into the place of safety principle, and design services that allow people to take control of their own well-being when they’re in distress. Services such as Bristol Sanctuary fulfil this role, allowing people to have their own sense of agency in resolving their distress, and reducing the need for more costly and direct interventions.
We call on BNSSG CCG to review the place of safety policy in North Somerset, and consult with service users and other interested parties to find ways forward that suit all involved.