Abstract
Aims and methodTo audit the quality of medical recommendations for detention under the Mental Health Act 1983, Section 2 and 3. The recommendations were tested against a gold standard based on the statutory criteria. Two cycles were completed, the first containing 214 recommendations, the second 202. Relevant education took place after the first cycle.ResultsThe percentage of medical recommendations containing clear statements of why each of the statutory criteria was met increased in the second cycle. It reached 87% for mental disorder; 87% for nature and/or degree; 75% for why community treatment was not possible; 64% for why detention was in the interests of health; 60% for safety; 55% for protection of others; and 70% why informal admission was not possible.Clinical implicationsDoctors, scrutineers and approved mental health practitioners welcomed clear guidance about what is expected in a medical recommendation for detention and endorsed the gold standard described. Armed with a better understanding of what is expected and a template to follow, there was an improvement in the reasons given for detention.
Highlights
The percentage of medical recommendations containing clear statements of why each of the statutory criteria was met increased in the second cycle
It reached 87% for mental disorder; 87% for nature and/or degree; 75% for why community treatment was not possible; 64% for why detention was in the interests of health; 60% for safety; 55% for protection of others; and 70% why informal admission was not possible
Clinical implications Doctors, scrutineers and approved mental health practitioners welcomed clear guidance about what is expected in a medical recommendation for detention and endorsed the gold standard described
Summary
In the first cycle of the audit, 214 medical recommendations signed by 350 doctors were received in the two trusts; 78 were separate and 136 were joint recommendations. A total of 175 patients were detained, 99 under Section 2 and 76 under Section 3. The trusts received 202 medical recommendations signed by 352 doctors, 52 separate and 150 joint. There were 176 patients detained, 108 under Section 2 and 68 under Section 3.
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