Summary: We will not investigate this complaint about the decision to apply for a warrant to gain entry to Miss D’s home and take her to a place of safety to assess her mental health. It is unlikely we would find fault and Miss D had a right of appeal about the decision to detain her and this was the most appropriate route. It is unlikely we could achieve the outcome Miss D wants.

The complaint

1. Miss D complains about the way Portsmouth City Council (the Council) applied to the courts to obtain a warrant to enter her home with the police under the terms of the Mental Health Act 1983. She said she had arranged to meet the community mental health team and a breakdown in communication between the Council, Island City Practice (the GP Practice) and Hampshire and Isle of Wight Healthcare NHS Foundation Trust (the Trust) meant she was detained under the terms of the Mental Health Act for assessment.
2. Miss D feels the forced entry by the police could have been avoided because she had arranged to see the mental health crisis team. She said the events caused her avoidable distress and worry and impacted negatively on her mental wellbeing. Miss D wants a financial remedy and referred to compensation as an outcome to her complaint.

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The Ombudsmen’s role and powers

3. The Local Government and Social Care Ombudsman and Health Service Ombudsman have the power to jointly consider complaints about health and social care. (Local Government Act 1974, section 33ZA, as amended, and Health Service Commissioners Act 1993, section 18ZA)
4. We cannot question whether an organisation’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. If there was no fault in how the organisation made its decision, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended, and Health Service Commissioners Act 1993, sections 3(4)- 3(7))
5. We provide a free service, but must use public money carefully. We may decide not to start or continue with an investigation if we believe:
• it is unlikely we would find fault, or
• it is unlikely we could add to any previous investigation by the bodies, or
• we cannot achieve the outcome someone wants.

(Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

6. When investigating complaints, if there is a conflict of evidence, we make findings based on the balance of probabilities. This means that during an investigation, we will weigh up the available evidence and base our findings on what we think was more likely to have happened.

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How I considered this complaint

7. I considered evidence provided by Miss D, the Council, and the Trust as well as relevant law and guidance.
8. I have considered the Ombudsman’s Assessment Code.
9. Miss D had an opportunity to comment on my draft decision. I considered any comments before making a final decision.

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My assessment

Mental Health Act 1983

10. The purpose of a Section 135(1) warrant is to provide police officers with a power of entry to private premises, for the purposes of removing the person to a place of safety for a mental health assessment or for other arrangements to be made for their treatment or care. The warrant must be applied for by an Approved Mental Health Professional (AMHP) and can be granted by a magistrate when the person is believed to be:
• suffering from mental disorder and is being ill-treated, neglected or kept otherwise than under proper control, in any place within the jurisdiction of the Justice, or
• Being unable to care for themselves, is living alone in any such place.
11. Under the Mental Health Act 1983 (MHA), when someone has a mental disorder and is putting their safety or someone else’s at risk they can be detained in hospital against their wishes. This is sometimes known as ‘being sectioned.’ Usually, three professionals need to agree that the person needs to be detained in hospital. These are either an AMHP or the nearest relative, plus a doctor who has been specially approved in Mental Health Act detentions and another doctor (Section 12 doctors).
12. The AMHP is responsible for deciding whether to go ahead with the application to detain the person and for telling the person and their nearest relative about this. The AMHP acts on behalf of the Council.
13. People who have been detained under the MHA can apply for a hearing to the First Tier Tribunal (Mental Health) if they disagree with the decision. The Tribunal must discharge the person from detention if, on the day of the hearing, the person does not meet the criteria for detention.

What happened

14. Miss D received support from mental health services for several years. She said she experienced a relationship breakdown in 2023 which impacted her mental health. She received support from the GP Practice as well as an organisation which offered support to women.
15. The Trust’s Mental Health Crisis Team (the Crisis Team) had concerns about Miss D’s mental health in January 2024 and visited her property. The Council said she refused to see the team and an AMHP working for the Council decided she needed a Mental Health Act assessment.
16. The GP Practice also had concerns about Miss D’s mental health following a consultation with her. The GP Practice contacted the Crisis Team who agreed to contact Miss D to offer support. The Crisis Team told the GP Practice she would not engage and so the GP Practice contacted Miss D to encourage her to engage with the team.
17. The AMHP applied to the Magistrates Court for a warrant and the Magistrate granted the warrant. The police forced entry to Miss D’s home with the AMHP in attendance, but she was not home.
18. Miss D said she spoke to the Crisis Team the same day and arranged to get her keys for the new door lock which was fitted. She said she also arranged to see the Crisis Team two days later, but the team did not share this information with the AMHP or record it.
19. The AMHP applied for a second warrant from the Magistrate three days later which the Magistrate granted. Miss D was home when the police gained entry to her home with mental health professionals. She was taken to hospital and assessed by two doctors and the AMHP.
20. Miss D was assessed under the terms of the MHA and was admitted to hospital under Section 2 of the MHA. The purpose of detention under Section 2 of the MHA is for assessment of a patient’s mental health and to provide any treatment they might need. Patients can be detained under Section 2 for a maximum of 28 days.

My assessment

21. Miss D said because of the agreement to meet with the Crisis Team this information should have been communicated with the AMHP. She feels if this had happened the AMHP would not have applied for a second warrant and attended with the police who then forced entry. She also felt the GP Practice should have shared information with the Crisis Team about the support she already had in place.
22. Sections 16.3 to 16.13 of the Mental Health Act Code of Practice (the Code of Practice) provides directions and guidance on what councils and professionals such and AMHP should do when deciding to apply for a warrant. For example, it says an AMHP should contribute to any assessment of risk presented by the person.
23. In its complaint response the Council said the AMHP considered Miss D’s response to the visit from the Crisis Team and her unwillingness to engage with community support. It said, “based on your response to visits from the crisis team, it was anticipated that if these other professionals attempted to visit you at home, you would refuse to see them.”
24. The Ombudsmen cannot question whether the Council’s decision to apply for the warrant the second time was right or wrong simply because Miss D disagrees with it. We must consider whether there was fault in the way the decision was reached. It is unlikely we would find fault with the way the Council made its decision. We will not investigate this complaint.
25. The GP Practice said it has a responsibility to act in a patient’s best interests when patients do no appreciate how unwell they are. It is unlikely the Ombudsmen would find fault with the clinical judgement made by the GP Practice when it shared information with the Crisis Team. We will not investigate this complaint.
26. Once Miss D was detained, she could have applied to the First Tier Tribunal (Mental Health) if she disagreed with that decision. This would have been the most appropriate way to challenge the decision.
27. I recognise Miss D’s view that the events which took place were distressing for her. As it is unlikely we would find fault in the way the Council made its decision to apply for the warrant on both occasions and unlikely we would find fault in the way she was assessed by the AMHP and doctors we will not investigate this complaint. We cannot achieve the outcome Miss D wants.

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Final Decision

28. We will not investigate Miss D’s complaint about the decision to apply for a warrant so she could be taken to a place of safety to have her mental health assessed in line with the Mental Health Act 1983. It was reasonable for Miss D to appeal to the tribunal about the decision to detain her as this was the most appropriate route.

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Investigator's decision on behalf of the Ombudsman