Mental Health Act

Question 1

Which Article in European Convention on Human Rights (ECHR) give right to liberty?

Answer 1

Article 5: Right to Liberty & Security

Question 2

When does ECHR Article 5 give you a limited right to liberty?

Answer 2

• guilty of a crime
• not followed a court order
• suspicion of having committed a crime
• MENTAL HEALTH condition makes it necessary to detain you
• capable of spreading an infectious disease
• attempting to enter country illegally
• away deportation or extradition

Question 3

When was the MHA enacted and amended?

Answer 3

MHA 1983,

amended 2007

Question 4

How many parts and sections to the MHA?

Answer 4

10 parts

149 sections

Question 5

What is a “mental disorder” according to the MHA and what is excluded?

Answer 5

“mental disorder” = any disorder or disability of the mind
- does NOT specific what constitutes a mental disorder

DOES specific exclusions:

• dependence on alcohol or drugs
• learning disability unless associated with abnormally aggressive or seriously irresponsible conduct

Question 6

What are the Parts of the MHA?

Answer 6

I: Application of the Act

II: Compulsory Admission (‘civil’ sections)

III: Patients Concerned in Criminal Proceedings (‘forensic’ sections)

IV: Consent to Treatment

V: Mental Health Review Tribunals

VI: Removal & Return of Patients within the UK VII: Management of Property & Affairs

VIII: Miscellaneous Functions

IX: Offences

X: Miscellaneous and Supplementary

Question 7

What are the criteria for detention under MHA?

Answer 7

The patient must be suffering from a mental disorder…

…of a nature and/or degree

…that makes it appropriate and necessary for
them to be detained in hospital

…in the interests of

• their own health
• their own safety
• the protection of others

and appropriate treatment is available

Question 8

What 6 sections of the MHA should you know about?

Answer 8

Section 2

Section 3

Section 4

Section 5

Section 135

Section 136

Question 9

What powers are given in each of the 6 most important sections the MHA?

Answer 9

Section 2
- detention for assessment and or treatment

Section 3
- detention for treatment

Section 4
- emergency treatment

Section 5
- hospital inpatient (informal patients)

Section 135
- warrant to search for a patient (eg in their home)

Section 136
- power of a police constable to remove a patient (eg from a public place)

Question 10

What is needed and given under Section 2 of MHA?

Answer 10

Assessment and or treatment:

• Two doctors (“registered medical practitioners”)

• At least ONE must be section 12 approved
• They provide 2 medical recommendations (med recs)

this goes to:
• Approved Mental Health Practitioner
- Usually a social worker (previously ASW), sometimes CPNs
- If satisfied the criteria are met, they complete an Application for detention

• Nearest Relative (NR) must be informed
• Lasts 28 days
• Can’t be renewed
• Allows compulsory treatment

Question 11

What is needed and given under Section 3 of MHA? Main differences from Section 2?

Answer 11

Treatment:

• Two doctors (“registered medical practitioners”)

• At least ONE must be section 12 approved
• They provide medical recommendations (med recs)

• Approved Mental Health Practitioner
- If satisfied the criteria are met, they complete an Application
for detention

• Nearest Relative can OBJECT

• Lasts 6 months
• CAN be renewed (for 6/12, then annually)
• Allows compulsory treatment

Question 12

What is needed and given under Section 4 of MHA?

Answer 12

Emergency detention:

• ONE doctor (any doctor…)
• Approved Mental Health Practitioner
• Lasts 72 hours
• Can’t be renewed
• Does NOT allow compulsory treatment

• Heavily scrutinised (try not to use it)

Question 13

What is needed and given under Section 5 of MHA?

Answer 13

Detention of Hospital Inpatients:

• Only applies to informal patients

• those already admitted to hospital
• not just psych wards
• doesnt apply to A&E

first:
• Section 5(4): Nurse’s holding power 
- one form
- hold patient for 6 hours
- long enough to get the doctor

then:
• Section 5(2): Doctor’s holding power 
- one form
- holds patient for 72 hours
- long enough to convene full MHA assessment

• No compulsory treatment

Question 14

Treatment under MHA s2 and s3: restraint? capacity? consent?

Answer 14

• treatment by the Responsible Clinician (RC)

Restraint:

• by staff (governance of techniques used)
• physical (eg handcuffs), rarely
• seclusion (strict policy)

Consent:
- none required for first 3/12

Capacity:

• assessment at 3/12
• capacity and consent = T2 form
• no capacity or no consent –> Second Opinion Approved Doctor –> T3 form

Question 15

Under what section of MHA is leave granted and are patients discharged?

Answer 15

Granting leave (s17)

• RC can grant leave outside hospital
• escorted or unescorted
• initially to test patients prior to discharge or specific purposes
• can be long-term eg a week at home prior to discharge

Discharge (s23)

Question 16

How often are patients under MHA read their rights?

Answer 16

Section 132 requires they are read their rights on a weekly basis

They have right to appeal

Question 17

If a patient appeals their detention where does it go and what happens?

Answer 17

Mental Health Review Tribunal
Panel:
- legal member
- consultant psychiatrist
- lay member

• medical reports
• oral evidence
• burden of proof on the detaining authority
• patient represented by a solicitor

Question 18

What powers do section 135 and 136 give?

Answer 18

Section 135
• Power to enter a home
• Granted by a magistrate (application by an AMHP)

Section 136
• Power of a police constable to detain someone from a
public place
• If a person appears to a constable to be suffering from mental disorder and to be in immediate need of care or control