Children as young as nine detained under the Mental Health Act are spending hours in accident and emergency departments under police control rather than in specialist mental health assessment suites.

In A&E other people can see and hear them as they undergo a mental health crisis or disclose to health workers the sexual or physical abuse they may have suffered, research says.

Dr Jayne Erlam, of Liverpool John Moores University, analysed data on 2,696 people in one north of England police constabulary who were detained under the Act between 2017 and 2021, and also interviewed police officers.

Under the 1983 Act, police officers are obliged to take a person to a ‘place of safety’ if they think they are a risk to themselves or others due to an episode of mental distress. Changes in 2017 forbad children being detained in police cells, but insufficient suitable alternatives have led to the use of A&E departments.

Dr Erlam found that 7% (187) of those detained by the police were aged 9 to 18. Some were detained several times, leading to 300 detentions in total.

A quarter, mainly children 16 and over who were able to access adult facilities, were taken to specialist suites, which are purpose-built private rooms under the care of trained mental health staff.

But owing to a lack of provision specifically for children these suites were often unavailable, so the remaining three-quarters were taken to busy A&E departments, where legally they could wait for up to 24 hours, accompanied by police officers, until they were assessed.

Occasionally children can spend overnight in paediatric wards, but they remain under the control of police officers and not nurses.

In a follow-up to the research, she found that in 2024, 83% of detained children went to A&E where they spent an average of 18.5 hours under the control of two police officers.

Dr Erlam told the British Sociological Association’s medical sociology conference at Northumbria University today [Friday 12 September] that “What is clear is that the youngest detained do not gain access to specialist suites and instead are taken to A&E.

“The person requiring assessment is in the company of two police officers, and the arrival of such a group of people in an A&E department captures the attention of a bored audience who might assume that the detained person has committed some kind of offence for which they are in trouble.

“Taking into consideration that the person has been detained because of mental distress, such a public environment under the gaze of others can do nothing to alleviate any distress. The public nature of A&E departments is concerning, and police officers are fiercely against the use of them as a place of safety.”

One police officer told Dr Erlam that an A&E department was “wholly inappropriate – that place is like a zoo, it’s the most chaotic environment you can imagine, a nightmare. A lot of people we take there are vulnerable, scared, paranoid, intimidated.

“They can’t even find room to do the assessment so the patient can talk privately. They are sometimes just in a bay with a curtain. This person may be disclosing historic child sex abuse. They are not going to do that when the only sound barrier is a curtain.”

Another officer told her that they had to keep the young detainee in an A&E corridor for hours. “It took nearly 13 hours for someone to come out, and they did the assessment there. I tried to get them somewhere to rest, such as a suite, but there wasn’t one. It’s frustrating.”

Almost all of the children who are then assessed are not admitted to hospital, the research found.

Dr Erlam told the conference: “Too many detained persons remain under police supervision and control rather than being supported through their mental distress by mental health-trained medical professionals.

“As police must remain with detained persons in A&E, detained persons are spending an inordinate time under the supervision and control of detaining police officers.

“Shortfalls in health and social care provision increase police contact with persons experiencing mental distress to the point where there is a reliance on policing to bridge gaps and to safeguard people who are at risk of future episodes of acute mental distress.

“The high incidences of repeated detentions of the same detained individuals, suggestive of a lack of effective ongoing care and support provision.” She called for more specialist suites to be available.

• Dr Erlam’s research looked at figures over a 40-month period (December 2017 to April 2021) in one unnamed county in the north of England, but her findings apply more widely across the country. There were 1561 detentions of children aged below 18 years in England and Wales in the year ending March 2024. Dr Erlam is a former nurse, with experience of working on an acute psychiatric ward.  The research is funded by the ESRC.

Notes:

The BSA’s medical sociology annual conference takes place from 10-12 September 2025 at Northumbria University. Around 150 presentations are given. The BSA’s charitable aim is to promote sociology. It is a company limited by guarantee, registered in England and Wales. Company Number: 3890729. Registered Charity Number 1080235 www.britsoc.co.uk

For more information, please contact:
Tony Trueman
British Sociological Association
Tel: 0044 (0)7964 023392
tony.trueman@britsoc.org.uk