Review Article Section 136 of the Mental Health Act: a new literature review R D Borschmann DPsych*, S Gillard PhD † , K Turner BA (Hons) † , M Chambers PhD ‡ and A O’Brien MRCPsych † *Institute of Psychiatry, De Crespigny Park, London SE5 8AF; † Division of Mental Health, St George’s University of London; ‡ Joint Faculty of Health and Social Care Sciences, St George’s, University of London/Kingston University, Cranmer Terrace, London SW17 0RE, UK Correspondence: Dr Rohan Borschmann. Email: rohan.borschmann@kcl.ac.uk Abstract Section 136 of the Mental Health Act 1983 (amended) provides police officers in the United Kingdom with the authority to remove individuals who appear to be suffering from a mental illness from any public place to a designated ‘place of safety’ for appropriate assessment. A considerable amount of research has been dedicated to investigate who is detained under this section and how it is implemented. A review of the literature revealed a high prevalence of schizophrenia, personality disorders and mania in individuals detained under Section 136 and an over-representation of black detainees. Several studies also reported poor communication between different agencies and poor levels of knowledge regarding the implementation of the section. There is a lack of qualitative research exploring detainee and professional experience of Section 136 and in particular the patient pathway to mental health care via Section 136 experienced by black detainees. Implications for clinical practice, multi-agency collaboration and future research are discussed. Med Sci Law 2010; 50: 34–39. DOI: 10.1258/msl.2009.009004 Introduction It has been well-documented that atypical behaviour result- ing from serious mental illness often results in attention from the police. 1–3 Such behaviour typically deviates from what is accepted by society but often does not constitute an offence. 4 In the United Kingdom (UK), one option available to any police officer upon becoming aware of such behaviour is to detain the individual under Section 136 (hereafter S136) of the Mental Health Act (1983), 5 which states: (1) If a constable finds in a place to which the public have access a person who appears to him to be suffering from mental dis- order and to be in immediate need of care or control, the con- stable may, if he thinks necessary to do so in the interests of that person or for the protection of other persons, remove that person to a place of safety... (2) A person removed to a place of safety under this section may be detained there for a period not exceeding 72 hours for the purpose of enabling him to be examined by a registered medical practitioner and to be interviewed by an approved social worker and of making any necessary arrangements for his treatment or care. A place of safety, as defined in the Act, refers to residential accommodation provided by a local services authority, a hospital as defined by the Act, a police station, a mental health nursing home or residential nursing home for men- tally disordered persons, or any other suitable place the occupier of which is willing to temporarily receive the indi- vidual. S136 is the only section of the Act whereby one person – acting without medical evidence or training – has the authority to deprive another person of his or her personal liberty. 6,7 Perhaps not surprisingly, this section is viewed by many as controversial and previous researchers have highlighted the ethical and moral ambiguity of several aspects of S136. 2 These include the ‘serious civil liberty issues’ associated with compulsorily removing a person from a public place – often to a police cell, despite no offence having been committed – and the fact that police officers do not necessarily have to be correct in their informal diagnosis of mental illness in order to implement the section; rather, the individual merely needs to appear to the officer to be mentally ill on the basis of his or her observable behaviour. 2,7 Research in the UK has investigated various aspects of S136 ranging from admission rates and subsequent diag- noses to levels of knowledge among professionals and the experience of individuals referred. To the knowledge of the authors, however, there has been no formal review of the UK S136 literature since 1999 when Churchill et al. 8 included S136 in their systematic review of research relating to the Mental Health Act (1983), during which time a con- siderable amount of research has been conducted in the area. Further, the new Code of Practice 9 to the recently amended Mental Health Act (1983/2007) places new obli- gations on the police and mental health professionals to work together to develop, implement and monitor the use of S136, while at the same time indicating the potential role of S136 in the enforcement of new supervised Community Treatment Orders. A review of the literature Medicine, Science and the Law 2010; 50: 34–39