Archive for the ‘Advocacy’ Category

Disability Wales Independent Living Campaign

June 7, 2010


 Disability Wales Independent Living NOW! Campaign

 Mid Wales Campaign Briefing – a free event  

Wednesday 7th July 12.30pm – 3.30pm,

 starting with lunch

Llandewi Village Hall, Llandewi Ystradenni, Powys LD1 6SF

‘Independent Living enables us as disabled people to achieve our own goals and live our own lives in the way that we choose for ourselves’ (DW 2009)

 Disability Wales in partnership with Disability Powys and Dewis Centre for Independent Living invite disabled people & local organisations to attend a half day event to find out more about the Independent Living NOW! Campaign and how you can get involved.

The campaign was launched in Cardiff Bay on 28 April 2010 and will run through to March 2011. The campaign provides an opportunity for all disabled people in Wales to make their voices heard ahead of the next National Assembly Elections in May 2011. The campaign is calling for  the introduction of a National Strategy on Independent Living. An online petition has been started to support this on the National Assembly for Wales website. PLEASE SIGN THE PETITION TODAY!!

 During the campaign we are gathering disabled people’s experiences of Independent Living – both good and bad. Do you have experiences that you would like to share? Whether it relates to housing, transport, personal assistance, community care, employment, aids & equipment, advocacy…we are keen to listen and utilise your experiences to influence change in Wales.

For further information and to book a place please contact:

Disability Wales, Bridge House, Caerphilly Business Park, Van Road, Caerphilly CF83 3GW  Tel: 02920 887325  Email:



Independent Police Complaints Commission – Report on S136

September 10, 2008


Twice as many people are detained in unsuitable police custody for assessment under the Mental Health Act as those taken by the police to hospital for this purpose, according to research published by the Independent Police Complaints Commission (IPCC) today (10 September).

During a one year period (2005/06) over 11,500 people were detained in a police cell as a place of safety under section 136 of the Mental Health Act. In the same period 5,900 people were taken to and detained in a hospital.

The IPCC’s report, ‘Police Custody as a “Place of Safety”: a National Study Examining the Use of Section 136 of the Mental Health Act 1983’, examines the nature and extent of the use of police custody as a place of safety across England and Wales. It is the first time national data on the use of section 136 by all 43 police forces has been collated. The report makes a number of recommendations for the police and health services to improve practice and the experiences of the many thousands of people detained by the police under this power.

Under section 136, police officers can detain people, believed to have a mental disorder, who are in a public place and take them to a place of safety such as a hospital or police station for assessment.

Ian Bynoe, IPCC Commissioner with national responsibility for mental health, said: “Someone whose distress or strange behaviour causes the police concern needs rapid medical and social assessment in a safe environment. It is therefore intolerable that even though it has been Government policy since 1990 that a hospital is the preferred place of safety for such an assessment our research shows that twice as many people are detained in police custody as in a more fitting hospital environment.

“Police custody is an unsuitable environment for someone with mental illness and may make their condition worse, particularly if they are not dealt with quickly, appropriately and don’t receive the care they need. The continued use of cells not only diverts police resources from fighting crime, but criminalises behaviour which is not a crime. A police cell should only be used when absolutely necessary, for example when someone is violent, and not as a convenience.”

Key findings

  • An estimated 11,500 people were detained in police custody as a place of safety in 2005/06. This compares with about 5,900 people in a hospital environment that year.
  • The use of section 136 varies significantly between police forces. The average rate of detention across England and Wales was 55 detentions per 10,000 people in custody. Low rates of detention were reported by Cheshire and Merseyside Police (1 per 10,000 people in custody). High rates were reported by Sussex Police (277 per 10,000) and Devon and Cornwall (174 per 10,000).
  • Just under two thirds of people (61%) detained in police custody were male.
  • The average age of those detained was 36 years, but the ages ranged from 12 to 89 years. Four per cent of detainees were aged 17 or under. Four people were 12 years old.
  • Almost eight out of 10 (78%) of detainees were White; 4% were Black; 3% were Asian; 2% other ethnic origins and 14% were of unknown ethnicity. When compared to the general population the rate of detention for Black people was almost twice (1.7 times) as high than for White people.
  • The majority of people (78%) were detained in police custody for 12 hours or less. The average length of time spent in police custody was nine hours and 36 minutes. Ten individuals were detained for over the legal limit of 72 hours. Almost two thirds (65%) of section 136 detainees arrived in police custody outside of normal office hours (between 6 p.m. and 9 a.m.).

Differences across England and Wales

The IPCC’s research examined why the rates of the use of section 136 varied so much between police forces.

The strongest factor in explaining the differences in the rates of use of police custody is the availability of alternative places of safety. Alternative places of safety were more readily available and more commonly used in low rate and some medium rate forces, than higher rate areas.

A strong factor in some forces was suicidal behaviour associated with high local populations of transient and deprived populations, along with well known ‘suicide spots’ such as seaside cliffs in the police force area. These tended to be in areas where there was little or no alternative to police custody and so had the effect of pushing rates of detention up.

A number of people were being repeatedly detained and released under section 136. They were often felt to be more difficult to assess and care for due to the complexity of their problems, for example having a combination of mental disorder and substance abuse. In some areas outreach work was being conducted in order to reach these people and reduce the numbers of detentions in future.

Other examples of differing practice include officers in forces with lower rates of the use of section 136 finding it less bureaucratic to arrest for minor offences such as breach of the peace, compared to officers in higher rate forces where the reverse was true. This could account for some differences in the rates of detention.

Inconsistent and incomplete data recording by police forces means that information is not available on what happened to section 136 detainees after they were released from police custody. This makes it difficult to establish whether the power is being used appropriately.

Mr Bynoe said: “The strongest factor in explaining the differences in the rates of section 136 use by police is the availability of alternative places of safety. Our research found that alternative places of safety were more readily available and more commonly used in low rate forces.

“When senior police officers and senior staff within health and social care recognise this is a joint problem which requires a coordinated approach it becomes more likely that alternative places of safety will be developed.”


The IPCC report sets out 22 recommendations to improve practice in the future:


NHS commissioners should:

Recommendation 1: work with relevant organisations to develop alternative places of safety to police custody. Consideration should be given to using existing facilities, such as hospital emergency departments and psychiatric units where it may be possible to set aside a space that can be used as a place of safety. These facilities should adhere to the Royal College of Psychiatrists’ standards on places of safety (2008).

Recommendation 2: consider applying for Department of Health funding to set up purpose built facilities where necessary; taking into account how they will staff these facilities using their existing resources. This funding does not apply to Wales and health boards there will need to consider local funding arrangements.

Recommendation 3: consider what preventative outreach work might be conducted to help individuals who are detained under section 136 frequently. Such outreach work may help to prevent some section 136 detentions and ensure that at risk individuals receive appropriate care and treatment.

Recommendation 4: use specialists, such as community psychiatric nurses, to provide outreach services to police custody and arrange mental health assessments. Joint funding from both the police and primary care trust/NHS commissioner would increase staff availability outside normal working hours.

Police forces should:

Recommendation 5: consider ways to improve the co¬ordination and timeliness of mental health assessments. For example, where specialists such as community psychiatric nurses are not available to arrange assessments, agreements could be made for approved social workers to co-ordinate assessments.

Recommendation 6: raise any problems with lengthy delays in mental health assessments in hospital emergency departments with the relevant primary care trust/NHS commissioner to see if a solution can be agreed – for example, the implementation of target times.

Recommendation 7: ensure that officers on the street have adequate training to recognise symptoms of mental disorder, understand their powers under the Mental Health Act 1983, and know what their local arrangements are for places of safety.

Recommendation 8: agree with other agencies that officers can contact individuals with mental health expertise, such as approved social workers, to get advice on particular individuals.

Recommendation 9: ensure that custody officers and staff receive refresher training on mental health symptoms and section 136 processes so that detainees held in police custody

Recommendation 9: ensure that custody officers and staff receive refresher training on mental health symptoms and section 136 processes so that detainees held in police custody receive appropriate care and attention.

Police forces and NHS commissioners should jointly:

Recommendation 10: meet at a strategic level to review the current arrangements with regard to section 136 detentions in their area. This should include a review of the effectiveness of existing protocols and agreements, if they exist. Section 136 should be seen as a joint problem and joint solutions should be sought.

Recommendation 11: review their arrangements for detaining under section 136 people who are intoxicated and/or violent to ensure that they get the most appropriate care. It might be possible to provide a non-police facility where individuals can be safely detained and assessed with police officers present.

Recommendation 12: look for solutions that improve the availability and/or timely attendance of doctors approved under section 12 of the Mental Health Act 1983, where this is a problem. Forces should require their forensic medical examiner provider to ensure that sufficient forensic medical examiners are section 12 approved. This could be particularly helpful in increasing the availability of specialist doctors outside normal working hours.

Recommendation 13: accurately and consistently record section 136 detentions both in police custody and hospital environments. The records should include key demographic details such as age, gender and ethnicity, along with the length and outcome of the detention (for example, whether the individual was taken to hospital). We support the Royal College of Psychiatrists’ (2008) suggestion that one national recording form for England and Wales is introduced. Police forces should also work to ensure that offenders with mental disorders are captured on their systems in order to identify the true scale of the detention in police custody of people with mental disorders.

Police forces, NHS commissioners, ambulance services, and social services should jointly:

Recommendation 14: agree a policy on the transportation of section 136 detainees being admitted to hospital following an assessment (within the wider conveyance policy required under the Mental Health Code of Practice). This should include detainees being held in police custody and at alternative places of safety. Ambulances should generally be used for transportation, unless there is sufficient risk to ambulance staff due to the violence of the individual. In such cases it may be acceptable to use a police vehicle. It is imperative that the transportation of a detainee occurs as promptly as possible, so as not to prolong their detention in police custody. It is therefore important that appropriate and realistic target times for transportation are set, agreed and adhered to.

Recommendation 15: agree a policy on the transportation of section 136 detainees being released back into the community (when transportation is necessary). This should include detainees being held in police custody and at alternative places of safety. The policy should specify which organisations are responsibility for transportation in the different circumstances, and which is responsible for paying for the costs involved in using taxis.

Recommendation 16: monitor section 136 detentions by multi-agency groups at a local level to identify any problems. This should include monitoring of the new power to transfer between places of safety to see how it is being used in practice.

The Healthcare Commission, and its successor, the Care Quality Commission, should:

Recommendation 17: collate annual data on section 136 to improve data collection and increase understanding of the use of section 136. If a national form is adopted for recording all section 136 detentions in custody and alternative places of safety, as suggested by the Royal College of Psychiatrists (2008), this information should be collected locally. The information can then be provided to the Care Quality Commission for collation.

Recommendation 18: conduct analysis into the data gathered on section 136 detentions, such as the make up of the detainees, length of time they are detained and the outcome of section 136 detainees to see what happens to the individuals. This will help to determine whether this power is being appropriately used across police forces. The data should be presented annually and be made available to the public.

The police, social services and mental health trusts should:

Recommendation 19: provide joint training on section 136 and mental health. This will help to improve communication and understanding about the different roles and responsibilities between the various organisations.

Recommendation 20: clarify the current situation by providing joint training on information sharing and what can be shared legally about a section 136 detainee.

Further research should:

Recommendation 21: examine and seek to explain disproportionality in the ethnic make up of section 136 detainees.

Recommendation 22: explore the experiences and perceptions of section 136 service users’ experiences. This is an important gap in our knowledge and understanding the experiences of these individuals could help improve the detention process and the care that people receive.

Mr Bynoe added: “This is an important piece of research which has implications for the police, health and social care services. We have written to the chief xxecutives of all primary care and mental health trusts, as well as all chief constables of police forces in England and Wales to make them aware of the findings and recommendations and encourage them to act upon these.

“Over the next year IPCC Commissioners will monitor whether their forces and local health and social care authorities have developed new protocols on the use of section 136 in their area taking account of the new Mental Health Act and the revised Code of Practice limiting the use of police custody to exceptional situations.”

“The IPCC will now work with ACPO, the Royal College of Psychiatrists and the Sainsbury Centre for Mental Health to ensure that our work and recommendations are taken forward.”

* ‘Police Custody as a “Place of Safety”: Examining the Use of Section 136 of the Mental Health Act 1983′,
Maria Docking, Kerry Grace and Tom Bucke, IPCC, London ISBN 978-0-9556387-1-8.

The report can be found here or is available from the IPCC,

90 High Holborn, London WC1V 6BH.



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IPCC publishes major study on use of s136 Mental Health Act

Monmouthshire Mental Health Service User and Carer Forum

February 16, 2008

The next meeting of this Forum will be at The Sessions House, 43 Maryport Street, Usk on Wednesday 20th February, 1.30 – 3.45 with a break in the middle.  You are welcome to arrive from 1pm onwards for a hot drink and a chat before the meeting starts.   For details see larger post further down this page.

Mental Health Services in Gwent.

February 15, 2008

The meeting being held on 11th March (see below) is important and was originally requested by the service users and carers in the Monmouthshire Mental Health Forum.   At a Forum meeting held in the Autumn of 2007, during which members held an open discussion with Rhian Lewis, Patient’s Panel Co-ordinator and the Chair of the Panel, seven Forum members volunteered to become panel members in order to represent mental health interests.   Following that meeting this one (11th March) has been arranged and will be attended by senior members of the Gwent NHS Trust.  All mental health carers and service users are strongly encouraged to try to find time to attend.  Places are limited (25) and if you are a carer or service user who has been, or still are receiving services, and who has a view on what needs to be done to improve these services, then you need to attend.  If you pass up this chance then you may well be ‘kicking’ yourself in the months ahead as new changes take place.  Is a member of your family about to move from children’s mental health services to adult services, or an adult member about to move to older adult services – and do you have worries about this?  What do you feel about mixed wards and facilities?  About services for Eating Disorders?   Do you self harm – and how have you been received and treated in A&E?    There are many issues for discussion – go along and have your say.   Phone Rhian for help with transport or anything else that you need, and you can also phone or speak to Jen Pearce or Tony Rigby if you prefer.  01291-673728   What is important is to fill those 25 seats and take the chance to talk with those who make the decisions.           

Gwent Healthcare NHS Trust

February 15, 2008

Gwent Healthcare NHS Trust wants to hear your views on

‘Mental Health Services in Gwent’ 

f you are a service user, carer or advocate the Patients’ Panel would like you to join them at a special meeting to discuss mental health services.   

Date:               Tuesday 11th March 2008

Time:              10am – 3.15pm

Venue:           YMCA, Mendalgief Road, Newport 

Numbers are limited, so if you would like to book a place, please contact Rhian Lewis, Patients’ Panel Co-ordinator by 4th March:     01633 623812 or 01633 623465Or e-mail to: 

What is the Patients’ Panel?    The Patients Panel is a very active group of about 60 patients, carers and members of the public whose aim is to work with the Trust to improve health services for all patients in Gwent.  There are four main meetings a year and panel members also contribute to many committees and working groups within the Trust and further afield.   In the four years since it was set up, the panel has become a very valued resource for the Trust and has gained a reputation for the positive contribution its members make. 

What is the purpose of this special panel meeting?  This panel meeting has been arranged to provide an opportunity for you to get your voices heard.  Senior members of the Trust will be there to listen and respond to the views expressed.   The Patients’ Panel is also keen to recruit more members who have direct experience of mental health services.  Information will be provided about how to join the panel. 

Format of the day… 

10.00 am       Tea/Coffee 

10.30 am       Welcome & introductions                                                                             

10.40 am       Presentation on the history of Psychiatry in Gwent                                    

11.10 am       What are your burning issues?                                                                         

11.40 am       Tea / Coffee                                                                                                   

12.10 am       Small group discussions (based on the hottest ‘burning issues’)                  

1.15 pm          Lunch                                                                                                                

2.00 pm          Feedback and questions from small groups to staff panel                             

3.00 pm          Closing comments 

3.15 pm          Tea / Coffee 

Please inform us of any support / access requirements that we can assist you with, e.g. ·        Dietary requirements·        Disabled parking·        Assistance in the car park·        Assistance with transport·        Hearing loop·        Information in large font·        Interpreter (please let us know which type)·        Wish to attend with a friend/carer?

Any other support required?

When ‘must’ becomes ‘should’

February 3, 2008

Well, when DOES ‘must’ become ‘should’?   You should stop at a red traffic light?  You should stop when people are using a pedestrian crossing?   You should not open the door of a moving train?   This could go on for a long time – but the reality is that if people are allowed to operate choice in these types of situation, then things will go wrong, and the people involved, and their families, may well suffer seriously.

Last Monday, 28th January, was the last day for responding to the Welsh Assembly Government’s request for comments of the draft Code of Practice for the Mental Health Act.  (The draft Code of Practise now reflects the Mental Health Act 1983 as amended by the Mental Health Act 2007).  Hopefully many people – receivers of services, carers, professional workers, voluntary agencies and others with an interest in mental health in Wales – did so.  The document itself is large – 219 pages including appendicies – and being written in ‘document speak’ is not the easiest read.  But it needs to be read as it is important for everyone who may be treated under the MHA 2007 and their relatives.      So important that Edwina Hart, AM,  Minister for Health and Social Services has apparently said that she intends to read every response to the Consultation.    But to my mind there is a basic problem with the advisory words and phrases used throughout the Code in that there are many ‘shoulds’ and few ‘musts’.   Just taking the pages 3 – 7, which contain the guiding Principles 1 – 28, there are 33 ‘shoulds’ and five ‘musts’.    Yet, taking just a couple of examples for the purpose of this post, (chosen only because they are relatively brief and save me work)  it is hard to understand why ‘should’ was used instead of ‘must’.   1.25 reads:  Decisions under the Act should be taken with a view to minimising the harm done by mental disorder, by ensuring the safety and wellbeing (mental and physical) of patients and protecting the public from harm.    1.29 reads:  Where patients are in transition from one service to another, for example from adolescent to adult care or from adult to older adult services, practitioners should ensure that patients are receiving the most appropriate service to meet their needs and, where practicable, delivered in line with their expressed wishes.        Surely these two ‘shoulds’ ought to be ‘musts’?   Why would you NOT want the ‘must’ word here?     Well, I can think of reasons, such as service weaknesses and lmited budgets, but therein lies the problem for the service receivers and carers.  

Does this matter?   Yes, it does.   The intention of the Code is to guide practitioners in the discharge of their duties and also to protect the service receivers and their carers and families.   Never mind the ‘should’ protect them – it ‘must’ protect them.  The Code is the protection for both those who provide services and those who receive them – but on present reading it appears weak in relation to those who receive.  What has also surprised me is that although service users and chosen voluntary agencies have been involved throughout the drafting process, they seem to have missed this essential point – in law ‘must’ is protective and ‘should’ is not.   It is difficult to understand how the discussions were able to progress without this basic understanding having been resolved.  In fact, I don’t understand.  Along with some other professional colleagues I raised this issue at one of the WAG consultation events – and the hesitant response was far from convincing.  I become concerned when, in matters which may restrict an individual’s liberty and encroach their Human Rights they are not firmly protected – maybe because to guarantee such protection and properly recognise individual Human Rights would require major alterations to current mental health services – and attitudes?  Time is running out if implementation is to take place in October 2008.    But should the service users, carers and particularly the Voluntary agencies that were involved in this process have been prepared to admit any flexibility on such important issues?   I think not, and I would like to know why they did?

All comments, explanations, clarifications and any other ‘tions’ will be welcome. 

Independent Mental Capacity Advocacy Wales

January 16, 2008
IMCA Wales is the largest provider of Independent Mental Capacity Advocacy services in Wales.  
To see their website click on the following link:

Network and Forum – programme change.

November 26, 2007

Sorry, but there has to be a change around of the format for the meetings.   The Network will now be at 1.30 – 2.30 and the Forum 2.45 – 3.45.   We are sorry for this short notice, but the situation is unavoidable if we are to help people attend the Forum.   The agenda is as published but there will also be a chance to say whether you prefer that advocacy is provided as at present – with a separation between in-patient and community advocacy, or whether you would prefer generic advocacy – where the same advocate can work with you in either situation.  Have a think about it before the meeting, and we will try to get a group decision.

Stigma – one point of view

February 12, 2007

Mental Health Care has published a free, downloadable leaflet on the subject of Stigma. Just go to their site, using this link,

and read the information for yourself. An extract follows:

Stigma and mental illness Stigma is best defined as three things: • Ignorance • Prejudice • Discrimination This section contains information about several ways in which stigma is experienced by people with mental health problems.  Mental Health Care has published an information leaflet on the topic of stigma, written by Professor Graham Thornicroft.

Workplace Bullying and harrassment

February 9, 2007

In response to those who are distressed and asking for support, but don’t want to be identified, then take action to protect yourself by trying at least the following:

Look at the ACAS internet site (Arbitration, Conciliation,Advisory Service) – it has all manner of advice and guidance for employees who are in difficulty – I will put a link on this site tonight;

Look at Health Minds in Work – and then contact them by ‘phone.   They WILL advise and help you and I will put a link on this site tonight;

Look at Just Fight On – link is on this site under Links – contact them.

Don’t let your worries go on any longer – take action in the morning – and talk with a trusted friend and accept support.  

Finally, if you are a user of mental health services or a carer, then contact a mental health advocate in your area – they will help you or support you in finding help.