Detention of elderly psychiatric inpatients under section 5(2) of the Mental Health Act 1983

Emergency detention of elderly psychiatric inpatients appears to have attra cted very little or no attention in published studies. In this retrospectiv e review, all applications of sections 5(2) and 5(4) of the Mental Health A ct 1983, detaining elderly inpatients in North Cheshire between 1985 and 19 97 were reviewed. Forty-three percent of elderly inpatients under s.5(2) regained their volun tary status, while 57% were detained under another section by the end of th e 72 hours (p<0.05). Duration in hospital prior to applying s.5(2), clinica l diagnosis of functional mental illness and use of s.5(4) appear to increa se the likelihood of converting s.5(2) into other sections. The high rate of non-conversion of s.5(2) in the elderly to s.2 or 3 may im ply that in almost half of the cases, emergency detention may have been use d to control isolated incidents of disturbed behaviour in otherwise co-oper ative patients. Educating doctors and nurses in guidance put forward by the Code of Practic e (1993) remains, probably, the main key to a better use of emergency holdi ng powers.