Section 4 of MHA

Dear All,
I would be interested in people’s views and experiences of using s4 of the MHA.

To put the question into context I am a consultant psychiatrist in a large rural area, with a small number of s12 approved Drs. Transport distances are long and the catchment area is large. Like everyone else our police and ambulance services are desperately stretched also.

We can at times struggle to find 2 drs to attend for a MHA assessment. GPs are often not able to attend and whilst we always have a named person to attend for emergency MHA assessments we are not able to provide a rota for 2 s12 approved drs.

Whilst mindful that s4 does not give authority to treat a view has been suggested that we would have one doctor and where we cant source a second within working hours, we should undertake the assessment and utilise Section 4 if appropriate, rather than delay the assessment to out-of-hours, which increases risk due to delays, being out of hours, need for handover to different team (EDT) etc.

Everyone agrees that use of s4 is far from perfect but our circumstances paired with the contracting workforce does mean that we do need to think of a solution to a situation which is unusual but does need a contingency plan.

best wishes

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I’m afraid this won’t be overly helpful in pragmatic terms, but this is exactly why the AMHP Leads Network requested both during the Wessely Review and the White Paper consultation for a duty to be placed on the NHS to provide doctors in the event that an application under the MHA may be required.
There is of course, and has been for decades a duty on the local authority to provide an AMHP, but no mirror duty on the NHS to provide a doctor.
Disappointingly, but unsurprisingly, no mirror duty was forthcoming in the draft Bill.


Thanks for that Steve, I recognise your point.