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

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

Principles.

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

1. Least Restrictive Option and Maximising Independence

2. Empowerment and Involvement

3. Respect and Dignity

4. Purpose and Effectiveness

5. 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

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

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

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

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

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



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

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:-

oSandalwood Court, Swindon

oGreen Lane Hospital, Devizes

oFountain Way, Salisbury

oOr GWH ED if no other capacity or concurrent health

concerns eg self poisoning, self harm.