Mental Health Act 1983 Summary Guide For Ed

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The Mental Health Act 1983 – A Summary Guide for ED
For the purposes of the Act a Mental Disorder is defined as
“any disorder or disability of the mind”
Clinically recognised conditions that could fall under this definition are listed below –
this is not an exhaustive list
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Affective disorders, such as depression and bipolar disorder
Schizophrenia and delusional disorders
Neurotic, stress-related and somatoform disorders, such as anxiety, phobic
disorders, obsessive compulsive disorders, post-traumatic stress disorder and
hypochondriacal disorders
Organic mental disorders such as dementia and delirium (however caused)
Personality and behavioural changes caused by brain injury or damage (however
acquired)
Personality disorders
Mental and behavioural disorders caused by psychoactive substance use
Eating disorders, non-organic sleep disorders and non-organic sexual disorders
Learning disabilities
Autistic spectrum disorders (including Asperger’s syndrome)
Behavioural and emotional disorders of children and young people

Any decisions made under the act must adhere to the 5 overarching Guiding
Principles.

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2.
3.
4.
5.

Least Restrictive Option and Maximising Independence
Empowerment and Involvement
Respect and Dignity
Purpose and Effectiveness
Efficiency and Equity

Specific Sections of the Mental Health Act

Section 2
 Criteria – Suffering from mental disorder + in interests of health or
safety or protection of others
Assessment order
Lasts for 28 days and cannot be renewed
Application by AMHP or nearest relative supported by 2 doctors, one
of which needs to be Section 12 approved

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Section 3
 Criteria – Suffering from mental disorder + in interests of health or
safety or protection of others + treatment cannot be provided without
detention
Detention for treatment
Up to 6 months initially and may be renewed
Application by AMHP or nearest relative supported by 2 doctors, one
of which needs to be Section 12 approved

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Section 4
 Criteria
1. Suffering from mental disorder + in interests of health or safety or
protection of others
2. Patient’s detention required as matter of urgent necessity AND
3. Obtaining a second medical recommendation would cause
undesirable delay

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Detention for Assessment
Treatment not allowed without consent until 2nd medical
recommendation received
Application by AMHP or nearest relative
Lasts 72 hours and only > 24 hours after 2nd Medical
recommendation

Section 5 (2)
 Criteria
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Doctor or approved clinician in charge of a hospital in-patient
concludes detention required
Cannot be used in ED or outpatients
Does not apply to those liable to be detained under Sections
2/3/4 or those under section 135/136

Holding Power whilst arrangements made for assessment
Application made on Form 12 to Hospital Managers
Maximum of 72 hours

Section 5 (4)
 Criteria
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Hospital in-patient already receiving treatment for mental disorder
Invoked by registered mental health nurse
Cannot be used in ED or outpatients
Necessary to immediately prevent patient from leaving hospital
Not practicable to secure attendance of doctor immediately

Holding power for 6 hours until clinician with power to use 5(2)
arrives

Section 135(1)
 Provides police officers with power to enter private premises for
purposed of removing person to a place of safety for mental health
assessment

 Application by AMHP and granted by magistrate
 Arrangements for assessment either in person’s home or elsewhere
should then be made

Section 135(2)
 Warrant to provide police officers power to enter private premises
and remove patient liable to be taken/returned to hospital under the
Mental Health Act

 Granted by magistrate
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Section 136
 Emergency power allowing police to remove a person from a public
place to a place of safety

 Used if appears to police officer person is suffering from a mental
disorder and need immediate care or control

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Can be applied to the Emergency Department
Only used to enable person to be examined by doctor/AMHP
Maximum period of detention is 72 hours
Does not allow treatment without consent
Police should be allowed to leave once agreed to be safe for patient
and staff

Places of Safety
 There is locally agreed policy between the local authority, NHS
commissioners, hospitals, police and paramedics as to agreed
places of safety.

 A police station should not be used as a place of safety apart
from in exceptional circumstances

 All patients should be conveyed to a Health Based Place of
Safety. In the surrounding area these are:-

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Sandalwood Court, Swindon
Green Lane Hospital, Devizes
Fountain Way, Salisbury
Or GWH ED if no other capacity or concurrent health
concerns eg self poisoning, self harm.
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