MHA 1983 s2 allows for up to 28 days of detention for assessment, or assessment followed by treatment.

Admission criteria

"(a) he is suffering from mental disorder of a nature or degree which warrants the detention of the patient in a hospital for assessment (or for assessment followed by medical treatment) for at least a limited period; and

(b) he ought to be so detained in the interests of his own health or safety or with a view to the protection of other persons." (s2(2))

Paperwork

• Two written medical recommendations, which can be on a joint recommendation form, are required (s2(3)); one doctor must be approved under s12 by the Secretary of State as having special experience in the diagnosis or treatment of mental disorder.

• The application, by an Approved Mental Health Professional or Nearest Relative (s11(1)). An AMHP must interview the patient in a suitable manner and satisfy himself that detention in a hospital is in all the circumstances of the case the most appropriate way of providing the care and medical treatment of which the patient stands in need (s13(2)).

Procedure

• The patient must be conveyed to hospital within 14 days beginning with the date on which the patient was last examined by a registered medical practitioner before giving a medical recommendation (s6(1)(a)).

• There must be no more than five clear days between the two medical examinations (s12(1)). I.e. If the first were on a Sunday the second must be no later than Saturday.

• The applicant (usually AMHP, but could in theory be NR) must have personally seen the patient within the period of 14 days ending with the date of the application (s11(5)).

Involvement of NR

Where the application is made by an AMHP, he must, before or within a reasonable time after the application, take such steps as are practicable to inform the person (if any) appearing to be the nearest relative of the patient of (i) the application and (ii) the NR's discharge powers (s11(3)).

Duration

The section will usually lapse at midnight on the 28th day (e.g. if the section began on a Sunday, it will expire at midnight on a Saturday/Sunday) and cannot be renewed (s2(4)); however

• the patient can be placed under s3 at any time during the s2, and

• if action is taken to displace the NR (under s29(3)(c) or (d)), the s2 is extended for the period specified in s29(4).

Discharge routes

• One application can be made to the Mental Health Review Tribunal, but only during the first 14 days of detention (s66(2)(a)). The hearing should be held within 7 days of receipt of the application (MHRT Rules r31) (The application can be faxed).

• Hospital managers' hearing (see Code of Practice ch 23 and s23).

• The nearest relative's discharge powers apply to s2 as they do to s3, the only difference being the NR's inability to apply to the MHRT following an RC's barring order. It is therefore sometimes wiser for the NR to wait until the patient is on s3.

• The Responsible Clinician can discharge at any time (s23).

Other

Section 2 is generally used for first admissions. Once someone is known it is more common for them to be admitted under section 3 (admission for treatment).

The patient can be forcibly medicated, and the Consent to Treatment provisions apply (s56).

An emergency admission for assessment can be made under s4.

See also

• Reference Guide to the Mental Health Act 1983, 2. Compulsory admission to hospital under Part 2 of the Act