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Public mental health crisis management and Section 136 of the Mental Health Act
  1. Aileen O’Brien1,
  2. Faisil Sethi2,
  3. Mark Smith3,
  4. Annie Bartlett1
  1. 1 Institute of Medical and Biomedical Education, St George’s, University of London, London, UK
  2. 2 ES1 Psychiatric Intensive Care Unit (PICU), Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK
  3. 3 Head of Suicide Prevention and Mental Health, British Transport Police, London, UK
  1. Correspondence to Dr Aileen O’Brien, Institute of Medical and Biomedical Education, St. George’s University of London, London SW17, UK; aobrien{at}


The interface between mental health services and the criminal justice system presents challenges both for professionals and patients. Both systems are stressed and inherently complex. Section 136 of the Mental Health Act is unusual being both an aspect of the Mental Health Act and a power of arrest. It has a long and controversial history related to concerns about who has been detained and how the section was applied. More recently, Section 136 has had a public profile stemming from the use of police cells as places of safety for young, mentally disturbed individuals. This paper explores the current state of health of this piece of legislation. Specifically, we consider whether alternative approaches are more suitable for those individuals in crisis and/or distress who come into contact with the police. This requires careful thought as to the proper role of both health and criminal justice professionals who are daily grappling with an ethically contentious domain of multiagency work.

  • bills, laws and cases
  • psychiatry
  • mentally ill and disabled persons

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  • Contributors All four of the authors provided substantial contributions to the conception or design of the work, were involved in drafting the work and revising it critically for important intellectual content, gave final approval of the version to be published and are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests AB is Clinical Director, Health in Justice & other Vulnerable Adults Clinical Network, NHSE (London).

  • Provenance and peer review Not commissioned; externally peer reviewed.