Mental Health Act

The Mental Health Act 1983 (amended in 2007) is a piece of legislation that sets out the legal framework for providing care and treatment for people with a mental disorder, including use of compulsory powers.  The Act explains how someone with a mental disorder is cared for and treated. 

For information about the care and treatment of someone who lacks the mental capacity to make decisions about themselves, see this article on the Mental Capacity Act.

 Page contents:

• Assessment and treatment in hospital under the Mental Health Act
• Treatment in the community under the Mental Health Act
• Further information

Assessment and treatment in hospital under the Mental Health Act

Sometimes it is legally necessary to admit a person to hospital for their own health or safety, or for the protection of others. Those admitted to hospital are detained for a period of time in order to complete an assessment and/or treatment.  When this happens, someone is made to go to hospital,  even if they do not want to.  For more information on this visit the website for Mind, a mental health charity. The MIND website contains an overview of people’s rights under the Mental Health Act and includes frequently asked questions (FAQs), explanations of legal terms and links to further information and support.

The Mental Health Act (MHA) and the MHA Code of Practice explain your rights if you are compulsorily admitted and detained in hospital due to a mental health condition.   They explain under what circumstances a person can be detained in hospital, how long someone can remain in hospital, and who can authorise the detention.  See the website for Mind for more information on when a person can be detained in hospital due to a mental health condition.

There are some situations where a person is legally entitled to the support of an advocate. This is called 'statutory advocacy'. If you are being detained under the MHA, you are legally entitled to support from an Independent Mental Health Advocate (IMHA). These are specially trained advocates who can support certain patients. You can find out more about IMHAs and other advocacy support available in this article.

Discharge

The responsible clinician (RC) in overall charge of the patient's assessment or treatment may discharge the patient from detention at any time.

The nearest relative of the patient may also discharge the patient from detention by giving 72 hours’ notice in writing to the hospital managers.

During the notice period the RC may overrule the nearest relative, in which case the detention of the patient will continue.

Appeals

Patients detained in hospital under the MHA have the right to appeal against their detention.

Appeals can be made to the hospital managers and to the Mental Health Review Tribunal (MHRT). The MHRT is an independent hearing with a panel composed of a lawyer, a doctor and a lay person (a lay person is someone who does not have specialised or professional knowledge in a certain subject). The Tribunal has the power to order the patient's discharge, if it considers there are no grounds for further detention.

Treatment in the community under the Mental Health Act

The MHA also explains how a person with a mental health condition can be assessed and treated in the community. 

Community treatment order

A Community Treatment Order (CTO) can be used for people who have been detained in hospital for treatment under section 3, where the responsible clinician (RC) considers that the person requires further treatment, which does not need to take place in a hospital setting.  The CTO is used when the person is unlikely to comply with their treatment in the community in the absence of a CTO.  CTOs come with conditions to promote the person’s ongoing treatment and recovery.  If a patient fails to comply with these conditions they can be recalled to hospital where the original detention for treatment can be reinstated.

Section 117 Aftercare

The purpose of Section 117 Aftercare is to support a person, who has been detained in hospital, safely back into the community.  It is designed to prevent the patient being readmitted to hospital because of their mental health needs. It can provide care and support free of charge to the person concerned.

Section 117 applies to anyone that has been detained in hospital under a Section 3. It also applies to people admitted under a hospital order (S37), a hospital direction order (S45A), and those who have been transferred from prison to hospital for treatment (under sections 47 and 48 of the Mental Health Act).

Before the person is discharged from hospital, a care planning meeting must take place involving the person, their family (where appropriate) and any relevant professionals involved in their care. This is called a Care Programme Approach (CPA) meeting.  The meeting is to identify and implement a care package to meet the person’s needs once discharged and to identify a care co-ordinator.

Guardianship

As a result of someone’s mental health needs, the people involved in the person’s care may consider that he or she needs a guardian to help them live in the community.

Under section 7 of the Mental Health Act a guardian can decide where a person should live, require a person to attend appointments or activities and to meet with certain professionals.  Guardianship cannot be used to deprive someone of their liberty.

The person cannot be given any treatment without consent while under Guardianship.  A person has a right to appeal a guardianship application to a tribunal.  

The MHA and The MHA Code of Practice give more information on what circumstances Guardianship can be applied for.

Further information

For more information on the Mental Health Act and mental health support read this article on Mental health and emotional wellbeing. You can also visit the following websites: Rethink Mental Illness a charity provider of mental health services in England, and Mind a mental health charity.