Certification confers the right to detain and treat the patient. The requirements are as for section 9 committal except that circumstances demand immediate hospitalization. A psychiatrist at the admitting institution can certify patients under this provision. If no further steps are undertaken after admission, the patient can nevertheless be detained in the hospital for 10 days. The hospital superintendent may apply for an extension of this period to 21 days.
Psychiatric hospitals serve large geographic areas.
Valkenberg hospital received patients from areas that can be 500 miles from the institution. Most towns and rural areas do not have psychiatrists practicing within a radius of 200 miles, and assessments are made by general practitioners who usually guess at a psychiatric diagnosis. Intoxicated individuals are not uncommonly labeled schizophrenic, sedated and referred by ambulance to a psychiatric hospital 500 miles from home. Unfortunately there is no coherent body of law that has developed as a general guide. Relying on ancient texts to substantiate their claims in court is not unusual for so-called experts.