Better Than Butlins ?

Cynics Guide To The Mental Health Act : 2b : How To Get Sectioned 2

Here is a very selective look at the ways you can be detained for being very mad.

Sections are particular bits of legal acts. Have a look at any of the on-line legislation. Each section has a number. Specific sections of the MHA83 (England) and MHCT03 (Scotland) are concerned with the detention of patients in mental health establishments. The numbers are generally used when referring to the ways of detaining people. Each type of detention has it’s own special rules and restrictions.

Often actually being sectioned can have it’s advantages as it is a sight easier to appeal against a formal detention rather than falling into the Neither Fish Nor Fowl category. I have no personal experience of this if anyone has any examples that confirm or deny this please do post them.

[MHA83] : English Detention : A Little Like Public School

Section 4

Emergency Admission for Assessment

Summary

Section 4 is intended for emergency admissions, where if it were not for the extreme urgency, a Section 2 would be appropriate. A Section 4 requires only one medical recommendation, compared with two for a Section 2. An Application has to be made, based on that single Medical Recommendation.

Duration

Up to 72 hours. During that time, if a second Medical Recommendation is made, the Section 4 effectively converts into a Section 2.

Conditions

The grounds for the Application are the same as for Section 2, that the person:

• is suffering from mental disorder of a nature or degree which warrants the detention of the patient in a hospital for assessment (or for assessment followed by medial treatment) for at least a limited period; and
• he ought to be so detained in the interests of his own health and safety or with a view to the protection of other persons.

However, in addition, it must be stated that:

• it is of urgent necessity for the patient to be admitted and detained under Section 2, and
• that compliance with the usual Section 2 requirements (that is, getting a second Medical Recommendation) would involve “undesirable delay”.

Notes

Section 4 offers less protection to citizens against unjustified detention because only one doctor has to recommend the compulsory admission under the Act. The doctor should be someone who either knows the patient, or who is recognised under Section 12 of the Act.
Section 4 has been mis-used at times, as an administrative convenience. It is easier for the professionals involved if only one doctor has to visit the patient in the community. The second doctor required for a Section 2 can then see the person in hospital after a Section 4 admission. The Mental Health Act Commission has been very critical of such an attitude. The Act clearly intends Section 4 only to be used in cases of genuine emergency.

Mark Walton’s site covers it here.

It requires the backup of either an approved social worker or your nearest relative.

The nearest relative is a weakness of the English law. The patient (to be) has no power over who their nearest relative is. They may not nominate another … I leave it as an exercise to construct a nightmare scenario involving a stressed out social worker, slightly dim easily led elderly psychiatrist and an evil Machiavellian nearest relative.

[MHCT03] : Scottish Detention : The Bonny Bonny Wards

Emergency detention

This is dealt with in Part 5 of the Act. Under the Act, any fully registered medical practitioner may grant a certificate that authorises the managers of a hospital to detain someone for 72 hours. This can only happen where that medical practitioner considers it likely that the following circumstances apply:

• the person has a mental disorder which causes his or her decision making to be ‘significantly impaired’
• it is necessary as a matter of urgency to detain the person for assessment
• the person’s health, safety or welfare, or the safety of another person, would be at significant risk if he or she was not detained
• making arrangements for the possible granting of a short-term detention certificate (see below) would involve ‘undesirable delay’.

Before granting an emergency detention certificate, the medical practitioner also needs to consult and gain the consent of a mental health officer, unless this is impracticable.

When a person has been detained in this way, the hospital managers then have to carry out a range of tasks. They must:

• notify various parties of the detention, including the patient’s nearest relative and named person, the Mental Welfare Commission and the Mental Health Tribunal
• appoint an approved medical practitioner to act as the patient’s responsible medical officer
• arrange for the patient to be examined by an approved medical practitioner.

If the approved medical practitioner who conducts the examination is not satisfied the criteria above are met, they have to cancel the certificate.

The named person is an improvement of the Scots Act over the English one. This being the only way Scotland will ever beat England at anything. They are selected (hopefully) by the patient to be before hand. Probably not of much use for the emergency one off admission, but good for people that may be in and out of the service for some time. Also the Scots Act states that certain principles must apply to all care given regardless of legal status.

Very bored with this post now.

I’ve rarely seen the emergency detention used, if anyone has personal experience from either side please leave a comment about it. Nurses I have spoken to are very aware of the potential dangers of misuse.

There is no appeal against use of emergency detention because it would take too long to get various organisations together.

I have no idea who normally picks people up from the community and takes them to hospital. Some places nurses from the ward go out. Other areas have specialist teams (often with emergency in their title) that go out and do emergency assessments and uplifts

Next post in this series will be about the exciting ones I promise.

Honest.

Almost all factual info in this posting is taken from Nigel Turners excellent hyperguide and other really good sites. All the made up stuff is by me unless otherwise stated. If you use this info as part of any legal type proceedings you are quite probably desperate and mad. I suggest you demand the services of an independent advocate, you have a right. – Mental