Emergency admissions under Section 4 of the Mental Health Act 1983: reasons for a high rate.

One of the aims of the Mental Health Act 1983 was to discourage the use of emergency orders; the criteria for using the emergency provisions provided by Section 4 of the Act are stricter than those of the corresponding Section 29 of the previous Mental Health Act 1959. In 1986-87 the Mental Health Act Commissioners found a comparatively high level of admission under Section 4 in Cambridge. This study was undertaken to examine the hospital careers of all Section 4 admissions in Cambridge over a two-year period, and to compare these with admissions for assessment by two doctors under Section 2 of the 1983 Act and informal admissions. Almost 50% of all the Section 4 admissions were not continued on a compulsory admission by the end of the 72 hour duration of the Section. The findings suggest that these patients might have been more appropriately admitted informally or not at all.