MHA

• Voluntary admission:

  • Section 131
  • Also known as information admission
  • When a patient with capacity agrees to be admitted
  • Does not involve detention under the mental health act
• The Mental Health Act (1983) (updated in 2007) provides a legal framework for keeping patients in hospital against their wish for assessment and treatment of a mental health disorder. This is called being detained or sectioned under the Mental Health Act.
• People involved:

  • Approved mental health professional (AMHP) - specially qualified professional e.g. mental health nurse that helps organise and contribute to MHA assessments
  • Section 12 doctor - qualified and approved doctor who can undertake MHA assessments
  • Responsible clinician - overall responsibility for the patient's care (generally consultant)
  • Nearest relative
  • Independent mental health advocate (IMHA) - allocated to patient being detained
• MHA assessment:

  • Detailed evaluation to determine whether to detain someone under the MHA
  • The AMHP is the primary person making the application and organising the admission - nearest relative can also make application
  • Decision needs to be recommended by 2 doctors - a section 12 doctor and another doctor e.g. GP
  • MHA assessment can result in compulsory admission under section 2 or 3
• Section 2:

  • Compulsory admission for assessment
  • Maximum period of 28 days
  • Cannot be renewed - ends either with discharge or further detention under section 3
• Section 3:

  • Compulsory admission for treatment
  • Maximum period of 6 months, after which the responsible clinician can renew for further treatment
  • Detention requires MHA assessment
  • Patients well known to mental health services may be detained under a section 3 straight from the community
• Section 4:

  • Used to detain for up to 72 hours
  • In urgent scenarios where other procedures cannot be arranged in time
  • Requires an AMHP and one doctor
  • Followed by a MHA assessment
• Section 5(2):

  • Used in an emergency to detain patients who are already in hospital voluntarily - including physical health issue
  • Lasts up to 72 hours
  • Requires only 1 doctor
  • Followed by a MHA assessment
• Section 5(4):

  • Used in an emergency to detain patients who are already in hospital voluntarily with a mental health issue
  • Lasts up to 6 hours
  • Requires only 1 nurse
  • Followed by a MHA assessment
• Section 136:

  • Used by the police to remove someone that appears to have a mental health disorder from a public place and take them to a place of safety where they can be assessed
  • Lasts up to 24 hours - can be extended 12 hours by a doctor if MHA assessment not available in time
  • Mental health hospitals often have 136 suits that act as a place of safety and used for assessment
• Section 135:

  • Court order allows police to enter a private property, remove person with mental disorder to place of safety
  • Detained up to 24 hours (extendable by 12 hours)
• Section 17a:

  • Community treatment order
  • Patients who are on a section 3 can leave hospital for treatment in the community if they are well enough
  • The patient can be recalled to hospital if there is non-compliance with treatment
• Section 117:

  • Aftercare
  • Health authorities and local social services have a legal duty to provide free aftercare for people who have been discharged under mental health act sections:
  • 3
  • 37
  • 45A
  • 47
  • 48