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14 January 2022

Availability of section 12 approved doctors – project report

What lies behind difficulties in finding doctors to take part in Mental Health Act assessments?

Arms and hands of someone looking over a lake

A new report from the NIHR Policy Research Unit in Health and Social Care Workforce presents findings of a ground-breaking study exploring the reasons for reported difficulties in accessing doctors to carry out Mental Health Act assessments (MHAAs). These assessments lead to major decisions about whether to compulsorily admit a person to hospital for mental health assessment or treatment. Many doctors legally approved to undertake MHAAs (known as section 12 (s12) doctors) do so not as part of their NHS jobs but on an independent basis, receiving a fee per assessment. The supply of these doctors, however they are paid or employed, is a vital consideration in ensuring timely MHAAs, which can make a great difference to the experiences of people being assessed and those who care about them.

The research involved an analysis of data contained in the National Register of s12 doctors and interviews with section 12 doctors, Approved Mental Health Professionals (mainly social workers) and key informants with roles in mental health services. We found that only a third of s12 doctors are available to undertake MHA assessments independently. This limited level of availability may be at least as significant a factor as the overall numbers of these doctors. NHS Trusts and local commissioners of healthcare could help find ways to encourage and incentivise doctors to take on this work. Our findings from the Register analysis suggest that this needs to collect more information about s12 doctors, including their demographic characteristics. More information is also needed to clarify, for example, the total number of MHAAs being carried out, by which doctors, working on what basis. Such extra data would enable better workforce planning for s12 doctors, which could help ensure timely MHAAs. As part of the study, we also talked to people with experience of mental health services and assessments which was a useful reminder, if needed, of the importance of good mental healthcare.

This publication

Stevens, M., Martineau, S., Steils, N., & Manthorpe, J. (2022) The availability of section 12 doctors for Mental Health Act assessments: Interview perceptions and analysis of the national MHA Approvals Register Database, London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London. (a summary report is also available via this link)

Project page: Availability of section 12 approved doctors (includes link to our 2020 literature review on the topic)

See also

Who wants to be an Approved Mental Health Professional? (a Unit study from 2017-18)

In this story

Nicole Steils

Research Fellow

Research Fellow

Jill Manthorpe

Professor Emerita of Social Work