Adult Medical Emergency Handbook - Scottish Intensive Care Society

ACUTE DISTURBANCE
Guide for medical practitioners on the granting of an emergency
detention certificate under section 36 of the Mental Health (Care and
Treatment) (Scotland) Act 2003.
Registered medical practitioner (see notes 1) carries out a medical examination and
recommends hospital admission.
Patient Refuses Admission Patient Agrees to Admission
The patients must meet these grounds for detention:
1. You consider it likely that conditions (a) and (b) are met:
(a) the person has a mental disorder (see notes 2) : and
(b) because of that mental disorder, the person’s ability to
make decisions about the provision of medical treatment
for that mental disorder is significantly impaired.
AND
2. You are satisfied that conditions (a) to (c) are met:
(a) it is necessary as a matter of urgency to detain the
patient in hospital for the purpose of determining what
medical treatment requires to be provided to the patient:
(b) if the patient were not detained in hospital there would
be a significant risk to the health, safety or welfare of the
patient or to the safety of any other person if the patient
were not detained in hospital.
(c) making arrangements with a view to granting a
short-term detention certificate would involve undesirable
delay.
AND
3. Immediately before the medical examination, the patient
was not detained in hospital by way of certain provisions
of the Act (see note 3).
AND
4. There was no conflict of interests in relations to the
medical examinations (see note 4).
Detention criteria
are met
MHO consent obtained.
Detention criteria are not met: emergency
detention certificate may not be granted.
Patient
subsequently
decides to leave
Non-AMP
available to
examine patient
Consider whether
criteria for an
emergency detention
certificate are met
You must, where practicable, consult a mental health officer (MHO) and obtain their consent to the
granting of the certificate. See notes 5 and 6.
1. Inform patient of decision to grant the certificate
2. Complete and sign the emergency detention on certificate within prescribed timescales (see notes 7,8 and 9)
3. Ensure that arrangements are in place for the patient’s transfer to hospital where this is required.
4. Ensure that the detention certificate is passed to the relevant hospital managers (see note 10).
Throughout the process of granting an emergency detention certificates, you are bound to have regard to the
principles of the legislation as laid out in sections 1 to 3 of the Act.
*AMP: approved medical practitioner
AMP* available
to examine
patient
Consider whether
criteria for a
short-term detention
certificate are met
Impracticable to consult and obtain the
consent of an MHO.
Continue hospital
treatment
278 adult medical emergencies handbook | NHS LOTHIAN: UNIVERSITY HOSPITALS DIVISION | 2009/11