Has provision of that support been referred? If so, by whom to who? What date and time did the police leave? Other comments Assessing Team Profession Name Time Contacted Time Arrived AMHP 1st Doctor 2nd Doctor How long did the client have to wait until the assessment 1 hour started? 1 2 – 2 3 Hours – 3+ 10 + Hours Outcome of Assessment Discharge no follow up – Discharge home based treatment – Discharge regular care team – Detained under MHA CTO Recall Admitted Informally Other Free text box ( E.g. admitted to acute trust etc) – Comments Police Involvement following 135/136 None Arrested following another offence Taken Home Transferred out of NTW area Other (please state) Details Further comments relating to 135/136
Has provision of that support been referred? If so, by whom to who? What date and time did the police leave? Other comments Assessing Team Profession Name Time Contacted Time Arrived AMHP 1st Doctor 2nd Doctor How long did the client have to wait until the assessment started? 1 hour 1 – 2 2 – 3 Hours 3+ 10 + Hours Outcome of Assessment Discharge – no follow up Discharge – home based treatment Discharge – regular care team Detained under MHA CTO Recall Admitted Informally Other – Free text box ( E.g. admitted to acute trust etc) Comments Police Involvement following 135/136 None Arrested following another offence Taken Home Transferred out of NTW area Other (please state) Details Further comments relating to 135/136
MHA-PGN-06-App4-Section135-136Form-V01-IssMay16-1.docx