11/14/24, 10\:40 AM The Mental Health Act (MHA)
The Mental Health Act (MHA)
Table of contents
Key points ⚡
Succinct notes to superpower your revision
Mental Health Act (2007)\: legal framework for informal and compulsory care/treatment of people with a mental disorder
in England and Wales.
Mental disorder\: includes mental illness, personality disorder, learning disability (with "abnormally aggressive behaviour" or
"seriously irresponsible conduct"), and disorders of sexual preference (e.g. paedophilia).
Exclusions\: people under the in
Key roles\:
Section 12 doctor\: approved to make speci
Approved mental health professional (AMHP)\: mental health worker with additional training.
Responsible clinician\: oversees patient care, responsible for renewing sections and discharging patients.
Nearest relative\:
Voluntary admission (Section 131)\: informal admission, no formal restrictions, patient must have capacity, consent, and not
resist admission.
Section 2\: compulsory detention for assessment, mental disorder warrants detention for at least a limited period, necessary
for health/safety or protection of others, maximum 28 days, requires AMHP/nearest relative and two doctors (one section
12 approved).
Section 3\: compulsory detention for treatment, mental disorder warrants treatment in hospital, necessary for health/safety
or protection of others, appropriate treatment available, maximum 6 months (renewable), requires AMHP/nearest relative
and two doctors (one section 12 approved).
Section 4\: emergency admission for assessment, primarily used in outpatient services, requires AMHP/nearest relative and
one doctor, maximum 72 hours.
Section 5(2)\: emergency order for inpatient detention for up to 72 hours, requires one doctor (in charge of patient’s care).
Section 5(4)\: nurse can detain patient for up to 6 hours for assessment if immediate restraint needed and doctor not
available.
Section 135\: court order allows police to enter private property, remove person with mental disorder to place of safety,
detained up to 24 hours (extendable by 12 hours).
Section 136\: police can detain person from public place to place of safety for up to 24 hours for assessment without a
warrant.
Section 17a\: patients under Section 3 can receive community treatment if well enough, decision by responsible clinician
and AMHP, can be recalled to hospital for non-compliance or missed appointments, detained for up to 72 hours for
assessment if recalled.
Article 🔍
A comprehensive topic overview
Introduction
The Mental Health Act (2007) refers to a law used in England and Wales which provides a legal framework for both
informal and compulsory care and treatment of people diagnosed with having a mental disorder.
A mental disorder is described as any disorder or disability of the mind and can include any of the following\:
https\://app.geekymedics.com/notebook/2755/ 1/511/14/24, 10\:40 AM The Mental Health Act (MHA)
Mental illness
Personality disorder
Learning disability
*
Disorders of sexual preference (e.g. paedophilia)
*Only if associated with "abnormally aggressive behaviour" or "seriously irresponsible conduct"
. There is a draft Mental
Health Bill (2022) which aims to reform the Mental Health Act and strengthen safeguards for people with learning
disabilities to prevent inappropriate detention under the Mental Health Act.
Anyone under the in
Act.
Individuals involved in the application of the MHA include\:
Section 12 doctor\: a doctor approved to make speci
Approved mental health professional (AMHP)\: mental health worker (e.g. social worker, psychologist, mental health
nurse, occupational therapist) who has additional mental health training and is approved by the local authority.
Responsible clinician\: an approved clinician with the overall responsibility of patient care, they are responsible for
renewing sections and discharging patients from a section.
Nearest relative\:
Voluntary admission
Section 131
Section 131 of the Mental Health Act is a section of the legislation which covers the informal admission of patients.
This means that patients can be admitted for care and treatment without formal restrictions, and they are free to leave at
any time.
To be admitted under section 131, patients must meet the following criteria\:
The patient must have capacity
The patient must consent to the admission
The patient must not resist the admission
Involuntary admission
Section 2
Section 2 of the Mental Health Act is used for compulsory detention for assessment.
A person can be detained under section 2 only if both of the following apply\:
The person su
period.
The person ought to be detained in the interests of their own health or safety or the protection of others.
The maximum period a person can be detained for assessment is 28 days, which cannot be renewed.
The application for admission can be made by an approved mental health professional (AMHP) or the nearest relative.
This application must be supported by two doctors, one of which must be an approved section 12 doctor.
Section 3
Section 3 of the Mental Health Act is used for compulsory detention for treatment.
A person can be detained under section 3 only if all the following apply\:
The person su
in hospital.
https\://app.geekymedics.com/notebook/2755/ 2/511/14/24, 10\:40 AM The Mental Health Act (MHA)
It is necessary for the health or safety of the person or the protection of others, that the person should receive
treatment which cannot otherwise be provided unless the patient is detained.
Appropriate medical treatment is available for them.
The maximum period a person can be detained under this section is 6 months, which can be renewed.
The application for admission can be made by an AMHP or the nearest relative. The nearest relative can oppose this
and/or request it is rescinded (unlike section 2).
This application must be supported by two doctors, one of which must be an approved section 12 doctor. Both doctors
must have seen the patient in the last 24 hours.
Emergency situations
Section 4
Section 4 of the Mental Health Act is used for admission for assessment in cases of emergency.
It is primarily used in outpatient services when it is not possible to wait for a section 2 to be arranged. An application can
be made by an AMHP or nearest relative and only requires the support of one doctor.
This section allows patients to be detained for a maximum of 72 hours, after which it often changed to a section 2.
Section 5(2)
Section 5(2) is an emergency order where an inpatient who is a voluntary patient in hospital can be detained for up to 72
hours for a mental health act assessment.
Only one doctor (usually the one in charge of the patient’s care) is required to make an application for this section.
Section 5(4)
This is similar to section 5(2), but a patient can be detained by a nurse for up to 6 hours to allow further assessment by
medical sta
The application can be made by a nurse if\:
The patient is su
protection of others, that they are immediately restrained from leaving hospital.
It is not feasible or practical for a clinician to be immediately available to detain the patient under Section 5(2).
Police powers
Section 135
Section 135 is a court order that allows police o
from a mental health disorder and place them in a place of safety (usually an Emergency Department or police station) if
there is reasonable cause to suspect that they\:
Have been ill-treated or neglected
Is unable to care for themselves and are living alone
The patient can be detained under this court order for up to 24 hours (although this can be extended by 12 hours).
Section 136
Section 136 allows police o
place to a place of safety without a warrant, for up to 24 hours to allow them to be assessed by a medical practitioner.
Community treatment orders
Section 17a
https\://app.geekymedics.com/notebook/2755/ 3/511/14/24, 10\:40 AM The Mental Health Act (MHA)
Under section 17a, patients who are on a section 3 can leave hospital for treatment in the community if they are well
enough.
The decision is made by the responsible clinician in agreement with the AMHP if the following criteria are met\:
The patient is su
treatment
It is necessary for the patient’s health or safety or the protection of others, that they should receive treatment
Treatment can be provided to the patient without the need to continue to detain them in hospital
Appropriate medical treatment is available to the patient
The patient can be recalled to hospital if there is non-compliance with treatment or they do not attend appointments.
Once recalled, they may be detained for up to 72 hours for assessment.
Summary table
Table 1. Summary of the Mental Health Act sections.
Section Purpose
People involved in
recommending this section
Duration
131 Informal admission of patients The patient -
2
Compulsory detention of a patient for
assessment
AMHP/nearest relative
Two doctors (one must be
section 12 approved)
AMHP/nearest relative
Two doctors (one must be
section 12 approved)
AMHP/nearest relative
One doctor
28 days
6 months
(can be
renewed)
72 hours
One doctor (in charge of the
patient's care) 72 hours
3
4
5(2) 5(4)
135
136
17a
Compulsory detention of a patient for
treatment
Admission for assessment in cases of
emergency
Emergency order to detain an inpatient
for an MHA assessment
Emergency order to prevent a patient
leaving hospital to allow further
assessment
Removal of a person from private
property to a place of safety
Removal of a person from a public place
to a place of safety without a warrant
An order allowing patients under a
section 3 to receive treatment in the
community
Nurse 6 hours
Police o
Police o
Responsible clinician
AMHP
-
References
T h e M e n t a l H e a l t h A c t 1 9 8 3 & 2 0 0 7 . [ O n l i n e ] . London\: The Stationary oLINK]
Department of Health.Mental Health Act 1983\: Code of Practice. Available from\: [LINK]
Fenton, C., Lodge, K.
-M., & Henderson, J. (2016).E u r e k a \: P s y c h i a t r y . Scion Publishing Ltd.
https\://app.geekymedics.com/notebook/2755/ 4/511/14/24, 10\:40 AM The Mental Health Act (MHA)
Azam, M., Qureshi, M., & Kinnair, D. (2016).P s y c h i a t r y \: A c l i n i c a l h a n d b o o k . Scion.
Reviewer
Dr Dawn Collins
Consultant Psychiatrist
Related notes
Anxiety Disorders
Bipolar Disorder
Bulimia Nervosa
Depression
Medically Unexplained Symptoms
Test yourself
Contents
Introduction
Voluntary admission
Involuntary admission
Emergency situations
Police powers
Community treatment orders
Source\: geekymedics.com
https\://app.geekymedics.com/notebook/2755/ 5/5