Section 12 Approved Doctors Under the Mental Health Act: A Staff Guide

When a person may need to be detained under the Mental Health Act 1983, the law requires medical evidence from doctors with special experience. Those doctors are known as section 12 approved doctors. Care and health staff often meet them at assessments and are asked to share information, so it helps to understand who they are, what they do, and how they differ from other professionals in the process. This guide explains the role in plain language. It complements our guides on the approved mental health professional (AMHP) qualification and section 2 versus section 3.

What the law says

Section 12 of the Mental Health Act 1983, as set out on legislation.gov.uk, covers medical recommendations for detention. In summary:

• Two registered medical practitioners must give medical recommendations. They may examine the person together or separately.
• If they examine separately, no more than five days may pass between the two examinations.
• At least one of the two must be a doctor approved as having special experience in the diagnosis or treatment of mental disorder, known as a section 12 approved doctor.
• Unless the approved doctor already knows the person, the other recommendation should, if practicable, come from a doctor who has previous acquaintance with them.
• A doctor who is an approved clinician is treated as also being approved for this purpose.
• No recommendation may be given where there would be a potential conflict of interest, as defined in regulations.
• Recommendations must be signed on or before the date of the application.

What a section 12(2) doctor can and cannot do

The Welsh approval service describes a section 12(2) doctor as a registered medical practitioner approved under the Act who can provide statutory medical recommendations for compulsory admission to hospital or reception into guardianship. They can also give medical evidence to courts in these matters and submit reports to the Secretary of State for Justice about the transfer of prisoners to hospital. A section 12(2) doctor cannot act as an approved clinician or responsible clinician. Approved clinicians have wider clinical leadership powers, such as reviewing detention, making discharge decisions and managing community treatment orders, whereas section 12(2) doctors have an assessment-focused role.

How doctors become approved

Approval criteria are published by the approving bodies. The Welsh service, which administers approval on behalf of the Welsh Ministers, sets these out:

• The doctor must hold a GMC licence to practise and meet the GMC's Good Medical Practice standards.
• Psychiatrists who are members or fellows of the Royal College of Psychiatrists or on the GMC Specialist Register can apply under one set of criteria. GPs need three years' whole-time equivalent primary care experience plus at least four months of supervised psychiatry experience.
• An alternative route exists: four years' equivalent psychiatry experience for psychiatrists, or four years' primary care plus four months' psychiatry for GPs (including 12 months of UK primary care), and forensic physicians need four years' post-registration experience including at least six months as a forensic physician. Applicants on this route complete two supervised Mental Health Act assessments within a year.
• Initial applicants must have attended an approved section 12(2) induction course within the two years before applying.
• Approval lasts for a maximum of five years. Re-approval requires a refresher course in the final two years of the approval, and the application must be submitted seven weeks before expiry.

These details come from the Welsh service. Arrangements for approval in England are run by different bodies, so doctors and services should check the criteria that apply where they work.

How this affects care staff

Care staff are not asked to judge whether a doctor is approved, but several practical points follow from the law:

• Be ready for the assessment. Have recent records, medicines charts, incident logs and details of the person's usual presentation available, and be able to describe changes in behaviour and risk.
• Know who is attending. At a Mental Health Act assessment you may meet an AMHP and two doctors, one of whom is section 12 approved. Doctors who know the person, such as their GP, are often involved because of the previous acquaintance rule.
• Support the person. Explain what is happening and, where appropriate, ensure they know they can ask for support from an advocate. Our guide to consent to treatment under the Mental Health Act explains what happens after admission.
• Record the outcome. Note who attended, what was decided and what care is required next.

Frequently asked questions

Is a section 12 doctor the same as an approved clinician? No. The Welsh service says a section 12(2) doctor cannot act as an approved clinician or responsible clinician, although an approved clinician who is a doctor is treated as approved for the purposes of section 12.

Can any GP give a recommendation? A GP may give one of the two recommendations, particularly if they know the person, but at least one doctor must be section 12 approved.

Where can staff learn more? Learnsignal's CPD courses for health and care staff cover the Mental Health Act and related law.