sectioning in general practice

Last reviewed 01/2018

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