Application of the powers of compulsory admission to psychiatric hospital by general practitioners, social workers and psychiatrists

Ways of extending or consolidating the powers of compulsory admission under the Mental Health Act 1983 have been discussed by the government and other organizations, including the Royal College of Psychiatrists. However there is little data on how existing legislation is applied. The authors examine d the differential application of the Act between GPs, psychiatrists and so cial workers by means of an anonymous, confidential questionnaire. Fourteen case vignettes were interpreted by 20 social workers, 19 GPs and 28 Sectio n 12 approved psychiatrists, who were asked to decide if they would detain the patient under the Act. Responses were analysed between and within the t hree groups. There was general agreement between groups on situations invol ving 'danger to self and 'danger to others', but social workers were less l ikely to detain on health grounds and GPs tended to use the Act unpredictab ly, in areas not covered by the Act. The authors conclude that the Act may not be used to its fullest extent due to differences in interpretation or i n knowledge, which may arise from differential constructs of mental illness and training. A national study of knowledge of mental health law is sugges ted.