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Bipolar disorder - Management
What if a person with known or suspected bipolar disorder needs to be admitted but refuses?

  • If the person needs to be admitted to hospital, every attempt should be made to persuade them to go voluntarily.
  • If the person refuses to go to hospital, compulsory admission may be necessary if the person:
    • Requires assessment and/or treatment in a hospital, and
    • Needs to be admitted in the interests of their own health or safety, and/or for the protection of other people.
  • Compulsory admission is arranged using the appropriate section (usually section 2) of the Mental Health Act (MHA):
    • Section 2 allows for compulsory admission for up to 28 days.
      • It requires an application from an Approved Mental Health Professional (AMHP, formerly an Approved Social Worker), or, rarely, the person's nearest relative, and recommendations from two doctors, one of whom is section 12-approved (usually a psychiatrist) and one who has previous acquaintance with the individual (usually the person's GP if at all practicable).
      • Ideally the person should be examined jointly by the two doctors with the AMHP also present. Where this is not possible, each doctor may carry out a separate examination. If the AMHP is not present it is essential that at least one of the doctors discusses the person with the AMHP.
    • Section 4 is used in exceptional cases to permit compulsory admission for up to 72 hours if there is 'urgent necessity', and 'undesirable delay' would occur while trying to arrange admission under section 2.
      • It requires an application from an AMHP (or, rarely, the person's nearest relative) and just one medical recommendation, preferably from a doctor with previous acquaintance (usually the GP).
    • Section 136 may be used by police to take someone from a public place to a place of safety and enable the person to be examined by a registered medical practitioner and interviewed by an Approved Social Worker. The person's GP, where known, may be informed.

In depth

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