Sectioning 'just in case'

Law and practice Mental Health Act
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I have come across two independent comments concerning section 2 discussions, both said that doctors and AMHPs were concerned about criticism in the case of suicide shortly after contact with them.

An article in the Mail on Sunday August 28 2022 by Darren Boyle discussed ‘Why are more people being sectioned by psychiatrists’.

Below is a cut from the article.

Experts say the situation is at least in part a symptom of a wider problem in the NHS: the practice of defensive medicine. This is when doctors offer treatment or an intervention that may not be warranted, simply in order to avoid the possibility of a complaint or legal action should something go wrong.

The Mental Health Act is currently being revised, and a first draft of the new Bill was published in June. However, critics worry it will not do enough to prevent over-cautious staff sectioning patients ‘just in case’.

I know a bit about ‘just in case’ but are there cases of doctors/ AMHPs that have experienced legal action due to being blamed for suicide soon after contact and are there any cases where they have experienced legal action for sectioning contrary to the MHA and Code of Practice?

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I don’t deny defensive practice exists, and the Mental Health Bill is far from ideal, but I always get a red alert when a publication like The Mail on Sunday states “experts say…” and “critics worry…” without naming any of the experts or critics they are referencing

2 Likes
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Yes I get the same reaction as you do, but this one names a lot of ‘experts’. Retired consultant psych and CQC reviewer Dr Duncan Double,mental health expert Keir Harding wrote in Lancet in Aug 2022, consultant Dr Jorge Zimbron Fulford hospital Cambridge, and Dr Adrian James President of the royal college of psych. Seems well researched.

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In the first category, two Supreme Court cases spring to mind – Savage v South Essex Partnership NHS Foundation Trust [2008] UKHL 74 and Rabone v Pennine Care NHS Foundation Trust [2012] UKSC 2 – though there are some others linked to from the Article 2 page.

In the second category, there are a variety of cases – like TTM v LB Hackney [2011] EWCA Civ 4 and PB v Priory Group Ltd [2018] MHLO 74 – which you could find by searching the website, perhaps beginning by browsing the “Unlawful detention cases” category.

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As an AMHP in practice, the case of Rabone is always on my mind in terms of Article 2 and the duty placed on the state to safeguard its citizens. We must take P as we find / assess them and where suicide colinks with risk to P’s health and or safety, its something which features and often drives the post assessment discussion and decision. AMHPs and doctors always make these decisions in real time which can be challenging to unpick with the benefit of hindsight. Often what I find is a lack of postive risk planning with P when they are not at risk of suicide and their ‘crisis plan’ is mostly undeliverable at these times when it is needed.