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Sect 135/136 assessment

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Is it mandatory to discuss with the duty consultant before you (as duty doctor/SHO) decide to discharge someone off the section or admit them? I understand that the ASW needs to be involved but our trust's policies seem to vary regarding the involvement of the duty consultant.

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It is not mandatory as in statute, but it will be your responsibility for having discharged someone. If you are inexperienced then it is always better to get supervision.

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I didn't think SHO's could discharge S136...thought you had to be Sec 12 approved...

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Nope a RMP is required and ASW can be consulted (not have to be).

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in our trust the ASW discharges or not after being informed of juniors' assessment (not section 12 approved)

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ASW discharges in my london placements, but quite often they don't turn up to do it, so we end up sending people home....!

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Practice varies in different trusts. But legal requirement as per MHA and code of practice is section 12 approved doctor and ASW should assess section 135 & 136 patient. My advice would be if you are SHO and not section 12 approved always discuss with section 12 approved doctor(senior on call/Consultant) before you make any decision and record it.

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in the act, neither 135 nor 136 require a section 12 doctor to be involved, but both require an asw and a registered medical practitioner to assess at some point. local policies/procedures vary as does the paperwork (from none to lots for 136s). for sho level docs i would suggest that discussion with someone more senior would be a good idea in these cases.

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A few years ago, I accidentally sent someone home once from A&E who was under a 136! Luckily, I had discussed it with the SpR anyway ( It was my first job) but didn't tell her he was a 136- I didn't know cos no-one had told me! Police had dumped him and left hours before and presumably the cas staff didn't realise the significance...the ASW was a bit surprised, and told me the call should have gone straight to the SpR, which is why I vaguely assumed it should be a Sec12 doc...

Now we have the 136 bed on the in-patient ward, it's a lot clearer, and that wouldn't happen. I hope.

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From code of practice about section 136 for info:

'Assessment

10.12 The local implementation policy should ensure that the doctor examining the patient should wherever possible be approved under section 12 of the Act. Where the examination has to be conducted by a doctor who is not approved, the reasons for this should be recorded.'

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Thanks Usthad- that clarifies it nicely.

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some places say the reason for a s12 dr not assessing is that it's not local policy. (never really been sure how that's a reason, but it's what they say)

if there is [highlight]no mental illness[/highlight], (or is it disorder?) dr can discharge without asw assessent.

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From code of practice about section 136 for info:

'Assessment

10.12 The local implementation policy should ensure that the doctor examining the patient should wherever possible be approved under section 12 of the Act. Where the examination has to be conducted by a doctor who is not approved, the reasons for this should be recorded.'

xyz

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