What is a Section 3 of the Mental Health Act?

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    What is a Section 3 of the Mental Health Act?

    Section 3 of the Mental Health Act is commonly known as “treatment order” it allows for the detention of the service user for treatment in the hospital based on certain criteria and conditions being met.  These are that the person is suffering from mental disorder and that the mental disorder is of a nature or a degree which warrants their care and treatment in hospital and also that there is risk to their health, safety of the service user or risk to others.  It also requires that the treatment cannot be given without the order being in place and that appropriate treatment must be available in the setting where it is applied. 

    Who would undertake a Section 3 assessment?

    In order to assess somebody under section 3 you require two medical recommendations which state the person needs to be admitted to hospital for treatment for their mental disorder.  One of the medical recommendations should be made by a suitably trained and experienced psychiatrist (often the Responsible Clinician) who is approved under section 12 of the Mental Health Act. The other medical recommendation should be provided wherever possible by a doctor who has had a previous acquaintance with the service user, wherever possible the service user’s own GP.  If the GP is not available and we then may have to ask an independent section 12 approved doctor’s list.  They have had specialist training in a mental disorder and the Mental Health Act, but they must not have been in a supervisory relationship with the first doctor providing a medical recommendation. The Approved Mental Health Professional requires the two medical recommendations in order to make an application.  They also need to consult with the Nearest Relative who could object to the application being made and if this is the case the application cannot proceed without further legal processes. However, there is subtle difference between agreeing with the application being made and objecting.  Sometimes relatives are not exactly agreeing with the decision, but are not objecting and the application could proceed. There are occasions when the Approved Mental Health Professional is unable to consult with the Nearest Relative and the reasons for this need to be justified and documented. 

    How long does a Section 3 of the Mental Health Act last and can you appeal?

    Section 3 can last up to 6 months.  However, usually this period is not required; the service user often improves and is able to accept voluntary treatment or is discharged home with follow up support.  As soon as the criteria for detention are no longer met then the section 3 can be rescinded.  In addition service users can appeal against their detention at any time and be supported by an Independent Mental Health Advocate to attend a hospital manager’s review / Mental Health Tribunal where their detention will be reviewed. 

    How does a Section 3 of the Mental Health Act work in practice?

    An example of a time when you might consider using Section 3 would be if somebody was well known to the community team and it became apparent that the person was becoming unwell, they may become less compliant with their care or treatment and there are increasing risk factors.  The person may not have insight into their condition and deterioration and the need to engage with care and treatment. A section 3 would be considered to enable treatment to be restarted in a hospital setting if it cannot be provided in the community. The Approved Mental Health Professional, the assessing Doctor’s and the multi-disciplinary team would need to consider risk factors, support available at home and whether the person can be cared for in a less restrictive way including voluntary admission.