The Mental Health Act 1983
The Mental Health Act 1983 sets out the law in relation to people with mental disorder. Prior to 1959 there were several pieces of legislation concerning the mentally ill and people with learning disabilities. In 1959 these were repealed and replaced with the 1959 Mental Health Act which attempted to unify the law in these areas.
Alterations in treatment, medication and attitudes led to further changes. In 1977 a review party was set up to examine the 1959 Act, leading to the introduction, in 1983, of the current Mental Health Act.
Like all pieces of legislation it is divided into different parts. Each covers specific areas. These in turn are divided into sections. This has led to the use of the term being 'sectioned' to refer to compulsory admission to hospital. The Act is divided into 10 parts with a total of 149 separately numbered sections. Some of these sections are used to define and clarified terms used in other sections. Like all legal documents it is at times difficult to read and hard to understand.
The Mental Health Act is primarily about restricting your civil liberties because of your mental state. This is done because other people think it should be. It allows certain people to make decisions about you.
These decisions can lead to you being compulsorily admitted to hospital and being given treatment against your will. It can also be decided that you can lose direct control over your finance and property.
For most people the Mental Health Act is primarily concerned with your compulsory admission to hospital and treatment. It is important to know that most people who enter psychiatric hospitals as patients do so voluntarily or informally. The Mental Health Act does not apply to these patients.
The major parts of the act are;
Assessment – everyone has a right to an assessment. Compulsory admission (sectioning) will only take place if one of three criteria are satisfied;
- In the interests of his or her own health, or
- In the interests of his or her own safety, or
- For the protection of other people
Where these criteria do not exist, then voluntary admission may be undertaken. This is subject to availability though, obviously more severe cases must take priority.
Sections – if compulsory admission is deemed necessary there are several different sections that can apply according to the circumstances and the judgement of the health professional.
Information – the Hospital managers have a duty to ensure patients are kept informed. This duty is normally devolved but includes both general information, e.g. about their rights, as well as more personal information. This information must be given so that it is understood, although the inability to comprehend must not be used as an excuse not to give information. Patients have a right to know why they are being detained, what their diagnosis is, what treatment is planned and also to have their views listened to.
Treatment – The right to have a say is also vital in treatment. In general any treatment cannot be given if the patient specifically witholds consent. However, because of the nature of mental illness, a problem arises. Treatment may be given where a patient is incapable of understanding or using information to reach a balanced decision. This is a very complex area of law.
Security – the act differentiates between those patients who are an immediate danger, to themselves or others, and those who are percieved to be a potential danger. The Code of Practice gives possible reasons why disruptive behaviours may occur and potential solutions to the problem. The solutions may include restraint but this is a last resort, prevention is considered better than cure.
Leave of Absence – there is no legal right to leave, it is a power awarded to medical staff. Staff are advised that this is an important step in recuperation, often building up to discharge. Patients may request leave and their care remains the responsibility of the hospital. Restricted patients, i.e. those from prison or other form of custody may not be given leave unless authorised by the Home Secretary.
Complaints – all patients have a right to comment/complain on their handling. In order not to potentially bias any treatment, it is advised that complaints are kept seperately from medical records. It is the responsibility of staff to bring the complaints procedure to the attention of patients and to give reasonable assistance to use the procedures.
Personal Searches – Whilst patients have the right to refuse being searched, hospital staff have a legal duty to provide a safe environment for all patients. Because of this a search can be carried out, over a persons wishes, if the doctor provides no clinical objection. The Code of Practice does state searches should be carried out with due regard to the dignity of the individual.
After – care – The act only describes this very broadly, but it is seen as essential that continuing support is given to enable patients to function in the outside world. There is a legal requirement that all discharges must be accompanied by a Care Programme Approach which both assesses and addresses the patients needs. Assessment must also be made of the risk the patient poses to themselves and others. At all times in this process the patient should be informed of and involved in the decision making process.
This is a brief overview of the Mental Health Act
If you require specific guidance,
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The Mental Health Act 2007 amends the Mental Health Act 1983 - for more information click here.