In England and Wales, tens of thousands of people with mental illnesses, learning disabilities, autistic spectrum disorders and other mental vulnerabillities are not getting the support that they are legally entitled to when they are detained or otherwise questioned by police.
In 2015 NAAN carried out research commissioned by, the then Home Secretary, Theresa May. We found that:
- Adults who are mentally vulnerable are significantly under-identified in police custody
- There is a substantial lack of provision of appropriate adult provision for mentally vulnerable adults in many parts of England and Wales.
Rt Hon Theresa May MP: “The status quo is not acceptable and I am concerned that vulnerable adults are not always receiving the support of an appropriate adult."
Why is this important?
Some people are 'mentally vulnerable' in the context of being detained or interviewed voluntarily by police. This includes, but is not limited to, people with:-
- mental illness
- learning disabilities
- autistic spectrum disorders
- neurodevelopmental disorders
- traumatic brain injuries
People who are mentally vulnerable may be prone to:
- unintentionally providing unreliable information
- being highly suggestible
- being eager to please
- becoming confused
- having difficulty understanding their rights and entitlements (or exercising them)
- having difficulty understanding the implications of police procedures and processes
- having difficulty understanding the significance of what they are told, of questions they are asked or of their replies.
Without appropriate adult provision
- may not be able to participate effectively in the process;
- are at significant risk of miscarriages of justice.
- cannot undertake many core tasks such as interviews, strip searches or ID procedures;
- may have their evidence ruled inadmissible in court, possibly causing a trial to collapse;
- may waste vaulable hours trying to locate a person to act as the appropriate adult;
- may feel forced to ask a member of the general public to act as the appropriate adult
- may have to place a vulnerable person on bail unnecessarily
What is NAAN doing about it?
- As Home Secretary, Theresa May commissioned us to develop a strong evidence base and recommendations for action. The resulting report, There to Help, was welcomed by the Home Secretary as the foundation for action.
- We are creating connections with, and between, leading academics with an interest in mental vulnerability in police investigations. These include Professor Gisli Gudjonsson (King's College London), Dr Iain MicKinnon (Newcastle University), Tricia Jessiman (University of Bristol) and Roxanna Dehaghani (University of Leicester).
- We have been supporting qualititative research by the Home Office's Crime and Policing Knowledge Hub, looking at the effectiveness of different models of AA provision and commissioning.
- We have been using both broadcast and social media to raise awareness amongst vulnerable adults, their supporters and front line police officers.
- We have been developing our networks and using speaking opportunities to engage with politicians, government officials, senior police officers, health and social care professionals and other strategic stakeholders.
Supporting policy development
- Following the publication of There to Help, the Home Secretary established a Home Office working group on the issue, reporting to the national PACE Strategy Board.
- NAAN supported officals in developing the group's membership and terms of reference. We remain a key member of the working group, in addition to having a seat at the PACE Strategy Board.
- July 2018 - The Association of PCCs released a statement welcoming the national focus and setting out proposed next steps, including a statutory duty on local authorities
- July 2018 - Policing Minister Nick Hurd MP wrote to all PCCs and directors of adult social care to highlight the new partnership agreement
- July 2018 - The Home Office published a partnership agreement setting out a framework for PCC and local authorities to work together locally to solve the lack of provision of AAs for adults
- July 2018 - The Home Office published significant revisions to the Police and Criminal Evidence Act Codes of Practice (PACE Codes) including redefining which adults an AA is required for and requiring police to make 'reasonable enquiries' as to what information is available about a person's potential vulnerability
- June 2018 - Lord Paddick, Liberal Democrat Home Affairs Spokesperson, raised the issue of AA provision for adults in a Lords debate on the revised PACE Codes
- January 2018 - Alistair Carmichael, Liberal Democrat Chief Whip raised the issue of appropriate adults for vulnerable adults with Policing Minister Nick Hurd in a debate in Parliament on People with Mental Health Problems: Detainment
- January 2018 - Members of Parliament, including Shadow Minister Kevin Brennan and Policing Minister Nick Hurd discussed the issue of AAs for adults as part of a debate in Parliament (Criminal Justice System: Adults with Autism)
- October 2017 - The Government response to the Report of the Independent Review of Deaths and Serious Incidents in Police Custody referenced There to Help, the working group, forthcoming changes to the PACE Codes and a forthcoming partnership agreement between local authorities and PCCs
- September 2017 - Policing Minister Nick Hurd MP wrote to all Police and Crime Commissioners, asking for support for a voluntary partnership approach with AA provision/commissioning led by local authorities and supported by PCCs
- September 2017 - Luciana Berger MP (Labour) asked in a written question whether the Home Secretary make statutory provision of appropriate adults for vulnerable adult detainees. Policing Minister Nick Hurd highlighted the There to Help report and the Home Office working group and replied that, "There are currently no plans to introduce a specific statutory requirement concerning provision".
- February 2017 - The Home Office working group met for the fourth time. The meeting focused on: (a) finalising proposed changes to PACE Code C; (b) an analysis of the costs of statutory provision undertaken by a Home Office economist; (c) draft commissioning guidance and (d) linking projects related to improving identification.
- February 2017 - NAAN held a meeting to develop links between separate work currently being undertaken by the Home Office, National Police Chief's Council, College of Policing and NHS England Liaison and Diversion on improving the identification of vulnerability by police.
- January 2017 - The Report of the Independent Review of Deaths and Serious Incidents in Police Custody, led by Rt. Hon. Dame Elish Angiolini DBE QC, recommended that: "Increased funding is required for appropriate adult schemes within a national framework for commissioning. This should include improved training and consistency of Appropriate Adult services".
- October 2016 - The Home Office working group met for the third time, to discuss findings of further research by the Home Office and separately by the University of Bristol, potential changes to PACE and potential solutions to the issue of provision. The Home Office and NAAN agreed to collaborate on commissioning guidance for AA schemes for adults.
- May 2016 - NAAN gave verbal evidence to Dame Elish Angiolini and made a written submission to the Independent Review of Deaths and Serious Incidents in Police Custody.
- April 2016 - The Home Office working group has met for the second time. Officials later concluded that further research is required and will seek additional resources to set up a Home Office research project. This will involve officials visiting a range of appropriate adult schemes with different models of delivery and commissioning, discussing issues with providers, commissioners and police.
- January 2016 - NAAN is supporting work by academics at University of Bristol to research adult social care involvement in the provision of appropriate adults, and engage with service users.
- December 2015 - The new Home Office working group has met for the first time, intiially with representation from organisations including Ministry of Justice, NPCC, NHS England, ADASS, LGA, College of Policing, Care not Custody Coalition, plus notable individuals including Lord Keith Bradley, Professor Gisli Gudjonsson and Police and Crime Commissioner Martyn Underhill (national lead on mental health). The meeting focused on terms of reference and identifying potential members for the group.
- August 2015 - There to Help, the report of the Home Secretary's commission has been published and is available to download. Theresa May MP ordered the establishment of a Home Office working group (reporting to the PACE Strategy Board) to consider our report's findings and recommendations.
- July 2015 - The Home Secretary and the Minister for Policing have written to NAAN thanking us for our report and setting out the next steps. We are working with the Home Office on a publication date.
- March 2015 - NAAN has submitted its report to the Home Secretary.
- January 2015 - NAAN has now been formally commissioned by the Home Office to undertake a research project in relation to AAs for mentally vulnerable adults. We have asked the Institute of Criminal Policy Research to work in partnership with us on the project.
- October 2014 - The Home Secretary announced that she will commission NAAN to consider the problems and solutions to ensure vulnerable adults receive the support they need from AAs. The Home Secretary recognised that The Home Secretary noted that, "There is evidence to suggest that there are not enough Appropriate Adults to support vulnerable people who are in police custody...It is right that all vulnerable people can access this invaluable service.”
- October 2014 - NAAN 10th Anniversary event at the House of Lords. Lord Bradley, Chris Bath and Superintendent Alan Greene (representing the national policing lead for custody) repeat the call for a statutory duty to provide AAs for vulnerable adults.
- August 2014 - The Avon & Somerset PCC, Sue Mountstevens, supports NAAN's call for a clear statutory position on provision for vulnerable adults. In the meantime, Ms Mountstevens has secured Appropriate Adult scheme coverage in the south of the force area and is currently in negotiations regarding the north area. The PCC will take on majority of funding responsibility for Appropriate Adults for vulnerable adults across the Avon and Somerset Police area from April 2015. The PCC supports NAAN's call for a clear statutory position on provision for vulnerable adults.
- July 2014 - NAAN's President, Lord Patel of Bradford, delivers speech in House of Lords [video] on need for statutory provision. Read the text version.
- May 2014 - The Derbyshire Police & Crime Commissioner, Alan Charles, has promised one-off funding to Derbyshire Appropriate Adult Service, a member of NAAN, to support continued provision of AA services. Mr Charles has published a strongly worded statement making clear that a long term solution is required.
- May 2014 - NAAN provides a briefing for Norman Lamb (Minister of State for Care & Support): Liaison & diversion and the provision of appropriate adults for mentally vulnerable adults
- January 2014 - NAAN publishes the position paper Who's looking out for the adults? setting out the problem and how the Government's development of Liaison & Diversion services provides an opportunity (and an imperative) for change
- Academic research indicates 11%-22% of detained adults meet the criteria under which an appropriate adult is required;
- Police data indicates that only 3% of adult detentions include appropriate adult support;
- This suggests that as many as 235,000 police detentions and interviews of mentally vulnerable adults are being conducted without an appropriate adult each year;
- Around 50% of England and Wales has no organised appropriate adult scheme. Unlike AA support for children, since the inception of PACE more than 30 years ago, no authority or agency has ever been given legal responsibilty to ensure provision of an AA for mentally vulnerable adults;
- Police are around 5 times more likely to idenitfy vulnerability and secure an appropriate adult in areas where there are organised schemes;
- Adult social services remain the largest funder of provision but in many areas police have been forced to fund provision, raising questions around independence.
[Source: There to help: Ensuring provision of appropriate adults for mentally vulnerable adults detained or interviewed by police. The Home Secretary’s Commission on Appropriate Adults. NAAN & ICPR (2015)]
What needs to change?
Our detailed recommendations are laid out below. In summary, they fall into six strands: -
- Funding and responsibility (the primary issue)
- Guidance for commissioners
- Support for appropriate adult schemes
Recommendations of the Home Secretary's Commission
1. To develop a new approach at a national strategic level and a vision shared by relevant departmental bodies, agencies and organisations that:
In the interests of individuals’ welfare and of justice, all mentally vulnerable adults should have access to the timely support of a competent AA throughout any period of detention in police custody or the conduct of any voluntary interview2. To locate AA provision within existing strategic frameworks, of which the preferred option is to incorporate AA services within the liaison and diversion framework
3. To establish AA provision within a clear and consistent national framework for local co-commissioning, with commissioning co-ordinated and informed by Health and Wellbeing Boards and Safeguarding Adults Boards
4. To develop enhanced national standards to provide national support for local co-commissioning
5. To ensure consistent police record keeping on vulnerable suspects, identification of need for AAs, the securing of AAs, and where they came from
6. To integrate simple screening questions in all police custody risk assessments and ensure all custody officers have received training on vulnerability and AAs
7. To amend the PACE Codes of Practice to clarify and simplify their provisions on AAs
8. To consider amending PACE 1984 to establish an explicit statutory duty on police officers to secure an AA for all mentally vulnerable adults; and to bring greater consistency to the approach of courts on the admissibility of evidence obtained in the absence of an AA
9. To consider establishing a statutory duty to ensure provision of an AA when requested by police, to create parity with children’s AA services;
10. To provide short-term programme funding of £3m to £5m per year to support the inclusion of AA provision within mainstream budgets. This could be to 2017 (subject to integration into the liaison and diversion framework and HM Treasury approval) or longer if required.
[Source: There to help: Ensuring provision of appropriate adults for mentally vulnerable adults detained or interviewed by police. The Home Secretary’s Commission on Appropriate Adults. NAAN & ICPR (2015)]
Who is responsible?
Responsibility to contact
Since the development of the Police & Criminal Evidence Act 1984 and its Codes of Practice (PACE) police have been required to contact an appropriate adult (AA) and have them present whenever the detain or question a child or mentally vulnerable adult.
Responsibility to provide
Usually the AA will be a parent or family member of the vulnerable person but sometimes this is not possible because they are unavailable or not suitable (for example they may be directly involved in the case as a witness or suspect).
It is a legal requirement that the AA is independent of the police. The AA may not be a police officer employed by the police, or engaged on police purposes.
For this reason, Youth Offending Teams (YOTs) have a legal duty to ensure that a child has an AA. This means that wherever a child is arrested in England and Wales, the police will be able to secure an AA for a child. The YOT may act themselves or commission another organisation. Many AA schemes are delivered by volunteers.
There is no legal duty to provide AAs for mentally vulnerable adults on any authority, agency or organisation.
Despite this, adult social services has historically led provision. For the first ten years of its existence, AAs for adults were increasingly social workers. From the mid 1990s, following advice from the Home Office and Audit Commission, adult social services increasingly recruited volunteers. In recent years there has been an increasing trend towards commissioning AA services. Adult social services remain the largest funder nationally, as a non-statutory service this support is under severe pressure due to budget cuts.
What's happening in my area?
Support for the project
“Appropriate adults provide vital support and help to de-mystify what can be a confusing, sometimes frightening, experience in police custody.
“Evidence suggests there is a lack of appropriate adults to safeguard the welfare and rights of mentally vulnerable adults in police custody. That is why I commissioned this review to determine where the problems lie.
“The status quo is not acceptable and I am concerned that vulnerable adults are not always receiving the support of an appropriate adult. We are currently examining the recommendations and implementation options to ensure that vulnerable people are provided with the support they are entitled to.
“I am grateful to NAAN for their continued dedication to ensure fairness and humane treatment of both vulnerable adults and children when they are in trouble and in police custody.”
Lord Bradley PC
“The police work in a difficult environment with incredible time pressures. Trained appropriate adults must be quickly available wherever they are needed. Along with liaison and diversion, and street triage, they are critical part of a coherent approach to vulnerabilities which both saves money and delivers better outcomes”.
Martyn Underhill, Police and Crime Commissioner for Dorset and chair of the Independent Custody Visitors Association
"We are clearly not getting it right for the more vulnerable members of our communities who need that extra protection and support. When a vulnerable person comes into contact with the police, their needs deserve to be properly identified, with a needs assessment made, and for them to then be dealt with quickly and fairly. For this to happen, every area needs an organised, trained appropriate adult scheme which is totally independent of the police.”
Avtar Bhatoa, Chair of the Law Society’s Criminal Law Committee
"To ensure fair justice for all, mentally vulnerable people need the help of an appropriate adult during what can be a daunting and confusing time. With the right support, mentally vulnerable people are less likely to suffer an injustice or to waive their right to free legal advice through fear and misunderstanding, which can compound their disadvantage in the justice system. It is vital that the recommendations in this important report are implemented."
Gísli Guðjónsson CBE FBPsS, Professor of Forensic Psychology(whose expert testimony saw the convictions of the Birmingham Six and Guildford Four overturned)
“Mentally vulnerable people are at increased risk of providing information which is inaccurate, unreliable or misleading. “The involvement of an appropriate adult to facilitate communication, ensure they understand their rights and are treated fairly, is absolutely critical to a fair process”.
James Bullion, Association of Directors of Adult Social Services
“Helping to support and safeguard our most vulnerable citizens, whether they are victims or suspects, is central to the role of adult social care services. Many local authorities have a long history of providing social workers or funding dedicated AA schemes. ADASS supports the report’s recommendations and is keen to work with central Government and local partners to ensure sustainable services are available for all.”
- 09/12/15 - The Guardian: The police can't prop up other struggling services forever
- 26/08/15 - The Guardian (Comment is Free): It’s time we gave our most vulnerable people proper protection in custody
- 26/08/15 - The Guardian (Society): Appropriate adult not available for many vulnerable people in police custody
- 26/08/15 - ITV News Mental health patients in police custody 'not given enough support'
- 26/08/15 - BBC News 'Appropriate adults not being used' for many vulnerable people in custody
- 26/08/15 - Huffington Post Mental Health Thousands Of Vulnerable People Are Not Getting The Support They Need In Police Custody
- 20/11/14 - Teenager with Down's syndrome who broke into his school to retrieve his favourite hat has police record wiped after 120,000 people sign petition Daily Mail
- 30/01/14 - Offenders with learning disabilities failed by criminal justice agencies Community Care
- 30/01/14 - Offenders with learning disabilities let down by criminal justice system Learning Disability Today
- 30/01/14 - Offenders with learning disabilities 'not supported' BBC
- 10/01/13 - Care not Custody is a promise worth keeping. The The Guardian
- 04/01/13 - Mental health nurses to be posted in police stations. The Guardian
- 13/10/11 - Vital role of ‘appropriate adult’ to help vulnerable people Community Care