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Mental Health Act

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For a more detailed guide, contact the Mental Health Act Commission, Maid Marlan, 56 Hounds Gate, Nottingham, NG1 6BG.

Recent figures suggest that 95% of persons in receipt of treatment for a mental health problem whilst in hospital are ‘informal' receivers of care and treatment. The remaining 5% of persons receiving treatment in hospital are compulsory detained and are known as ‘formal' patients.

There are six categories, listed below, for which the Mental Health Act can be used to treat and care for somebody in hospital.

Definitions

Mental Disorder means mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind.

Severe mental impairment means a state of arrested or incomplete development of mind, which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct.

Mental impairment means a state of arrested or incomplete development of mind (not amounting to severe mental impairment), which includes significant impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct.

Psychopathic disorder means a persistent disorder or disability of mind (whether or not including significant impairment of intelligence), which results in abnormally aggressive or seriously irresponsible conduct.

Mental illness is undefined, and its operational definition and usage is a matter of clinical judgement. Medical treatment includes nursing care, habilitation and rehabilitation under medical supervision.

Section 117

How long does it last?

Until such a time that the local Care Trust or Health Authority and the local Social Services Authority are in agreement that the person no longer requires the services. There is no obligation for the Patient to take up the after care services offered unless the services are provided under supervision.

What is the reason?

This section for the provision of aftercare to people who have been detained in hospital:

  • For treatment under section 3
  • Under a hospital order pursuant to section 37 (with or without a restriction order)
  • Following transfer from prison under section 47 or 48.

Who is responsible for providing the Services under Section 117?

The Patient’s Primary Care Trust and local Social Care Authority are responsible for providing the appropriate services.

Section 136

How long does it last?

72 hours

Who can issue a Section 136?

A Police Officer

What is the reason?

When a Police Officer attends a person in a public place who appears to be suffering from mental health problems and is needing immediate care and a place of safety e.g. a police station, psychiatric hospital or other safe accommodation.

Section 2

How long does it last?

This is a 28 day section.

What is the reason?

If a Patient suffers from a mental health problem, which warrants a period of assessment in the interests of their own health and safety or for the protection of other persons.

Medical Say So:

The application must be backed by two registered medical practitioners – Usually a Psychiatrist who knows the patient and preferably the patients own GP. One of the two must be registered as a Section 12 Doctor (having special experience in psychiatry)

Discharge Procedure:

Either by the Psychiatrist, a mental health review tribunal, three members of the hospital's management and rarely the nearest relative. The patient can apply to a tribunal in the first 14 days of admission.

Section 3

How long does it last?

6 months. May be extended for another 6 months and then annually (one year at a time)

What is the reason?

IA mental health problem that is of such a nature or degree that it is appropriate for it to be treated in hospital. Also, if treatment can be used to alleviate and prevent deterioration of the problem. Can be used for the protection of the person or of other persons.

Who can issue a Section 3?

An Approved Social Worker (ASW) or the nearest Relative. Whoever is the person applying for the section; they must have seen the Patient within the last 14 days.

Medical Say So:

Same as Section 2 except that both certificates by the Medical Practitioners must contain one diagnosis/symptom in common.

Discharge Procedure:

Mostly the same as Section 2. Patient can apply to a tribunal once during the first 6 months of admission, once during the second six months and once again during each subsequent year if no application made after six months, the care will automatically be referred to a tribunal. Section 3 can also be used to detain a person who is deemed unable to care for himself, obtain the care he needs or to prevent exploitation.

Section 37

How long does it last?

6 months can be increased to another 6 months and then a year at a time.

What is the reason?

The Crown Court and Magistrates Court can order hospital admission in respect of any person who has been convicted of an offence that would normally be a prison sentence.

Medical Say So:

Same as Section 2 except that both certificates by the Medical Practitioners must contain one diagnosis/symptom in common.

Discharge Procedure:

Mainly the same as in Section 2. Patient can apply to a tribunal once during the first 6 months of admission, once during the second six months and once again during each subsequent year if no application made after six months, the care will automatically be referred to a tribunal. Section 3 can also be used to detain a person who is deemed unable to care for themself, obtain the care they need or to prevent exploitation. The nearest relative cannot request discharge from the hospital.

Section 41

How long does it last?

Unlimited if necessary

What is the reason?

Same as Section 37 and it can only be made if a Section 37 has been made. Section 41 can only be made by a Crown Court. The court will consider, when making a Section 41, the nature of the offence, the reasons behind the offence, the future risk of further offences being committed and protection of the public from serious harm.

Medical Say So:

Same as Section 3 except one of the Doctor's must give spoken evidence in court.

Discharge Procedure:

Only by the Home Secretary or a tribunal.

Section 5

Section 5 is divided into two categories and these are used by a Doctor and are used in respect of a person already in hospital

Section - 5 (4)

Nurses holding power: This section can be used if a person suffering a mental health problem whilst informally receiving treatment in hospital. If the problem becomes likely to impose on the health or safety of that person or for the protection of others should that person leave hospital and it is not possible to engage a Medical Practitioner to furnish a report under Section 5 (2) then the Registered Mental health Nurse can apply the Section 5 (4) and await the Doctor.

How long does it last?

6 hours

Who can issue a Section 5 (4)?

Registered Mental Health Nurse (First level)

Section - 5 (2)

How Long?

72 hours

Who can issue a Section 5 (2)?

An Approved Social Worker (ASW) or the nearest relative. The person applying for the section must have seen the Patient within the last 14 days.

Medical Say So:

One Doctor must determine that it is of utter urgency for the Patient to be admitted under Section 2 and waiting for another Doctor to confirm the need for Section 2 would cause undesirable delay and increase suffering and/or risk. Patient must be admitted within 24 hours of request for detention or medical examination. The Doctor must have seen the person within the last 24 hours.