Izlaganje sa skupa
A CRITICAL REVIEW OF PATIENTS UNDER SECTION 5(2) OF THE MENTAL HEALTH ACT OF 1983
Hellme Najim
; Mental Health Unit, Basildon Hospital, Basildon, Essex, UK
Raja Shaik
; Mental Health Unit, Basildon Hospital, Basildon, Essex, UK
Sažetak
Background: Patients who suffer from mental illness within the definition of the Mental health Act of 1983 and present a risk to
themselves, to other people or at risk of self neglect or deterioration can be detained under section. Section 5(2), applies for patients
who are already admitted to hospital and express their wish to leave against medical advice. It requires the recommendation of one
medical practitioner. It gives the power to detain them for 72 hours in hospital for further assessment.
To safeguard malpractice of this section Trusts have developed policies and procedures which defines good medical practice
within the legal framework of the MHA 1983.
Aims: To evaluate current medical practice and insure that it complies with trust’s policies and procedures and applies good
medical practice.
Methods: Medical Case notes of patients admitted from 1.1.07-30.6.07 and were detained under section 5(2) were reviewed. A
special form was devised to collect information from the notes. It included age, sex, marital status, occupation, diagnosis, history or
violence, history of drug and alcohol abuse and circumstances of their detention were obtained.
Results: 44 patients were identified. 40% were men, 65% above the age of 50 years, 52% were sectioned after hours or at the
weekends. Measures to persuade patients to stay as an informal patient were taken in 16%. 55% were sectioned by the on call
doctor. 68.5% exhibited threatening behaviour. 30% had self neglect, 13% were a risk to others, 26% had a deliberate self harm
risk. 60% had moderate to severe suicidal risk and ideation. 68% did not have mental health capacity to give consent for admission.
60% had been assessed in the first 24 hours of their section. 60% were converted to section 2,3 of the Mental Health Act. 25% stayed
as informal patients and 7% were discharged.
Discussion: Female patients were more likely to be put on section 5(2) which was against expectation. Older people were more
likely to be put on section 5(2) which was again against expectation. Majority of patients were a risk to themselves and only 13%
were a risk to other people. Nearly two third were assessed within 24hrs from the section which was something we commend our
services on. 60% needed to be transferred to different sections which indicates that 40% of the sample could have been managed
more efficiently without warranting section 5(2).
Conclusion: Section 5(2) is a useful legal framework when it is used efficiently. This study has shown that current clinical
practice could be improved by applying the least restrictive measures by giving the patient more choice and empowering them in
clinical decision making.
Ključne riječi
Section 5(2); mental health act
Hrčak ID:
266616
URI
Datum izdavanja:
26.8.2013.
Posjeta: 175 *