To admit someone over 16 who will not agree to an informal (voluntary) admission and who is a danger to themselves or to others, the procedures of the 1983 Act must be used:
There are five sections of the Mental Health Act that may affect GPs in the emergency situation:
- section two
- admission for assessment
- allows admission and assessment of a patient for up to 28 days - treatment can be given for mental disorder without consent
- application is made by the Approved Mental Health Professional (AMHP) and two doctors make written recommendations
- the AMHP is takes the lead role in a Mental Health Act Assessment
- before the Mental Health Act 2007 this role was taken by a social worker who had undergone specialist training - an Approved Social Worker (ASW)
- this role has now been extended to other clinicians (e.g. community psychiatric nurses) who have undergone special training
- the AMHP will act on behalf of the nearest relative by coordinating the assessment and making the formal application
- one doctor (usually a psychiatrist) should have approval from the Secretary of State under Section 12
- the other doctor is a doctor who has previous knowledge of the patient (usually the GP)
- section three
- admission for treatment
- for patients who are already known to the service or who have already been assessed under Section 2
- lasts for up to 6 months - can be renewed thereafter
- application is made by the same professionals as in a section two
- section four
- emergency admission
- used to admit a patient when only one doctor can be found - this doctor may be the GP
- the AMHP makes the application and the doctor makes the recommendation
- detention is limited to 72 hours
- the purpose of the detention is so that a full Mental Health Act assessment can be undertaken
- section 135
- allows for a magistrate to authorise forced entry to a property where it is believed that a person is suffering from a mental disorder
- once the GP has alerted the services to the situation then he or she should be guided through the procedure by the AMHP
- section 136
- a police officer can detain, to a place of safety, a person in a public place who they believe may be suffering from a mental disorder
- this action allows a full Mental Health Act assessment to take place - to which the GP may be called
- in most areas, the "place of Safety" is the police station - however some Trusts have introduced dedicated Place of Safety sites within the hospital