Mental Health Act Summary

Basic Principles

  • Attempt voluntary admission first
  • Compulsory admission only if necessary and declined
  • Requires mental disorder warranting hospital assessment/treatment
  • Needed for person's health/safety or protection of others

Main Sections

  • Section 2: 28 days for assessment
  • Section 3: 6 months for treatment
  • Section 4: 72 hours emergency admission

Requirements

  • Application from AMHP or nearest relative
  • Medical recommendations:
    • Section 2/3: Two doctors (one section 12 approved)
    • Section 4: One doctor (preferably GP)

Emergency Powers

  • Section 5(2): Doctor holding power (72 hours)
  • Section 5(4): Nurse holding power (6 hours)
  • Only for already admitted patients
  • Not applicable in Emergency Department

Police Powers

  • Section 136: Remove from public place to place of safety
  • Enables medical examination and AMHP interview

Special Cases

  • 16-17 year olds with capacity: Cannot be admitted based on parental consent alone
  • Formal detention under Mental Health Act required if they refuse

Mental Health Act

Compulsory admission and treatment provisions

Introduction

If the person needs to be admitted to hospital, every attempt should be made to persuade them to go voluntarily. If admission is necessary but the person declines, compulsory admission may be arranged under sections 2, 3, or 4 of the Mental Health Act.

Mental Health Act (2007) Criteria

The Act allows compulsory admission of people who:

  • Have a mental disorder of a nature and degree that warrants assessment or treatment in hospital, and
  • Need to be admitted in the interests of their own health or safety, or for the protection of other people.

Compulsory Admission Sections

Section 2

  • Compulsory admission for up to 28 days for assessment
  • Requires:
    • Application from AMHP or nearest relative
    • Written recommendations from two doctors
    • One doctor must be section 12 approved (usually psychiatrist)
    • One doctor with previous acquaintance (usually GP)
  • If no GP available: Another section 12-approved doctor or any registered medical practitioner (no conflicts of interest)

Section 3

  • Compulsory admission for up to 6 months for treatment
  • Requires:
    • Application from AMHP or nearest relative
    • Written recommendations from two doctors
    • One doctor must be section 12 approved (usually psychiatrist)
    • One doctor with previous acquaintance (usually GP)

Section 4

  • Emergency compulsory admission for up to 72 hours
  • Used when urgent necessity and undesirable delay would occur with Section 2
  • Requires:
    • Application from AMHP or nearest relative
    • One medical recommendation (preferably from GP)
  • Usually converted to Section 2 after admission

Emergency Holding Powers

Section 5(2)

  • Doctor holding power
  • Duration: 72 hours
  • For already admitted patients

Section 5(4)

  • Registered mental health nurse holding power
  • Duration: 6 hours
  • For already admitted patients

Important Note

A patient in an Emergency Department is not an inpatient, so cannot be detained under Section 5. Restraint permitted by The Mental Capacity Act or Common Law is all that is available to provide temporary restraint for individuals who are a manifest danger either to themselves or to others while awaiting assessment by a psychiatrist.

Police Powers

Section 136

  • Allows police to take people from a public place to a place of safety
  • Enables examination by a registered medical practitioner
  • Enables interview by an AMHP
  • The person's GP may be informed (where known)

Special Considerations

Young People (16-17 years)

Young people aged 16 or 17 years who have capacity to consent, but refuse to do so, cannot be admitted or kept in hospital for treatment for a mental disorder on the basis of their parents' consent — they will need to be formally detained under the Mental Health Act.

Summary of Key Points

Section Purpose Duration Requirements
Section 2 Assessment Up to 28 days AMHP/relative + 2 doctors (1 section 12 approved)
Section 3 Treatment Up to 6 months AMHP/relative + 2 doctors (1 section 12 approved)
Section 4 Emergency admission Up to 72 hours AMHP/relative + 1 doctor (preferably GP)
Section 5(2) Doctor holding power 72 hours For already admitted patients
Section 5(4) Nurse holding power 6 hours For already admitted patients
Section 136 Police removal to place of safety Assessment period Police power for public place removal