Rapid responses are electronic letters to the editor. They enable our users to debate issues raised in articles published on thebmj.com. Although a selection of rapid responses will be included online and in print as readers' letters, their first appearance online means that they are published articles. If you need the url (web address) of an individual response, perhaps for citation purposes, simply click on the response headline and copy the url from the browser window. Letters are indexed in PubMed.
It is good to see space given to the voices of those detained under the Mental Health Act, and particularly the experience of what that means in reality for people.
It does need to be remembered, though, that while doctors can make recommendations to detain they cannot actually 'section' anyone beyond 72 hours (and only then in limited circumstances). The final decision, taking into account all circumstances of the case, belongs to the Approved Mental Health Professional (AMHP). It is important that we are open and honest about the individual responsibilities of those who perform different functions under the Act. It is equally important to convey why there is a separation of these responsibilities and powers and how important it is that the AMHP is able to exercise their powers with autonomy and free of undue influence. Not every Mental Health Act assessment results in admission, not every medical recommendation is acted upon.
If we are to develop truly open and accountable processes and practices around these often difficult moments in people's lives, we should be trying to reassure those who become subject to our services that the promotion of their fundamental rights are as important to us as well evidenced clinical intervention and timely responses to need.
No competing interests
17 August 2017
Approved Mental Health Professional
Wonford House Hospital, Dryden Road, Exeter, EX2 5AF