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Section 5(2) MHA 1983: results of a three-year rapid cycle clinical audit
Ambreen Rashid1, Padmapriya Musunuri, Tim Coupe
1Brooklands Hospital, Marston Green, Coleshill B37 7HL.
Abstract:
The aim of this paper was to establish whether section 5(2) of the Mental Health Act 1983 was being used appropriately in an inpatient psychiatric unit in the UK. A clinical audit was conducted over three consecutive years. Peer review of decisions to use section 5(2) on the hospital's adult and old age wards was conducted by junior medical staff. Ninety-eight per cent of the uses of section 5(2) were felt to be appropriate and most were reviewed within 72 hours. Very few patients (5%) were placed on this section again during their admission. The number placed on section 5(4) prior to section 5(2) increased from 2% to 12%. The proportion reviewed within the first 24 hours of detention nearly doubled over the audit period and fewer patients subsequently went on to sections 2 or 3 by the third year. There was no evidence of inappropriate use of section 5(2). Changes in the shift system for junior medical staff may have inadvertently led to a more frequent use of section 5(4). The use of further formal detention after section 5(2) declined, although this decline was not statistically significant.
Insights
This clinical audit found section 5(2) of the Mental Health Act 1983 was appropriately used in a UK psychiatric unit. Most detentions were reviewed promptly, with few patients re-detained, indicating effective Mental Health Act 1983 application.
Area of Science:
- Psychiatry
- Mental Health Law
- Clinical Governance
Background:
- Section 5(2) of the Mental Health Act 1983 allows for temporary detention of patients in psychiatric hospitals.
- Ensuring appropriate application of such legal measures is crucial for patient rights and effective treatment.
Purpose of the Study:
- To audit the appropriateness of section 5(2) usage in a UK inpatient psychiatric unit over three years.
- To assess review timeliness and subsequent detention patterns following section 5(2) application.
Main Methods:
- A three-year clinical audit of section 5(2) detentions.
- Peer review of detention decisions by junior medical staff.
- Analysis of patient re-detention rates and progression to other Mental Health Act sections.
Main Results:
- 98% of section 5(2) uses were deemed appropriate, with most reviewed within 72 hours.
- A significant increase in the use of section 5(4) preceding section 5(2) was observed.
- The proportion of patients reviewed within 24 hours nearly doubled, and fewer patients proceeded to sections 2 or 3.
Conclusions:
- Section 5(2) of the Mental Health Act 1983 appears to be used appropriately in this setting.
- Changes in junior medical staff rotas may have influenced the increased use of section 5(4).
- The study suggests a positive trend towards reduced formal detention post-section 5(2).
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