I work on a psychiatric intensive care unit (PICU) and have noticed a significant rise of patients being detained under Section 2 of the Mental Health Act. I recently had the dubious pleasure of being asked to do five hearings for tribunal and hospital managers in 5 working days. In our trust, figures suggest a steady increase for this type of work in recent years, although this may be partially offset by a reduction of such admissions to the acute wards.
Many health and social care professionals seem to be using Section 2 much more frequently than before. Out-of-hours assessments are carried out by duty staff with little or no prior knowledge of the patients and it is inevitable in such circumstances that Section 2 is more often used. This seems appropriate.
However, there is also an uncritical approach to using guidance Reference Jones1 that results in Section 2 being used much more frequently now. Whereas Jones makes an argument as to why Section 2 can be preferred to Section 3, the Mental Health Act itself has retained the use of Section 3 as a first option rather than recommend Section 2 be used indiscriminately.
I have yet to see reports of these trends in the literature but this situation is likely to impinge greatly on the workload of consultants and clinicians dealing with PICUs and admission/treatment wards as well as for administrative staff. The waste of time and resources in dealing with the inevitable extra tribunals must be a good enough reason for the law and code of practice to be made clearer.
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