Mental Health Act in a nutshell

Definition of mental disorder

A simpler definition has been introduced - 'mental disorder' is now 'any disorder or disability of the mind'.

Exclusions to Detention

Alcohol and/or drug addiction on its own will not be enough to detain someone under section.

'Appropriate Treatment'

The two doctors who complete the forms when detaining a patient under section 3 will have to write down the names of the hospitals where 'appropriate treatment' for the patient is available.

Definition of 'medical treatment'

In addition to medication, 'medical treatment' will include: nursing, psychological intervention and specialist mental health habilitation, rehabilitation and care. 'Habilitation' means learning new skills.

Introduction of new professional roles

Approved Social Workers (ASWs) will be known as Approved Mental Health Practitioners (AMHPs). AMHPs will be a wider group than social workers - they may also be nurses, psychologists or occupational therapists. To become an AMHP they will have to undertake specialist training and pass an Approval Panel.

Responsible Medical Officers (RMOs) will be known as Approved Clinicians (ACs). In future, ACs need not be a doctor as the role will be open to nurses, psychologists, occupational therapists and social workers. For anyone other than a doctor to become an AC they will have to undertake specialist training and be approved. When an AC is in charge of the care of a detained patient, they will be called a 'Responsible Clinician' (RC). Two doctors will still be required to detain a person under a section of the Mental Health Act.

Amendments to the Changes to the Nearest Relative:

Since 1 December 2007, Civil Partners have had the same status as husband and wife under the Mental Health Act. Although the MHA 1983 defines who the nearest relative is, changes from November 2008 will mean that, provided there are good reasons, the patient, any relative of the patient, anyone with whom the patient is living or the AMHP will be able to apply to the County Court to have the 'nearest relative' displaced. The Court may appoint whoever the patient identifies, if the Court agrees that they are suitable and the nominated person is willing to be the 'nearest relative'.

Referral to Mental Health Review Tribunals (MHRTs)

If a patient detained under Section 2 and then Section 3 and does not appeal to the MHRT, the Mental Health Act Administrators will refer the patient to the MHRT six months from the start date of Section 2. After this referral to the MHRT, if the patient continues to be detained under Section 3 and does not appeal then the Mental Health Act Administrators will refer the patient to the MHRT every 3 years.

Where a patient under the age of 18 is detained under Section 3, the Mental Health Act Administrators will have to refer the patient to the MHRT every year.

Electro-convulsive Therapy (ECT):

If a patient understands the treatment proposed and refuses it, then a course of ECT cannot be prescribed. If a patient does not understand the treatment proposed, a second opinion must be called for and if the second doctor agrees that ECT is necessary and appropriate, then this can be prescribed. If, however, the patient made an Advanced Decision, when they were well, saying they never wished to receive ECT and the hospital knows about this, then the treatment cannot be given. The only exception would be in an emergency if it is:

  1. Immediately necessary to save a patient's life
  2. Immediately necessary to prevent a serious deterioration of the patient's condition.

Advocacy:

Independent Mental Health Advocates (IMHAs) are to be introduced, but not before April 2009. They will meet with detained patients and nearest relatives on request. IMHAs will have the right to see patient records, consult with anyone professionally involved with the patient and could also accompany patients to Section Appeal and Renewal Hearings if requested to do so. They will not, however, take the place of the legal representative.

Patients Under 18

There are changes being introduced for informal and detained patients aged under 18. Details of these will be available in a separate leaflet.

NEW SECTION

Supervised Community Treatment - Community Treatment Order

This will replace the existing Supervised Discharge (Section 25A).

Responsible Clinicians will be able to consider using Supervised Community Treatment for some of their patients who are detained in hospital under Section 3 or Section 37 of the Mental Health Act 1983.

Victims' Rights

Where a patient, who has been convicted of a sexual or violent offence, is detained in hospital without a restriction order all Mental Health Trusts will have a duty to:

  1. Give the victim the chance to ask for conditions to be set for any discharge and to know what the final conditions are.
  2. Inform the victim if the patient's discharge is being considered and/or has been agreed.