Understanding and implementing the nurse’s holding power (section 5(4)) of the Mental Health Act 1983

Abstract

This article explores section 5(4) of the Mental Health Act, which permits nurses of a ‘prescribed class’ to detain an informal inpatient who is receiving treatment for mental disorder for up to six hours or until a doctor or approved clinician arrives. The article raises various issues in relation to the implementation of section 5(4), some, but not all of which are addressed by the relevant codes of practice for England and Wales. The authors raise important questions that nurses need to address if their holding power is to be applied appropriately in all cases. Aims and intended learning outcomes This article discusses issues relating to the implementation of section 5(4) (the nurse’s holding power) of the Mental Health Act 1983 for England and Wales. Following the style of the Mental Health Act 1983 (hereafter referred to as ‘the act’), the term ‘patient’ is used throughout. After reading this article and completing the exercises, you will be able to: ■ ■ Appreciate the importance and extent of the use of section 5(4). ■ ■ Identify national and local guidance regarding the implementation of section 5(4). ■ ■ Explore the main implications of the use of section 5(4) for patients and nurses. ■ ■ Reflect on your own practices regarding the implementation of section 5(4). ■ ■ Identify potential areas for practice development regarding the use of section 5(4) in your clinical area.