A registrar survival guide ... Sectioning

Know the Mental Health Act

The Mental Health Act 1983 is used to admit someone over the age of 16 who will not agree to a voluntary admission, is suffering from a mental disorder and is a danger to themselves or others. The most common types of section you will come across in general practice are sections 2, 3 and 4. Occasionally, when a GP believes the patient to be a danger to themselves or others, he or she can use section 4 to admit the patient for up to 72 hours with a recommendation from a nearest relative or an approved social worker (ASW).

Involve relevant professionals
The decision to section a patient may be made by the GP, a psychiatrist or recommended by an ASW. Contact the hospital to arrange a bed and also order an ambulance for the time of the psychiatrist's arrival. If the patient absconds or is violent, call the police. They have a legal duty to ensure a sectioned patient gets to hospital.

Use the notes
Take the patient's notes with you. If a section is necessary, both doctors will fill in form 7 and the ASW form 6. The GP must know the patient or be section 12 approved. Always document the assessment and the type of section used (2 for assessment and 3 for treatment). Don't forget to claim the standard fee for a GP's attendance.

  • Contributed by Dr Lizzie Croton, a salaried GP in Birmingham

ESSENTIALS CHECKLIST

  • In-depth knowledge of the Mental Health Act.
  • Prior contact with the receiving hospital.
  • Patient's notes.
  • Readiness to call the police, if required.

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