Warning against extending police detention powers to nurses

The Royal College of Nursing (RCN) is among a group of health organisations that have raised concern about amendments to the Mental Health Bill passed by the House of Lords.

The amendments would extend powers previously reserved only for police to detain and restrain people in public spaces or at home to mental health nurses and other health workers.

The list of “authorised persons” would now include any “medical practitioner, approved mental health professional, mental health nurse or doctor, or a person of description specified in regulations made by the secretary of state”.

It comes amid other reforms that have been made aimed at reducing police involvement in mental health crisis incidents such as the introduction of the Right Person, Right Care model.

The RCN has signed a joint statement – alongside others including the British Medical Association (BMA) and Royal College of Psychiatrists (RCPsych) – calling for the amendments to be reconsidered.

The statement warned that extending the detention powers to health professionals was a “radical proposal with a number of serious and potentially dangerous consequences”.

The health groups behind the statement said the changes had not been tested with health professionals or patients and risked damaging therapeutic relationships between the two.

“These responsibilities for public safety fall outside the scope of nursing staff”

Stephen Jones

They further said the proposed changes went against the intended principles behind reforming the Mental Health Act, which were to provide care that was the least restrictive, had therapeutic benefit, treated patients as individuals and provided them with choice and autonomy.

“It is difficult to see how delegating police powers to health professionals would be within the spirit of the proposed reforms to the Mental Health Act and it is worrying to see them tagged on to the reforms at such a late stage,” warned the letter.

In a statement for Nursing Times, Stephen Jones, head of nursing practice at the RCN, said: “As waiting lists for mental health services skyrocket, the pressure on frontline staff such as the police and nursing staff in emergency departments has become unrelenting.

“But the ‘authorised persons’ amendment would make matters far worse. The police have a vital role in reducing risk to vulnerable people and the public during severe mental health crises.

“However, these responsibilities for public safety fall outside the scope of nursing staff as clinical professionals and simply aren’t duties that severely under-resourced nursing staff would be able to fulfil.”

As well as the RCN, BMA, RCPsych, the statement was signed by the Association of Ambulance Chief Executives, the Association of Directors of Adult Social Services, the Approved Mental Health Professional Leads Network, the British Association of Social Workers, the College of Paramedics and the Royal College of Emergency Medicine.

The bill, which covers England and Wales, is now in the committee stage in the House of Commons and needs to pass several more hurdles before becoming law.

The government appears sceptical of the amendments approved by peers.

Responding to the statement from health groups, a Department of Health and Social Care spokesperson said: “Extending police powers to other professionals would represent a major shift in the roles, responsibilities and practice for health and care staff and would place additional resource on an already stretched NHS at a time where we are trying to rebuild a health service fit for the future.

“It also raises questions around whether it is right for the health and social care professionals to have powers to use reasonable force which could have implications for patient, public and staff safety, as well as potentially damaging the relationships clinicians have with patients.

“We are grateful to health and social care stakeholders for their in-depth engagement on this complex issue.”