Mental Health Act 1983

  • England and Wales

Part 1

  • Mental disorder

    • mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind

  • Psychopathic disorder

    • persistent disorder or disability of mind (whether or not including significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the persons concerned

  • Mental impairment / severe mental impairment

    • low IQ and impairment of social functioning "associated with abnormally aggressive or seriously irresponsible conduct"

  • Cannot be construed to be suffering from above

    • "by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs"

Part 2

  • application to hospital managers

  • by nearest relative or approved social worker

  • based on recommendations by doctors

  • two doctors may not be from staff of same hospital

  • patient can be discharged by RMO, managers of hospital, nearest relative (but can be over-ruled by RMO), Mental Health Review Tribunal

Section 4

  • emergency admission for assessment

  • when no psychiatrist to complete section 2

  • one doctor, if practicable with former knowledge of patient

  • 72 hours

  • can be converted to section 2 by psychiatrist

  • not a treatment power

Section 2

  • Assessment (± followed by urgent treatment)

  • two doctors

  • one must be a psychiatrist (approved by section 12)

  • other preferably has 'previous knowledge of patient'

  • "mental disorder of nature or degree to warrant detention of patient in hospital"

  • detained in interests of his own health or his safety or with a view to protection of other persons

  • 28 days

  • cannot be renewed but can be followed by section 3

Section 3

  • Admission for treatment

  • two doctors (one approved under section 12)

  • "mental disorder of nature or degree to warrant detention of patient in hospital" and

  • detained in interests of his own health or his safety or with a view to protection of other persons

  • and treatment cannot be provided unless detained under section

  • psychopathic disorder / mental impairment treatment "is likely to alleviate or prevent deterioration of the condition"

  • 6 months in 1st instance, then renewed for 6 months and then annually

Section 5(2)

  • if patient already in hospital for medical treatment

  • doctor in charge can detain without ASW / nearest relative

  • 72 hours

Section 5(4)

  • if patient already in hospital

  • nurse

  • if necessary for patient's health or safety or safety of others and no doctor available

Section 7&8

  • guardianship

  • of social services or other relevant body

  • guardian can require to live in certain place

  • to attend appointments

  • give access to residence

  • no powers to enforce

  • application by two doctors, one approved under section 12

Section 25A

  • inserted by Mental Health (Patients in Community) Act 1995

  • supervised discharge

  • 'power to convey' to hospital but no power to detain or enforce medication

Section 17

  • only responsible medical officer (RMO) can agree leave

  • forms needs to be signed beforehand

Part 3

  • application made by magistrate or judge

  • two doctors can both be on staff of same hospital

  • only if bed can be guaranteed to be available within specified time

Section 35

  • remand to hospital for assessment

  • where reason to suspect mental illness

  • based on recommendation of one doctor

  • 28 days renewable up to 12 weeks

  • have to admit within 7 days

  • doesn't allow treatment

  • RMO has no power to discharge

Section 37

  • sentencing to hospital

  • in lieu of punishment

  • recommendations of two doctors, one under section 12

  • 6 months, 6 months, annually

  • no right of appeal in first 6 months

  • discharge by RMO, tribunal or managers (NOT nearest relative)

Section 41

  • restriction orders

  • added to section 37

  • when 'necessary for the protection of the public from serious harm'

  • evidence from receiving psychiatrist

  • removes powers of leave and discharge from RMO

  • powers transferred to Secretary of State / Home Office

  • discharge conditional or absolute

  • most discharges by tribunal rather than Home Office

Section 36

  • transfer to hospital pre-sentence for treatment

Section 38

  • interim hospital order (transfer to hospital for trial of treatment)

Section 48

  • emergency transfer of remand prisoners to hospital

  • Home Office warrant on recommendations of two doctors

Section 47

  • emergency transfer of sentenced prisoners to hospital

  • Home office warrant on recommendations of two doctors

Section 49

  • restriction order applied to section 47 & 48

Part 4

Section 58

  • Treatments requiring consent or a second opinion

  • if patient detained for 3 months or ECT

  • may consent to treatment

  • if not then independent 2nd opinion doctor called

Section 59

  • treatments requiring consent and a second opinion

  • e.g. psychosurgery, hormonal implants

Section 62

  • urgent treatment

  • RMO may start ECT if condition life-threatening

Others

Section 136

  • police power to detain and take to place of safety

  • if found in public place

  • 72 hours

Section 135

  • magistrate issues warrant allowing entry to premises

  • allows search for and removal of patients in need of urgent attention

Section 117

  • on release from detention for treatment

  • after-care responsibilities to health and social services

 

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