Nigel Turner's HyperGUIDE to the Mental Health Act

Section 4

Emergency Admission for Assessment

Summary

Section 4 is intended for emergency admissions, where if it were not for the extreme urgency, a Section 2 would be appropriate. A Section 4 requires only one medical recommendation, compared with two for a Section 2. An Application has to be made, based on that single Medical Recommendation.

Duration

Up to 72 hours. During that time, if a second Medical Recommendation is made, the Section 4 effectively converts into a Section 2.

Conditions

The grounds for the Application are the same as for Section 2, that the person:

• is suffering from mental disorder of a nature or degree which warrants the detention of the patient in a hospital for assessment (or for assessment followed by medial treatment) for at least a limited period; and
• he ought to be so detained in the interests of his own health and safety or with a view to the protection of other persons.

However, in addition, it must be stated that:

• it is of urgent necessity for the patient to be admitted and detained under Section 2, and
• that compliance with the usual Section 2 requirements (that is, getting a second Medical Recommendation) would involve "undesirable delay".

Notes

Section 4 offers less protection to citizens against unjustified detention because only one doctor has to recommend the compulsory admission under the Act. The doctor should be someone who either knows the patient, or who is recognised under Section 12 of the Act.
Section 4 has been mis-used at times, as an administrative convenience. It is easier for the professionals involved if only one doctor has to visit the patient in the community. The second doctor required for a Section 2 can then see the person in hospital after a Section 4 admission. The Mental Health Act Commission has been very critical of such an attitude. The Act clearly intends Section 4 only to be used in cases of genuine emergency.