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Section 5(4) (The nurse's holding power): patterns of use in one mental health trust (1983–2006)
Author(s) -
ASHMORE R.
Publication year - 2010
Publication title -
journal of psychiatric and mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 63
eISSN - 1365-2850
pISSN - 1351-0126
DOI - 10.1111/j.1365-2850.2009.01520.x
Subject(s) - mental health , section (typography) , mental health act , power (physics) , medicine , psychology , nursing , psychiatry , family medicine , advertising , business , physics , quantum mechanics
Accessible summary• Section 5(4) (Nurses' holding power) allows a mental health nurse to detain a patient admitted informally to hospital for treatment of a mental health problem for up to 6 h or until they are assessed by a doctor. • The use of the holding power has risen significantly since its introduction in 1983 to an average of 1442 per annum (range 789–1953 per annum). • The study identifies a number of factors in relation to the use of Section 5(4) including: gender, clinical setting, temporal patterns and medical response time. • Although the majority of patients are assessed by a doctor within 4 h of the holding power being applied, 8.3% are detained for 6 h or longer. There is a need to explore this and other issues further.Abstract The majority of studies exploring the use of Section 5(4) (Nurses' holding power) of the Mental Health Act 1983 are now dated, report on small numbers and have been undertaken over relatively short periods of time. A retrospective study was undertaken which sought to identify the factors associated with the use of the section in one mental health trust over a 24‐year period (1983–2006). Section 5(4) was applied on 803 occasions, an average of 33.4 times per annum. The majority of sections were applied to female patients (58.4%) by male nurses (54.9%) within adult acute inpatient settings (93.4%). Significant differences were noted in the use of the section over the 24‐h period but not for month of the year or day of the week. A total of 349 (43.5%) sections were implemented during doctors' ‘office hours’ (Monday–Friday, 9:00 h to 17:00 h). The mean length of time spent on the section was 140 min; 80.6% of patients were assessed by a doctor within 4 h; and 8.3% remained on the section for 6 h or more. The holding power was converted to another section of the Act on 642 (80%) occasions. A similar, multi‐sited prospective study could be undertaken to validate the findings of this study.