Abstract
A survey of the use of section 5(2), Mental Health Act 1983 within a psychiatric hospital was carried out between January and December 2001.
Using computer-based patient records, it was found that 89 patients were placed on a section 5(2) between January and December 2001. Data on patient demographics, hospital admission date, date of implementation of section 5(2), date of reassessment after section 5(2) and outcome of the assessment was obtained from these records. In addition, the medical case notes of those patients identified (total of 81 case notes obtained) were studied with regard to the reasons for use of section 5(2), the process of implementing the section, the documentation of reassessments and the notification to the patient of his/her rights whilst under section.
It was found that the conversion rates to a further section after implementation of section 5(2) were significantly higher amongst patients who are over 65 years than amongst patients under the age of 65 years (Yates corrected chi-square test 3.87, p=0.04.df=1. Risk ratio 0.68 (0.51-0.92, 95% CI). 53% of patients detained under section 5(2) were male, 47% were female. Sixty-four per cent of section 5(2)s were converted to a further section, 37% to a section 2 and 27% to a section 3. A longer period of time until reassessment of the patients led to a lower conversion rate to a further section. Fifty-four per cent of section 5(2)s were implemented within 24 hours of the patient's admission.
Many current areas of practice do not meet with standards recommended by the Code of Practice. Higher conversion rates of section 5(2) to a further section may imply increasing psychiatric inpatient morbidity, hence higher numbers of patients being eligible for detention under the Mental Health Act 1983.
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