S136 in Sussex: Final Report

Background: The research addresses the controversially high rates of Section 136 (s136) detentions across Sussex in collaboration with Sussex Police and the mental health trust (Sussex Partnership Trust), in order to understand the consistent patterning of a ratio of 2:1 detentions to police custody, rather than the 5 specialist NHS S136 suites. Methods: Multi method study i) secondary analysis of existing s136 statistics collected by Sussex police and Sussex Partnership Trust ii) in depth interviews and deliberative workshop with 37 members of the public who had been detained under s136 iii) interviews, focus groups, and observations with 79 police officers 160 NHS and allied staff and voluntary workers. Main outcome measures: social patterning and reasons for use of s136; differences in type of Place of Safety used and experience of users; impact of good practice and joint working strategies Results: S136 is mainly used by police in Sussex as the only means of supporting suicidal and highly vulnerable people who are reported to be in extreme distress in public places when there is no other service available as the majority of incidents happen ‘out of hours’. Innovative inter agency policy and practice working, in particular the national ‘Street Triage’ pilot which was rolled out across Sussex during the life of the study, has produced successful interventions to reduce the use of s136, but complex factors such as repeated detentions of vulnerable and socially marginalised reveal some of the underlying complexity. Conclusions: This study challenges some of the simplistic assumptions around the high rates of S136 detention, which can be reduced through effective joint agency interventions, but may always be needed as a life-saving ‘default mechanism’ in complex situations. Alongside the need for adequate resources to support sustain and increase effective alternatives to the use of s136, the study recommends that the voices of those with ‘lived experience’ must be included in developing effective interventions. Keywords: Mental health emergencies; emergency services; help seeking, joint working, suicide and suicide prevention, user experience, Street Triage