"when someone is posing a danger to themselves or others they can be sectioned." It's not as simple as that, actually. You can only section someone who you believe to be suffering from some form of mental illness. Someone making a few superficial self-harm gestures with no evidence of mental illness (if this was indeed the case) is not sectionable. A section is not the same as a bloody ASBO. "My impression is that the difficulties in getting her sectioned would have been the logistics of getting the appropriate MH professionals out, rather than having the grounds for it." Yes, it would be difficult to get the relevant professionals out, but it can be done. Just because you get the relevant professionals out does not mean they're going to say "jolly good, chaps, let's section her". "As for it being a threat... what would you call it? A promise of a yummy treat?" This sentence makes very little sense to me, so please forgive me if I misconstrue it. No, of course I wouldn't call it a yummy treat. What an odd thing to say. I just said that this was a threat. Sectioning should not be used as a threat, because it is not a punishment. I agree sectioning is not a nice thing at all. Something to be taken very seriously and not used lightly. Ie, not to be used as something to threaten somebody who happens not to be doing what you want them to. If I need to let someone know I might have to consider placing them under the MHA, I will try my utmost to explain to them my reasons for this, and actually, that I'm really sorry for them that it might have to come to this, but it is in what I believe to be their best interests and I don't want them to think that it's a punishment or because of something they did wrong. I would not say "if you don't do what I say then I'm going to call the coppers, so ner-ner to you" (NB. Tom - I'm not suggesting this was your turn of phrase, merely emphasising a point). "How would YOU suggest ambulance staff get people like this into hospital?" Well, therein lies the problem. As I said, I don't know the LAS protocol. If I was assessing her, and my feelings were that she was not genuinely suicidal and did not pose a significant risk to herself, and she didn't want to come into hospital, I'd send her on her merry way, which is probably what the psychiatrist would have done. But I am a psychiatrist, so I am in a position to make that decision. It is harder for someone who is not a mental health professional, and you obviously need to cover your back in a situation like this. I understand why Tom didn't want to have to just leave her there. I presume he is supposed to bring all patients like this into gospital for assessment - it is certainly the policy in hospitals that all patients presenting with self-harm see the mental health bod. I totally appreciate that Tom would have been in a bloody difficult position. What I did not like was the implication that she was responding to a threat - the way he described it as a "trick" - offering someone an impossible choice. Perhaps I am too PC for my own good. When it boild down to it, perhaps we are all just threatening patients with the MHA when we explain to them they might have to be sectioned. But there are gentle ways of doing it, and way which do not lead patients to feel they are being punished.