Commonly Used Sections of the Mental Health Act

Section 136

  • This is an arrest by a police officer from a public place;
  • Compulsory detention to a place of safety for up to 72 hours for a Mental Health Act assessment by medical practitioner and an AMHP;
  • The detention starts when the person arrives at the place of safety (hospital or police cells);
  • The service user can be moved under this section.

Section 135

  • Allows the Police to gain entry into an individual’s home when an assessment under the Act is being considered and voluntary access is denied.

Section 5(4)

  • Compulsory detention in hospital for up to 6 hours for a Mental Health Act assessment;
  • Requires one nurse recommendation (RMN, RMNH, or SEN working in the speciality);
  • The detention comes into force immediately the nurse informs the service user they are being placed on a section 5(4);
  • The service user must already be an in-patient.

Section 5(2)

  • Compulsory detention in hospital for up to 72 hours for a Mental Health Act assessment by two medical practitioners and an AMHP;
  • Requires one medical recommendation;
  • The detention has an immediate effect on the doctor signing the section 5(2) form;
  • The service user must already be an in-patient.

Section 4

  • Emergency admission to hospital for up to 72 hours for a Mental Health Act assessment.;
  • Requires one medical recommendation;
  • Not more than 24 hours must have elapsed between the medical assessment and admission.

Section 2

  • Admission to hospital for assessment for up to 28 days;
  • Requires two medical recommendations one of which should be made by a doctor who knows the service user;
  • Not more than 5 days must have elapsed between the medical assessments;
  • If the section 2 was converted from a section 4, the 28 day period commences from the start of the section 4.

Section 2 Application

  • By an AMHP or the nearest relative;
  • Admission must be within 14 days after the last medical recommendation has been completed.

Section 3

  • Admission to hospital for treatment for up to 6 months;
  • Requires 2 medical recommendations;
  • Not more than 5 days must have elapsed between the medical assessments.

Section 3 Application

  • By an AMHP or the nearest relative;
  • The Social Worker must consult with the Nearest Relative before an application is made;
  • Admission must be within 14 days after the last medical recommendation has been completed.

Difference between Sections 2 and 3

Section 2

  • Mental disorder of a degree or nature that warrants detention;
  • Admission for assessment-may be followed by medical treatment;
  • Up to 28 days;
  • Cannot be renewed;
  • Nearest relative should be informed of the detention by the ASW.

Section 3

  • The mental disorder is of a nature or degree which makes it appropriate to receive medical treatment in a hospital;
  • Up to 6 months (x2; then annually);
  • Can be renewed for another 6 months and yearly thereafter;
  • Nearest Relative can object to the detention;
  • Appropriate Medical Treatment Test.

Supervised Community Treatment (SCT)/ Community Treatment Order (CTO)

  • Allows certain in-patients to be discharged with imposed conditions;
  • They can be recalled to hospital;
  • It is intended to:
      • improve engagement with services;
      • promote improved mental health;
      • allow for quick response to crisis situations;
      • support service users and carers.

SCT/CTO Conditions

  • Two mandatory conditions for all people on SCT/CTO which concern the renewal of the CTO and an assessment for a Second Opinion Appointed Doctor (SOAD) certificate;
  • Other conditions which must relate to:
  • receiving medical treatment;
  • preventing harm to self;
  • protecting others.
  • This is all about care planning and could require the involvement of others to monitor,e.g. families, friends, community workers, other professionals etc.

Section 117

  • The duty to provide after care for people who are subject to certain sections of the Act;
  • To support their mental health for as long as they require it;
  • Service user does not have to pay for the services provided;
  • To stop it must be discharge by Local Authority and Clinical Commissioning Group.

Section 37/41

  • Forensic;
  • Hospital order;
  • Restriction order;
  • Conditionally discharged;
  • Similarities with SCT;
  • Can be removed by Mental Health Review Tribunal and Home Office only.

Section 17 Leave

  • Can be granted to allow service users who are subject to the restrictions of the Mental Health Act to leave the Ward;
  • The written permission of the Responsible Clinician must be in place.

Electro-convulsive Therapy

  • Where service users have capacity to consent, consent must be sought;
  • Where service users have capacity but refuse to give consent, ECT cannot be imposed – even under section;
  • Except in emergencies:
  • life saving;
  • preventing SERIOUS deterioration.