An Introduction to the Mental Health Act 1983

In the majority of cases, people who receive hospital or mental health treatment facility, do so voluntarily and are known as being a "voluntary patient". However, in some instances, a person may be detained (commonly referred to as being ‘sectioned) through the Mental Health Act (1983). This means that such patients are treated without their prior agreement. This is a delicate area of medicine and is governed by the legislation set out in the Mental Health Act (1983). The Act covers the evaluation, care, treatment and rights of people who have a mental health disorder.

Individuals who are detained through the contents of the Mental Health Act receive urgent treatment for mental health illnesses and are offered protection for their health and wellbeing as well as protecting others under the contents of the Mental Health Act (1983).

What is the Mental Health Act 1983?

The Mental Health Act (MHA) 1983 is the national legislation that governs the ways in which a person who has a mental health problem is assessed, treated and cared for. The contents of the Act include considerations such as:

• How a patient is assessed and treated in hospital
• Mental health treatment and care in the community
• Pathways into hospital for the receipt of required treatment. This can include civil or criminal, voluntary or involuntary.

The majority of inpatient who are receiving mental health treatment on psychiatric wards in UK hospitals do so on a voluntary basis, though almost half of patients do so without having given prior agreement and they are referred to as ‘formal' patients. Formal patients are those who have been detained under the Mental Health Act (often called being sectioned).

Formal patients lose certain rights upon being admitted to hospital and this includes the right to leave the hospital freely. This is by way of protecting the patient and others and so it is important that wherever possible, the patient fully understands their rights in connection to the way in which they are admitted and treated as per the content of the Mental Health Act.

What does the Mental Health Act cover?

• The Mental Health Act is divided into multiple sections which offer guidance on various considerations. Some of the information contained in the Act includes:
• The rights of a patient when they are detained in hospital against their wishes
• The rights of a patient's family once a patient is detained
• The rights of a detained patient in hospital in connection with the criminal justice system
• The rights of a patient regarding their consent to treatment
• The rights that community treatment must observe, for example on a community treatment order (CTO).

Who decides which person should be detained?

Those responsible for deciding upon whether a patient should be detained will vary depending upon the circumstances and urgency of each case, as detailed below:

In emergencies

Circumstances are considered to be an emergency when an individual appears to pose a serious risk of harming themselves or another person. This can happen in the following settings:

• Private premises. The police are authorised to enter a person's home, by force if required, under a section 135 warrant. In this instance, a patient may be taken to a safe place to be assessed by an approved medical professional and can be held in that place for up to 72 hours.
• in a public place. The police are authorised to take any person found in a public place who seems to have a mental disorder or who appears to need immediate help, treatment or control to a place of safety. This normally means that the individual will be taken to a hospital or other care facility and they can be detained under Section 136, and evaluated by a doctor and an approved mental health professional. The maximum amount of time that a person can be kept there is 72 hours.

For patients who are already receiving treatment in hospital, specific nurses have the power to stop them leaving under Section 5(4) whilst they wait for the doctor who is responsible for the patient's treatment and care to assess and determine whether to detain the patient further under Section 5(2). Section 5(4) gives nurses the authority to detain a patient in hospital for a period of up to six hours. Section 5(2) allows doctors the authority to detain a patient in hospital for a period of up to 72 hours. These periods should allow sufficient time for medical professionals to thoroughly assess a patient to determine whether additional detention under the Mental Health Act is required.

Non-emergencies

In the majority of non-emergency situations, a person close to the individual concerned is likely to be aware of worrying symptoms. This includes relatives, a doctor, care worker or other professional who may raise concerns about a patient's mental health and wellbeing. In these instances, the patient should be engaged in conversations about their care and treatment and decisions should be made about what support, treatment or care might be needed. The concerned party should offer to arrange appointments with a GP to discuss options.

There may be instances when the person concerned is not aware of changes in their behaviour or health or is unwilling or unable to access the support offered to them. Their mental health disorder may impede their ability to accept the help that they are offered and in these circumstances, a formal evaluation of your wellbeing can be requested by your family, carer or doctor through the Mental Health Act process. The relative closest to the person concerned has the right to request such an assessment from an approved mental health professional service local to the area, under the Mental Health Act. In some instances, a court may also determine that this is necessary and can arrange for the assessment or transfer of an individual to a hospital from the court or prison. Patients in such scenarios will be assessed by a medical professional and an approved mental health professional and if necessary, a treatment plan will be arranged.