A 28-year-old man was admitted under psychiatry for an acute psychotic episode after his colleague found plans to end his life and called the police. The police brought him to hospital under section 135. In A&E, he exhibited persecutory delusions and suicidal ideation, stating he has made several plans to end his life and would do so if discharged.


He has been held under section 5(2) while awaiting a full assessment and it has been decided that he is not safe to leave as he is a high risk to himself with serious concern that he would end his life if he were to leave.


Under which section of the mental health act (1983) should he be detained?

Options:
explanation: A patient can be detained under section 5(4) of the mental health act by a nurse who has been qualified and trained to work with mental health problems or learning disabilities. It is a short term emergency section to detain a patient for up to 6 hours until they can be seen by a doctor. This patient has already been detained under section 5(2) and so detention under section with a longer time period would be required to provide further assessments and/or treatment. The most appropriate answer would therefore be section 2 to detain the patient for up to 28 days
name: Section 5(4)
label: c
answer: no
explanation: When a patient is detained under section 3 of the mental health act, they can be detained for up to 6 months with option of further renewal. This patient has only had a short assessment so far and so would need a longer period of detention. Usually the least restrictive method, and therefore the shortest time required, would be used and so detention under section 2 would be used initially to detain the patient for 28 days
name: Section 17
label: d
answer: no
explanation: This patient has presented with an acute psychotic episode and is currently not safe to leave due to strong concerns that he is at risk of ending his life if he were to leave. He should therefore be detained under section 2 of the mental health act which allows detention for a period of 28 days. If the patient continues to require psychiatric treatment after the 28 days, then he could be considered to be detained under section 3 which would allow him to be detained for up to 6 months with option of further renewals. Section 2 can't normally be extended or renewed once expired
name: Section 2
label: a
answer: yes
explanation: Section 136 is slightly different to section 135. Both are carried out by police officers if they believe the patient has a mental disorder and in need of immediate care of control where they can detain a patient against their will to be taken to a place of safety until examined by a doctor. Section 135 is used when police require entry to a persons home, if need be by force, when they believe a person is at serious risk of harming themselves or others. Section 136 is used when police find the person in a public place and feel they need to bring the patient to a place of safety. A patient can be detained under section 135 and 136 for up to 24 hours
name: Section 136
label: e
answer: no
explanation: When a patient is detained under section 3 of the mental health act, they can be detained for up to 6 months with option of further renewal. This patient has only had a short assessment so far and so would need a longer period of detention. Usually the least restrictive method, and therefore the shortest time required, would be used and so detention under section 2 would be used initially to detain the patient for 28 days
name: Section 3
label: b
answer: no

Correct answer: a

Section 2

Learning point: Section 2 of the Mental Health Act (MHA) allows for the detention and assessment of an individual in a hospital for up to 28 days without their consent if they are deemed to have a mental disorder that requires immediate treatment and poses a risk to their safety or the safety of others.