THE MENTAL HEALTH ACT 1983

This piece of legislation provides health balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily with the power to make decisions about a person’s welfare when that person, due to a mental disorder, is not able to make decisions regarding his or her own welfare.

We take the right to freedom for granted unless we commit serious balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily offences when we might then expect the authorities to take away that freedom.
However, in Health and Social Care there is legislation, including the Children Act 1989 and the Mental Health Act 1983, which may restrict the balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily of individuals for their own, or others, health and social well being.
Obviously, restricting someone’s liberty is a major step and it is essential that abuses of power do not take place, therefore the Mental Health Act lays down clear balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily supported by a CODE OF PRACTICE.


People with serious mental health problems may have no insight into their condition or may display challenging behaviour. Health and social care practitioners may need to balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily the public from an individual or protect the individual from balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily themselves.

The MENTAL HEALTH ACT therefore tries to strike a balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily between maintaining basic civil liberties of the individual with the need to impose interventions in the patient/client’s life.

It is important to note that SECTION 131 of the Mental Health Act 1983 states clearly that INFORMAL (VOLUNTARY) ADMISSION should always be the balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily and ‘should be used whenever a patient is not unwilling to be admitted and can be treated without the use of compulsory powers’.

COMPULSORY (FORMAL) admission to hospital can be made under the MHA in a number of ways.


Firstly, however, two conditions must be met:

The patient must be suffering from a mental disorder.

AND

The patient must be a balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily to themselves or others or the patient’s health is at risk.
It would be illegal to ‘SECTION’ the patient if only one of these conditions were met.
( NB. Being ‘SECTIONED’ refers to being compulsorily admitted to psychiatric hospital under one of the Sections of the MHA)
If the two conditions are met then one of the following 'sections' might be applied:

SECTION 2

This allows for admission for assessment (or assessment and treatment) for up to a maximum period of 28 days.
The application must be founded on applications signed by the ASW or nearest relative and TWO medical practitioners (usually the patient’s GP and a Consultant balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily).

SECTION 3

This allows for admission for treatment for up to a maximum period of 6 months, and also involves the power to give treatment without balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily. The application must be supported by signed documents as in Section 2.

SECTION 4

This allows for admission in balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily situations where undesirable delay would be caused by going through the procedures required in Section 2. The admission is for assessment and allows detention for up to 72 hours. This application must be supported by documents signed by a doctor and an ASW (or nearest relative).

Other Sections of the Act allow qualified nurses to have ‘holding powers’ over informal (voluntary) patients whose condition is causing major concern but who are intent on leaving hospital, and police to remove from the community to a ‘place of balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily’ those they consider are mentally disturbed.

*ASW = ‘APPROVED balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily WORKER’- this is a qualified social worker (who therefore must have the Diploma in Social Work) who also has additional training and qualification in Mental Health.

**Often the ‘nearest relative’ declines to sign the admission forms as they find it too personally balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily, or feel that they will be accused later by the patient of having been responsible for ‘putting them away’. Therefore relatives often prefer to leave matters to the detached balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily of the ASW.

The role of the ASW with regard to compulsory admission is to safeguard the rights of the person who is being considered for a ‘Section’:

Before signing the Section order the ASW must be sure that such action is necessary and that the client is unwilling to go into hospital balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily.
The ASW is responsible for transport of the committed person to hospital, perhaps needing the help of the ambulance service or police.

The MHA balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily of Practice also says that the ASW must take into account a number of factors before making a decision about compulsory admission:
1. The clients wishes
2. The clients’ views on their own balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily
3. Information from friends, relatives, and other professionals
4. The impact the compulsory admission will have on the person’s life after discharge from hospital



The ASW also has to inform the client of their rights as a formal (compulsory) patient eg their right to apply to the MENTAL HEALTH REVIEW TRIBUNAL (MHRT).

So, clients have the right to voluntary admission and treatment unless the conditions outlined in the MHA are met whilst the Health and Social Care practitioners have a duty to:

balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily people only when the the conditions are met.
Respond to a request from a GP for assessment of a patient.


MENTAL HEALTH ACT COMMISSION

This is a special Health Authority which acts as a public watchdog over the balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily and interests of patients detained under the Mental Health Act. The Commission can visit hospitals without warning and can deal with balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily from detained patients.


MENTAL HEALTH TRIBUNAL

The detained patient may apply to the Mental Health Review Tribunal, which has the power to order balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily. Patients may be legally represented at these hearings.

SUPERVISION REGISTER

There is a legal requirement that Health Authorities maintain supervision registers for people with serious mental illness, who are a risk to themselves or others and fall into
one of three ‘at-risk’ groups:
1. Significant risk of balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily
2. Significant risk of serious balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily to others
3. Significant risk of severe self balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily



The patient should always be informed when they are placed on the Supervision balanceCodecomplaintsconsentcriminaldangerdischargedistressingemergencyharminglibertyneedsneglectnormproceduresprofessionalismprofessionalsprotectPsychiatristRegisterrightssafetySectionSOCIALsuicideviolencevoluntarily unless there are clinical reasons why this is inappropriate e.g. where informing the patient might cause serious harm to his or her physical or mental health.