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November 19, 2018

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legislation

Mental Health Act – explained

The Mental Health Act 1983 is the main piece of legislation in England and Wales that covers the assessment, treatment and rights of people with a mental health disorder.

Under the Mental Health Act, mental disorder is defined as “any disorder or disability of mind”.

The Act was significantly amended by the Mental Health Act 2007 and the Government recently announced it plans to introduce a new Act in the New Year, following the publication of an independent review into the legislation.

What does the Mental Health Act cover?

The legislation contains information on the following:

  • Your rights when you are detained in hospital against your wishes.
  • Your family’s rights when you are detained.
  • Your rights when you are detained in hospital and also part of the criminal justice system.
  • Your rights around consent to treatment when you are detained.
  • Your rights when you are leaving hospital, including how to have your section lifted and care planning.
  • Your rights when you are being treated in the community, for example receiving section 117 aftercare or on a community treatment order.

The 1983 Mental Health Act states that in some circumstances, you can receive treatment from medical professionals for your mental disorder, without your consent.

This can happen when you detained under certain sections of the legislation.

In addition, it only authorises treatment for a mental disorder, so you cannot be given treatment without your consent for a physical illness under the legislation, unless the physical problem is a symptom or underlying cause of a mental disorder.

The Act defines an Approved Mental Health Professional (AMHP) as a practitioner who has extensive knowledge and experience of working with people with mental disorders.

Until the 2007 Act, this role was restricted to social workers, but other professionals such as nurses, clinical psychologists and occupational therapists are now permitted to perform this role. AMHPs receive specialised training in mental disorder and the application of mental health law, particularly the Mental Health Act.

Training involves both academic work and apprenticeship and lasts one year. The AMHP has a key role in the organisation and application of Mental Health Act assessments and provides a valuable non-medical perspective in ensuring legal process and accountability.

Criticisms of the Mental Health Act

In June 2017, the Mental Health Alliance, which is a coalition of more than 65 organisations, published a report which warned the 1983 Act is “not fit for purpose” and urgently called for a review of the legislation.

A survey of more than 8,000 individuals carried out for the report revealed a “deep concern that people’s dignity, autonomy and human rights” are being overlooked.

Many of the respondents said people have been denied opportunities to be involved in their care, along with their family, friends and carers.

The majority of respondents did agree that compulsory treatment in hospital is sometimes necessary when people pose harm to themselves or others.

But the report warned it was clear that “important principles are currently flouted” and that genuine parity between physical and mental health is needed.

It also criticised the “nearest relative” allocation system, which lists who your nearest relative is in strict order, causes “intolerable misery and delay for people at their most vulnerable.

The future of the Mental Health Act

In December 2018, the Government announced plans to introduce a new Mental Health Bill to transform mental health care, following publication of the final report from the Independent Review of the Mental Health Act 1983.

The review was established by Prime Minister Theresa May last year to look at how the legislation is used and what needs to change.

Recommendations include minimising the numbers of people being held against their will; strengthening the rights, dignity and wellbeing of people who are in extremely vulnerable situations; and dealing with racial inequality in the use of the Act.

“This outdated legislation has seen thousands of people experience poor, sometimes appalling, treatment, who still live with the consequences to this day,” said Mind Chief Executive, Paul Falmer.

“We are pleased to see that many of our concerns – and those of the people we represent and have supported to feed into the review – have been heard.

“The recommendations to strengthen people’s rights, empower them to question decisions about their care, choose their treatment and involve friends and family have the potential to make a real difference to those who are in an extremely vulnerable situation,” added Mr Falmer

“We back the call for people on mental health wards to have a legal right to an independent advocate and agree that people who have been detained should be able to choose which family members and friends can make decisions about their care and treatment.”

Professor Wendy Burn, President of the Royal College of Psychiatrists commented: “Sometimes using the Mental Health Act is necessary for a person’s safety, or to stop a patient’s condition from deteriorating any further. That doesn’t mean it isn’t stressful for patients.
“The proposals to help people feel as safe and supported as possible are certainly welcome, and the rebalance of choice towards the patient is a way of creating a more modern Mental Health Act.”
The Government is expected to issue a formal response to the review’s recommendations in the New Year, before preparing the new legislation.

 

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