Sections 4 & 5 of the Mental Health Act

Section 4

Section 4 is used in emergency situations where, were it not an emergency, detention under Section 2 would ordinarily be used.

Section 4 allows a person to be admitted to hospital for an assessment of their mental health for a limited period of time and requires the recommendation of only one doctor (unlike Section 2 which requires two medical recommendations)

You can be detained under a section 4 if:

• You are suffering from a mental disorder of a nature or degree which warrants your detention in a hospital for assessment or assessment followed by medical treatment
• You need to be detained in the interests of your own health, your own safety or with a view to the protection of other people; and
• It is of urgent necessity that you are admitted and detained under section 2
• Compliance with the usual Section 2 requirements would involve an "undesirable delay"

How long can I be detained for?

You can be detained for up to 72 hours but this does not necessarily mean you will be. A second doctor should assess you as soon as possible after you are detained and decide whether the Section 4 should be converted into a Section 2.

Can I be treated against my will?

Under Section 4 you do have the right to refuse treatment and your consent must be provided for any treatment to be given.

There are some circumstances when treatment can be given without your consent:

1. Where you do not have the capacity to make a decision about treatment and the treatment is in your best interests.
2. When the treatment needs to be given in an emergency to prevent serious harm to yourself or others.

Section 5

Section 5 is used by a doctor or nurse to prevent someone leaving hospital who is a voluntary patient. It should be used only in circumstances where it is not possible or safe to use Sections 2, 3, or 4.

Section 5(2) is the doctor's holding power. The doctor in charge of your care at the time or one nominated by him/her must produce a report about you stating how the criteria are met and reasons why informal treatment is no longer appropriate. Section 5(2) can be used both in a psychiatric hospital and a general hospital.

Section 5(4) is the nurse's holding power. This power can only be used if you are receiving in-patient treatment for a mental disorder so that:

• you are is suffering from mental disorder to such a degree that it is necessary your health or safety or for the protection of others for you to be immediately stopped from leaving the hospital
• it is not practicable to get a doctor to attend who might place the patient on section 5(2)

How long can I be detained for?

Under a section 5(2), you can be held for up to 72 hours. This is not renewable. You must be assessed as quickly as possible by an Approved Mental Health Professional (AMHP) and doctors for possible admission under the Mental Health Act.

Under section 5(4), you can be held up to 6 hours. This is not renewable. The holding power ends as soon as a doctor arrives. The doctor may transfer you onto a 5(2) or section 2, or 3 or you may continue as a voluntary patient.

Can I be treated against my will?

Under Sections 5(2) and 5(4), you do have the right to refuse treatment and your consent must be provided for any treatment to be given.

There are some circumstances when treatment can be given without your consent.

1. Where you do not have the capacity to make a decision about treatment and the treatment is in your best interests.
2. When the treatment needs to be given in an emergency to prevent serious harm to yourself or others.