Vulnerable adults

Video: BBC News report on launch of There to Help (2015)

The issue 

Who is responsible?

Our activities

Latest updates

Press and media

The issue

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.

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, vulnerable people:-

  • may not be able to participate effectively in the process;
  • are at significant risk of miscarriages of justice;

And police:-

  • 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.

Who is responsible?

Since the development of the Police and 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.

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. 

Our activities

NAAN raised the issue with the Home Office. In response, in her speech to the Policing and Mental Health Summit in 2014, Home Secretary Theresa May said: 

"There is evidence to suggest that there are not enough Appropriate Adults to support vulnerable people who are in police custody. Appropriate Adults provide vital support and help to de-mystify what can be an intimidating and threatening experience. It is right that all vulnerable people can access this invaluable service. So the Home Office will commission the National Appropriate Adult Network to examine this situation and help us determine where the problems lie, and what can be done to ensure that that all vulnerable adults in police custody are able to receive the support they need from Appropriate Adults".

There to Help (2015)

The resulting report There to Help (2015) found that in the year 2013/14:

  • Adults who are mentally vulnerable were significantly under-identified in police custody
  • There was a substantial lack of provision of appropriate adult provision for mentally vulnerable adults in many parts of England and Wales. 

The report made 10 recommendations. 

The report gained significant media attention and the Home Secretary promised action to ensure all vulnerable people got the support of an appropriate adult.  

2017 theretohelp button

There to Help 2 (2019)

In May 2019 NAAN published a further report, this time based on the year 2017/18. It found that since the original There to Help report :

  • Police identification of vulnerable suspects had improved but remained much lower than the actual rate of prevalence
  • Many adult suspects who were recorded as vulnerable by Liaision and Diversion services were not provided with an appropriate adult 
  • The availability of appropriate adult schemes had improved but significant gaps remained.

The report made 14 recommendations. 

2019 There to Help 2 thumbnail

Other activities

In addition: 

  • 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.
  • 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.

Latest updates 

June 2019

  • Addressing the NHS England event The Bradley Report 10 Years On – a review of progress and next steps, Lord Bradley, author of the seminal Bradley Report (2009) which highlighted the importance of idenficiation and effective AAs, said "We have to get statutory provision of appropriate adults for vulnerable adults".
  • In ten years time (2019), a report by Revolving Doors Agency and Centre for Mental Health (Co-Chairs of the Bradley Report Group) referenced both There to Help (2015) and There to Help 2 (2019). The report marked 10 years since the Bradley Reoprt and set out a roadmap for the next decade in terms of improving outcomes for people with mental ill-health, learning disability, developmental disorders or neuro-diverse conditions in the criminal justice system.
  • There to Help 2 (2019) was highlighted in the ADASS (Association of Directors of Adult Social Services) bulletin and circulated to the ADASS Care and Justice Network

May 2019

February 2019

  • The Home Office sent a survey to all Police and Crime Commissioners, with a letter from the Policing Minister, asking them about the partnership agreement published in July 2018, whether it has been implemented and what has changed. This will be used to evaluate the impact of this voluntary approach and inform decisions about future steps.
  • Criminal Law Review published a paper on the July 2018 changes to the PACE definition of vulnerability by Dr Roxanna Dehaghani and Chris Bath [This material was first published by Thomson Reuters, trading as Sweet & Maxwell, 5 Canada Square, Canary Wharf, London, E14 5AQ, in Criminal Law Review as Vulnerability and the Appropriate Adult Safeguard: Examining the Definitional and Threshold Changes within PACE Code C Issue 3 and is reproduced by agreement with the publishers].
  • Chris Bath and five leading academics wrote to the Chair of the NPCC working group on risk assessment. The letter proposed that existing plans for a new national tool be extended to include not just physcial / healthcare risks but also criminal justice risks arising out of mental vulnerability.     

November 2018

  • The Scottish Government published an analysis of responses to its public consultation on establishing a statutory appropriate adult service.

August 2018

July 2018

  • NAAN submitted Freedom of Information Act requests to all territorial police forces and British Transport Police. The requests seek find out whether the percentage of adults identified as needing an AA has changed since There to Help. Data was also requested from NHS England's liaison and diversion programme and NAAN members. This will be analysed and inform a new report providing an update on changes since There to Help (2015).
  • The Association of PCCs released a statement welcoming the national focus and setting out proposed next steps, including a statutory duty on local authorities. 
  • Policing Minister Nick Hurd MP wrote to all PCCs and directors of adult social care to highlight the new partnership agreement.
  • 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. The Home Office committed to reviewing the effectiveness of the agreement after 6 months and 12 months. 
  • 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.
  • NAAN published a guide to the revisions to the PACE Code, to assist appropriate adult schemes and police to implement the changes. 

June 2018

January 2018

October 2017

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
  • 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 but 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.
  • 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.
  • The Local Government Association (LGA) Community Wellbeing Board discussed an LGA Review of Appropriate Adult provision for vulnerable adults, developed in response to There to Help (2015). The paper set out seven future options for the provision of AAs for vulnerable adults and asked the Board to select one or develop a new one. The Board. The Board did not agree to support any of the seven future options included in the report and did not propose an alternative.

January 2017

November 2016

  • The Home Office's Crime and Policing Knowledge Hub's researcher reported back to the Home Office Police Integrity and Powers Unit. The report estimated the number of adults living in areas that do not have AA coverage and the additional costs for AA provision (in custody only). It concluded that the figures were "broadly comparable with the findings of the NAAN report". 

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 met for the second time. Officials later concluded that further research is required and will seek additional resources to set up an additional research project to be delivered by the Home Office's Crime and Policing Knowledge Hub. 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

December 2015

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

March 2015

  • NAAN has submitted its report, There to Help, to Home Secretary Theresa May.

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

  • 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.
  • 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.”

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

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

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.

Press and media




31/05/19 - The Guardian: Report raises alarm over police detention of vulnerable suspects 

31/05/19 - The Justice Gap: More than 100,000 vulnerable adults a year detained by the police without ‘appropriate adult’ 

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

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