DETENTION VERSUS DUTY OF CARE

DUTY OF CARE

• Common Law provides a broad provision to medical practitioners to detain a person impaired by a medical or psychiatric condition and are at imminent threat to themselves or others.
• Frequent reasons where this can be employed include - alcohol/drug intoxication, acute head injuries, acute confusional states/delirium, dementia, intellectual disability and other psychiatric conditions
• The medical officer should clearly document in the case notes the reasons for detaining the patient and the necessary interventions required
• There is specific provision in the Mental Health Act for detaining patients with psychiatric conditions and should be employed when required

DETENTION UNDER THE MENTAL HEALTH ACT

• This action is provided by the Mental Health Act and applies only to those with mental illness
• The requirements for detention are:

• The person has a mental illness that requires immediate treatment
• The treatment is available
• The person is at risk to the safety of themselves or others

• It is not necessary for the patient to refuse admission (he voluntarily remains in the hospital) before a detention order can be placed
• A Form 1 will need to filled out (in addition to documentation in the case notes)
• The patient is provided his Legal Statement of Rights (Form 7)
• It may be advisable but not necessary for the patient to be admitted to a closed/locked ward

see Consent issues in psychiatric patients