What is the Mental Health Act?
Introduction
The Treatment of Mental Illness has a very long and extensive history which would be very difficult to cover in detail while staying relevant to the Act of 1983. However, a breakthrough report by Lord Percy in 1957 stating that people suffering from mental illness should be treated in the same manner and with the same kind of care as people with physical illnesses, eventually lead to the Mental Health Act (1959). This began a substantial growth in Psychiatric Units throughout England and Wales and importantly Community Care for many people suffering with Mental Illness.
The Mental Health Act 1983 greatly expanded and improved the care of Mental Health patients. It very firmly set in place the legal requirements necessary for a person to be detained in Hospital.
Since the Act of 1983 there have been several amendments and changes but probably the most prominent changes were made in 2007 when the Community Treatment Order (CTO) was established allowing patients treatment and care in the Community while still remaining on Section under the Mental Health Act 1983. Amendments were made including allowing Approved Mental Health Professionals to be Responsible Clinicians other than the just the Consultant as well as giving Approved Mental Health Practitioners, other than just Approved Social Workers the authority to complete an application for a person's detention to Hospital for assessment / treatment.
How does it work?
As soon as the decision has been made and the appropriate forms completed the patient is officially detained under the Mental Health Act 1983. The Nearest Relative or an AMHP (Approved Mental Health Practitioner) can make an application for a person to be detained, Doctors, Approved Social and Approved Mental Health Professionals are all involved in the decision and the assessment process for placing a person on 'Section'.
It is the Responsible Clinician, the Tribunal Panel or the Hospital Managers who have the power to discharge a patient. A Care Plan Meeting would have to take place in the Hospital prior to the patients discharge to ensure that adequate and appropriate support has been arranged with the Community Team.
The Nearest Relative also has the right to apply for Discharge, however if the Responsible Clinician decides that the patient remains on Section for appropriate treatment and care in Hospital a barring order can be put in place. This will be followed quite swiftly by an Independent Managers Hearing to be held at the Hospital.
All patients detained in Hospital under the Mental Health Act must be given written information regarding the Section they have been placed on. The Information will advise them on how to appeal against their Section and make applications for Hospital Managers Hearings and Tribunal Hearings. All patients have the right to a Managers Hearing or a Tribunal Hearing. The frequency of applying for a Tribunal Hearing is based on the type of Section the patient has been placed on. Most patients will appoint a Solicitor to deal with their Mental Health legal matters while they are detained in Hospital
Compulsory Admission to Hospital
Compulsory admission consists of parts II & III of the Mental Health Act 1983. Part II of the Act deals with patients who are detained in hospital but have no criminal proceedings against them.
Section 4 is an emergency application by an Approved Mental Health Professional (AMPH) or the nearest relative. This section lasts for 72 hours and is usually necessary when a patient needs to be detained under immediate circumstances before being placed on a Section 2.
Section 2 is an assessment section lasting 28 days. In this period of time a patient can apply for a tribunal within the first fourteen days. The Responsible Clinician will decide within the 28 days whether the patient should be discharged or continue appropriate treatment in Hospital in which case the patient will be assessed for a Section 3.
Section 3 is renewable for the first and second six month period and onwards on a yearly period. A patient on Section 3 can appeal to the Hospital Managers for a Hearing. Referrals for Hospital Managers Hearing will automatically take place whenever the section is renewed. Section 3 patients can also apply for Tribunal Hearings although automatic referrals are arranged on behalf of the patient after the first six months of their section if they have not made an application themselves.
Part III of the act deals with patients who are involved in criminal issues.
Section 35 and 36 are 28 day sections initiated by the Crown or Magistrates Court for a person on remand. Section 35 allows 28 days for assessment in Hospital and Section 36 allows 28 days for medical treatment. Only the Crown can initiate a Section 36.
Section 37 is a Hospital Order for a person convicted of an offence and the Court is satisfied that the person is in need of compulsory admission to Hospital for appropriate treatment. The section 37 is similar to a Part 11 Section 3 with renewals for the first and second six month period and then every year after that.
Section 41 is a Restriction Order which applies to a person on a Section 37 Hospital Order who is deemed a great risk to the public. This order will be attached to a Section 37 (Section 37/41) disallowing any normal provisions usually given to a patient on a Section 37. The Secretary of State would be responsible for all decisions regarding ward transfers, transfers to other hospitals and Section 17 leave.
Section 47/49 are used for a person already serving a sentence of imprisonment allowing them to be transferred to Hospital for appropriate treatment. The Secretary of State after being satisfied by the recommendations of two registered doctors will direct the person from prison to the appropriately assigned Hospital. The same restrictions would then apply as that of a Section 41 with the Secretary of State making all final decisions regarding any changes to the patient's circumstances.