using the Mental Health Act in primary care

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