Here are some summary points on the mental health act that I wrote for a talk to medical students. It’s not comprehensive and is intended to cover the basics.
The Mental Health Act 1983 was amended in 1987 and is legislation governing the formal detention and care of mentally disordered people in hospital. The 2007 MHA also governs care of some people in the community with ‘Community Treatment Orders’
There are 50 000 compulsory admission in the UK every year. However most mental health treatment is carried out with patient consent.
When seeking to treat someone with mental health problems the least restrictive option for treatment should always be sought.
The act defines mental disorder as ‘any disorder or disability of mind’ (further discussion)
Note that drug or alcohol dependence are not considered mental disorders but paraphilias are under the scope of the act.
When detaining someone in hospital appropriate treatment must be available for them there and actually available to the patient.
Important people to enactment of mental health leglisation are:
Section 12 doctor – someone approved to make medical recommendations under the act
AMHP (approved mental health professional) – someone approved by the local authority to perform certain roles under the act
Nearest relative: clearly defined under the act and not the same as next of kin. See here for details
Responsible clinician: several roles, but mostly renew and discharge detentions. Since the 2007 Act this is no longer solely the role of a doctor
Types of commonly used sections:
Section 4: Emergency admission for assessment
Lasts 72 hours
Requires one medical practitioner and AMHP to enact
Section 2: Admission for assessment
Max duration 28 days
Requires two medical practitioners and AMHP to enact
Section 3: Admission for treatment
Maximum duration 6 months, can be renewed
Requires two medical practitioners and AMHP
Nearest relative must consent.
Allows detention of an informal patient for up to 72 hours
Designed as an emergency order in order for a mental health act assessment to take place
Doctor does not have to be approved under section 12
One medical recommendation required. This should be completed by doctor in charge of patient’s care.
Allows a police officer to remove someone who appears to be suffering form a mental health disorder to a place of safety
Should not exceed 72 hours and allows patient to be assessed by medical practitioner.
The following people can discharge someone from a section of the MHA
Nearest relative (Responsible Clinician has the power to block this)
Mental health tribunal
This is a rather brief rundown. For further details:
Mental health Act manual 2009 – Richard Jones