Samantha is aSenior Lecturer in Paramedic Science at Sheffield Hallam University, where she has worked for the last 8 years, after being an Operational Paramedic and Clinical Educator.
Samantha lectures in Law, Ethics, Research and Evidence Based Practice. She is also a Dissertation advisor for level 6 and 7 studies. Samantha has a keen interest in Mental Health for service users as well as all ambulance clinicians.
Mental Health Act 1983/2007
Mental health patients can be complex and difficult to manage in the pre-hospital environment, the social isolation of COVID-19 is likely to increase the volume of mental health emergency calls.
There are planned temporary changes to the Mental Health Act 1983/2007, which may be applied to patients during the corona virus pandemic. These will be discussed under a separate subheading.
These are the sections ambulance clinicians may be involved in.
· Section 2
· Section 3
· Section 136
Section 2
This section is used for the admission to a mental health unit to assess an individual that may have a mental health disorder, where their admission is necessary for their health and safety, and potentially the protection of others/public. This can be for up to 28 days.
Section 3
This section allows admission for treatment for up to six months, the person would have a mental disorder and it is necessary for that person to be detained in a mental health unit for their health and safety and the protection of other persons.
Section 136
This is used by the police for a person in public that may be displaying a mental health disorder and are a danger to themselves or others. The police can remove them to a place of safety.
Place of safety
A police station is not deemed a place of safety, therefore should not be used unless the below criteria is met
A. The behaviour of the person poses an imminent risk of serious injury or death to themselves or others,
B. Because of that risk, no other place of safety other than a police station that is in the relevant area can be reasonably expected to detain the person and,
C. The decision maker is a police officer with the rank of inspector or above.
For a person to be detained in a police station the police constable must first consult a healthcare professional, which includes paramedics.
Temporary Changes to Mental Health Act 1983/2007
Why are the government making emergency changes to the Mental Health Act?
The Mental Health Act must continue to function effectively throughout the Covid-19 pandemic, in order to ensure the safety, care, and treatment of people severely affected by mental illness.
Emergency legislation has been introduced to Parliament which includes temporary measures to change the Mental Health Act. This is because the government is concerned that Covid-19 will reduce the number of mental health professionals available to help people whose mental health places them at risk.
The changes will not apply from the moment the legislation is passed - they may be activated if the crisis worsens.
If activated these changes will beapplicable to Paramedics
Changes to the number of doctors required to detain a person under the Mental Health Act for assessment and treatment
Usually three people have to agree that you need to be detained.
These are normally an approved mental health professional (AMHP) and two doctors.
Under the new legislation the number of doctors is reduced to one.
The AMHP has to record the reason why the decision to detain them was made on the recommendation of only one doctor. And they should only take this decision if they believe that staff shortages caused by coronavirus mean it would take too long for a second doctor to assess them.
Changes to the transfer of prisoners to hospital
Under the Mental Health Act if they are a prisoner they can be transferred to hospital. This happens if two doctors think this is the best thing for them, because of the nature of their mental disorder. The Secretary of State for Justice must consent to the transfer.
This power is covered in section 47 of the Mental Health Act.
The emergency legislation says that only one doctor needs to recommend the transfer of them from prison to hospital. But the Secretary of State for Justice must still consent to the transfer.
Changes to police holding powers
A person might be in the community or their own home. Police might be concerned about the safety of them or others and that they have a mental disorder.
The Police have powers under the Act to hold a person in a place of safety. Depending on the circumstances, this could be a hospital, their home, the home of another or a police station.
The police have these powers under sections 135 and 136 of the Mental Health Act.
A person can usually be held for an initial period of up to 24 hours. Which can be extended for a maximum of another 12 hours. The patient can only be held after that time if a full Mental Health Act assessment is done. And professionals agree to further detain the patient.
This will usually be under sections 2 and 3 of the Mental Health Act.
The change means that they can be held for an initial period of up to 36 hours. This can be extended for a maximum of another 12 hours.