Section 5(4) of the Mental Health Act 1983: a review of local policy and guidance in England and Wales

Purpose – The purpose of this study is to review policy or guidance on the implementation of Section 5(4) written by NHS mental health trusts in England and health boards in Wales. Design/methodology/approach - A Freedom of Information request was submitted to all trusts in England (n = 57) and health boards in Wales (n = 7) asking them to provide a copy of any policy or guidance on the implementation of Section 5(4). Documents were analysed using content analysis. Specific attention was given to any deviations from the national Mental Health Act Codes of Practice. Findings - Forty-one (67.2%) organisations had a policy on the implementation of Section 5(4). There was a high level of consistency between local guidance and the Mental Health Act Codes of Practice. There were however; different interpretations of the guidance and errors that could lead to misuse of the section. Some policies contained useful guidance that could be adopted by future versions of the national Codes of Practice. Research implications - The research has demonstrated the value of examining the relationship between national and local guidance. Further research should be undertaken on the frequency and reasons for any reuse of the section. Practical implications - Greater attention should be given to considering the necessity of local policy, given the existence of national Codes of Practice. Originality - This is the only research examining the policy framework for the implementation of Section 5(4). Keywords: Best practice, in-patient, Mental Health Act, Nurses’ holding power, Policy, Section 5(4). Paper type: Research