What is a Section 2 of the Mental Health Act?


What is a Section 2 of the Mental Health Act?



Section 2 is part of the civil sections under the Mental Health Act.  It provides for someone to be detained in hospital under a legal framework for an assessment and treatment of their mental disorder. 

What is the purpose of a Section 2 of the Mental Health Act?

Section 2 is specifically designed for people who we (the Approved Mental Health  Professional and Psychiatrists) consider are in need of an assessment for a mental disorder and that due to their presentation and possible risks feel that this needs to take place in a hospital setting.  The section 2 provides the legal framework for this assessment to take place. We can therefore determine whether the person has a severe mental disorder and the possible care plan and treatment options available.

What is the criteria for a Section 2 of the Mental Health Act?

The criteria for Section 2 is that the person who is potentially suffering from a mental disorder of a nature or degree which warrants their detention in hospital and that it is in the interests of the person’s own health, their safety or for the protection of the people.

Why would a Section 2 of the Mental Health Act be considered?

When people have a severe form of mental illness or as public say a “severe breakdown” they are sometimes so unwell that they would not be able to accept that they may need to go into the hospital for their health, safety or protection of others.  So we use the power of the Mental Health Act to care for them within a comprehensive legal framework to assess and where suitable provide treatment and enable their recovery as soon as possible. 

What is the role of the Approved Mental Health Professional and who would undertake a Section 2 Assessment?

The Approved Mental Health Professional is in the majority of cases the “applicant” for Section 2 under the Mental Health Act. In order to be an applicant you need to ensure that you have two medical recommendations which state the person needs to be admitted to hospital for assessment and possible treatment for a 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 previous acquaintance with the service user and wherever possible the service user’s own GP.  If the GP is not available 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 supervisory relationship with the first doctor providing a medical recommendation.

What is the role of the Responsible Clinician in Section 2 Assessment?

The responsible clinician is the senior clinician.  He or she is usually a doctor, but there are also other professions who can also undertake this responsibility.   He or she will be responsible for the assessing the needs of the service user whilst in hospital and as part of this duty if at any point the person does not need to be detained under the section he must rescind / end it immediately. 

What is a medical recommendation?

These are formal and legal documents, once signed they are legal and they contain an explanation of the assessment and why hospital admission is recommended in this case and why this cannot be provided in the community.  This is provided along with the application and then received on behalf of the hospital managers.

Informing the Nearest Relative

Along with the application and two medical recommendations, the Nearest Relative must be informed wherever possible as they have a range of rights under section 2, the right to be informed, the right to apply for discharge or apply for a review. 

How long does a Section 2 of the Mental Health Act last?

Section 2 should end as soon as possible but it can be in place for up to 28 days.  In many cases the detention ends prior to this or there is further consideration of ongoing detention and the person may be assessed under section 3. 

Can you appeal against a Section 2 of the Mental Health Act?

All service users admitted on the section 2 have access to an Independent Mental Health Advocate and they can appeal to the hospital managers and the mental health tribunal where they can ask for their detention to be reviewed and whether the criteria for their ongoing detention hospital is met.  They can appeal immediately on admission within the first 14 days of their detention under section 2 and the appeal will be heard within days. 

How is a Section 2 of the Mental Health Act discharged?

In the vast majority of cases section 2 is discharged by the responsible clinician.  This can be that the service user is assessed as not requiring further detention as they are willing to be in hospital informally or they can return to the community with support.  In this case the section 2 is rescinded.  Or if the assessment has concluded that longer term treatment is needed there may be the consideration of section 3.  In addition the service user can be discharged by the hospital managers or a Mental Health Tribunal if they feel the criteria are no longer met. 

How does a Section 2 of the Mental Health Act work in Practice?

A recent example of a section 2 was a man who was seen by his GP. The GP was concerned by his presentation and contacted mental health services.  He presented quite differently from previous and on assessment the responsible clinician and Approved  Mental Health Professional were quite concerned by his mental state.  He was not agreeable to support at home or for admission to hospital but his mental state was of such a risk that we needed to consider a legal framework to admit him to hospital for further assessment and possible treatment.