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The practice has now been established that, except in cases
of extreme urgency, the patient's own doctor or mental health social
worker will arrange for the patient to be seen by a psychiatrist
before compulsory admission under the Mental Health Act. The social
worker acts in liaison with the doctor and psychiatrist and works in a
supportive and reassuring role with the patient and the family in
situations which are sometimes delicate and often unpredictable. The
excellent co-operation between the doctors and social workers, and
access to appropriate out-patient clinics by social workers has
considerably reduced the number of acute emergency admissions, and
many patients referred for compulsory admissions have entered hospital
inf ormally. A marked change is evident in the mode of admission
The table shows that over the year the number of acute emergency
admissions fell from 22 in the first quarter to only 4 in the fourth
quarter. Of the 34 patients notified in the last quarter, 30 were
seen jointly by the general practitioner, psychiatrist, and social
worker, and more than half (l6) accepted informal admission. There
has been an increase in the number of patients referred for admission,
but no increase in the numbers admitted under compulsory procedures.
The increase has been wholly absorbed by informal admissions. This
may indicate the growing confidence of doctors and psychiatrists in the
ability of mental health social workers to alleviate the distress
sometimes associated with compulsory admissions and has led to early
referrals from which a fall in the number of future compulsory
admissions might be expected.