Definitions and criteria: the 2007 amendments to the Mental Health Act 1983

SummaryThis article deals with the provisions for the lawful detention and compulsory treatment of patients in England and Wales. The 2007 amendments to the Mental Health Act 1983 redefine ‘mental disorder’ and ‘medical treatment’ and remove the classifications required for longer-term detention, abolishing the so-called ‘treatability test’ and introducing a new appropriate-treatment test. ‘Learning disability’ is brought within the definition of mental disorder but only if ‘associated with abnormally aggressive or seriously irresponsible conduct’. The exclusion for promiscuity, other immoral conduct or sexual deviancy is repealed; the exclusion for dependence on alcohol and drugs is retained. The revised definition of ‘medical treatment’ includes psychological treatment and removes the requirement that treatment is under medical supervision. The basic structure of the 1983 Act is retained. Use of the powers is discretionary. The principles of the Mental Capacity Act 2005 are imported into the decision-making framework through the wording of the Mental Health ActCode of Practice.

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The case for removing intellectual disability and autism from the Mental Health Act

The British Journal of Psychiatry ◽

10.1192/bjp.2019.26 ◽

2019 ◽

Vol 215 (5) ◽

pp. 633-635

Author(s):

Sheila Hollins ◽

Keri-Michèle Lodge ◽

Paul Lomax

Keyword(s):

Mental Health ◽

Intellectual Disability ◽

Health Services ◽

Mental Disorder ◽

Learning Disability ◽

Mental Illnesses ◽

Mental Health Act ◽

Definition Of ◽

Serious Mental Illnesses

SummaryIntellectual disability (also known as learning disability in UK health services) and autism are distinct from the serious mental illnesses for which the Mental Health Act is designed to be used. Their inclusion in the definition of mental disorder is discriminatory, resulting in unjust deprivations of liberty. Intellectual disability and autism should be excluded from the Mental Health Act.Declaration of interestNone.

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An Inconvenient Mirror: Do we already have the next Mental Health Act?

International Journal of Mental Health and Capacity Law ◽

10.19164/ijmhcl.v1i13.176 ◽

2014 ◽

Vol 1 (13) ◽

pp. 138

Author(s):

David Hewitt

Keyword(s):

Mental Health ◽

Broad Definition ◽

Code Of Practice ◽

Mental Health Act ◽

The Status ◽

Recent Developments ◽

The Government ◽

Draft Bill ◽

Definition Of ◽

Key Aspects

The Government intends to replace the Mental Health Act 1983, and the most recent of its proposals were contained in the Draft Mental Health Bill published in June 2004.The 1983 Act is now very different to the statute introduced at the end of 1982. Parliament and the courts have made a number of significant changes over the last 20-odd years, and they have brought us a lot closer to the next Mental Health Act than many people – and possibly even the Government – suppose. In fact, those changes may have brought us rather close to the Draft Mental Health Bill. That will be an uncomfortable thought for many people.This paper will consider five key aspects of the Draft Mental Health Bill:• the provisions dealing with risk and treatability;• the notion of compulsion in the community;• the status of the Code of Practice; and• the abolition of the Approved Social Worker.The paper will ask whether, because of the changes of the last two decades, the current Mental Health Act has already arrived at much the same point. In addition, the paper will consider the position of incapable patients. Although the Draft Bill contains precious few proposals about them, the paper will ask whether recent developments have made a broad definition of mental disorder all but essential.

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Mental capacity assessments in secure care: an unnecessary complication?

Psychiatric Bulletin ◽

10.1192/pb.bp.108.020115 ◽

2009 ◽

Vol 33 (12) ◽

pp. 461-464

Author(s):

Ashimesh Roychowdhury

Keyword(s):

Mental Health ◽

Best Practice ◽

Mental Capacity ◽

Code Of Practice ◽

Mental Health Act ◽

Secure Care ◽

Clinical Scenarios ◽

Clinical Thinking ◽

Mental Capacity Act ◽

The Impact

SummaryThis is a review of the key criteria and implications of the Mental Capacity Act 2005 for patients in forensic care detained under the Mental Health Act 1983. Both Acts were amended by the Mental Health Act 2007 and its subsequent Code of Practice; the impact of these changes will be explored here. Through review of the Code of Practice and hypothetical clinical scenarios, I argue that capacity judgements in mental disorder are inherently complex, unreliable and inextricably linked to risk assessment, and that an overemphasis on capacity when making decisions about patient management in secure care can paradoxically obscure the more central issue of risk and proportionality. the key clinical implication is a call for secure services to be balanced in how they adopt best practice principles from the new Mental Capacity Act so that the spirit of the Act, such as valuing patient autonomy, is preserved and that the debate about what practices in secure care are truly proportionate and justified remains at the forefront of clinical thinking.

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Safeguards for informal patients

International Journal of Mental Health and Capacity Law ◽

10.19164/ijmhcl.v0i20.248 ◽

2014 ◽

pp. 71

Author(s):

Aswini Weereratne

Keyword(s):

Mental Health ◽

Mental Disorder ◽

Residential Care ◽

Elderly Person ◽

Mental Capacity ◽

Best Interests ◽

Mental Health Act ◽

Mental Capacity Act 2005 ◽

Mental Capacity Act

In light of the plethora of new provisions safeguarding patients who might previously have been cared for and treated informally, it may be instructive to consider who may now be considered a truly informal patient, i.e. one for whom neither process nor formality is needed. When applied to an incapacitated patient requiring treatment for mental disorder, the word “informal” may now seem oxymoronic and possibly redundant. Can such a patient ever be truly informal? Part IV of the model statute suggests that an informal patient is one who lacks capacity and does not object to proposed treatment which is in their best interests, or a patient who may be treated without the use of compulsory powers; but even such a patient must now be subject to some formality if their care or treatment is to be long term or they are to be deprived of their liberty in order to ensure proper safeguards are in place.Currently the boundary between the Mental Capacity Act 2005 (“MCA”) and Mental Health Act 1983 (“MHA”) is essentially one determined by whether the patient objects to treatment and is defined with formidable complexity in schedule 1A to the MCA. A patient eligible for MCA deprivation of liberty (“DOL”) safeguards, who could be an elderly person in long term residential care, is now subject to formal processes. There is little true informality for a patient lacking treatment capacity. It is questionable whether even a capacitated patient with mental disorder, who is by definition vulnerable, may be treated informally under the MHA4 if they feel suborned into consenting by the possibility of coercion. The terminology offers a slightly deceptive impression of a benign approach with concomitant levels of autonomy, but while it is appropriate to highlight a difference from compulsory process and keep formality to a minimum for the sake of informality, it is also important not to overplay formality in the name of safeguards. The latter appears to be the vice in which the MCA and MHA is now arguably gripped.

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Adolescents and Mental Disorder: Who Consents to Treatment?

Medical Law International ◽

10.1177/096853329700300103 ◽

1997 ◽

Vol 3 (1) ◽

pp. 51-74 ◽

Cited By ~ 3

Author(s):

Caroline Bridge

Keyword(s):

Mental Health ◽

Mental Illness ◽

Young People ◽

Mental Disorder ◽

Medical Treatment ◽

Mentally Ill ◽

Young Person ◽

Refusal Of Treatment ◽

Mental Health Act ◽

Adolescent Autonomy

Although English law recognises that developing adolescents may acquire the capacity to make decisions about medical treatment themselves it does not address the problem of mentally disturbed or disordered adolescents. This article examines the nature of adolescent refusal of treatment and suggests that a line be drawn between three categories of adolescent disturbance—the competent young person who refuses treatment that an adult too may refuse, the rebellious teenager whose refusal is triggered by simple teenage angst, and the mentally ill teenager whose refusal is triggered by mental illness. It suggests that adolescent autonomy needs to be more fully understood and the Mental Health Act more readily used in treating young people.

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Mental Health Act 1983

10.1093/med/9780199659425.003.0031 ◽

2021 ◽

pp. 339-348

Author(s):

Anna Smajdor ◽

Jonathan Herring ◽

Robert Wheeler

Keyword(s):

Mental Health ◽

Mental Disorder ◽

Brain Tissue ◽

Emergency Admission ◽

Convulsive Therapy ◽

Mental Health Act ◽

Definition Of ◽

Electro Convulsive Therapy

This chapter covers the Mental Health Act 1983 and includes topics on The definition of mental disorder under the Mental Health Act, Criteria for admission under s.2 Mental Health Act, Criteria for Admission under section 3, Criteria for Emergency Admission under section 4 Mental Health Act, Brain Tissue Treatment under Mental Health Act, Electro-convulsive Therapy.

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Exploring professionals' understanding, interpretation and implementation of the ‘appropriate medical treatment test’ in the 2007 amendment of the Mental Health Act 1983

BJPsych Open ◽

10.1192/bjpo.bp.116.003939 ◽

2017 ◽

Vol 3 (1) ◽

pp. 57-63 ◽

Cited By ~ 1

Author(s):

Benjamin I. Perry ◽

Nina Champaneri ◽

Frances Griffiths ◽

Moli Paul ◽

Zoebia Islam ◽

...

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Qualitative Study ◽

Mental Disorder ◽

Medical Treatment ◽

Mental Health Act ◽

Training And Support ◽

The Impact

BackgroundThe appropriate medical treatment test (ATT), included in the Mental Health Act (MHA) (1983, as amended 2007), aims to ensure that detention only occurs when treatment with the purpose of alleviating a mental disorder is available.AimsAs part of the Assessing the Impact of the Mental Health Act (AMEND) project, this qualitative study aimed to assess professionals' understanding of the ATT, and its impact on clinical practice.MethodForty-one professionals from a variety of mental health subspecialties were interviewed. Interviews were coded related to project aims, and themes were generated in an inductive process.ResultsWe found that clinicians are often wholly relied upon for the ATT. Considered treatment varied depending on the patient's age rather than diagnosis. The ATT has had little impact on clinical practice.ConclusionsOur findings suggest the need to review training and support for professionals involved in MHA assessments, with better-defined roles. This may enable professionals to implement the ATT as its designers intended.

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Amendments to the Mental Health Act 1983: implications for people with learning disabilities

Advances in Mental Health and Learning Disabilities ◽

10.1108/17530180200900002 ◽

2009 ◽

Vol 3 (1) ◽

pp. 3-8

Author(s):

Ian Hall ◽

Afia Ali

Keyword(s):

Mental Health ◽

Learning Disabilities ◽

Mental Disorder ◽

Learning Disability ◽

Community Treatment ◽

Health Practitioner ◽

Professional Roles ◽

Mental Health Practitioner ◽

Mental Health Act ◽

Definition Of

The new Mental Health Act 2007 substantially amends the Mental Health Act 1983. In this article, some of the most important changes are highlighted, including changes to the definition of mental disorder, the new professional roles of approved mental health practitioner and responsible clinician, and the new powers for Supervised Community Treatment. The likely impact of these changes for people with learning disability and professionals working with them is discussed.

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An audit of incomplete involuntary admissions to an approved Irish centre

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700001348 ◽

2010 ◽

Vol 27 (3) ◽

pp. 143-147 ◽

Cited By ~ 2

Author(s):

Atiqa Rafiq ◽

Mary O'Hanlon

Keyword(s):

Mental Health ◽

Mental Disorder ◽

Substance Misuse ◽

Alcohol Misuse ◽

Admission Rate ◽

Referral Rate ◽

Involuntary Admission ◽

Mental Health Act ◽

Audit Cycle ◽

Definition Of

AbstractObjectives:With the implementation of the Mental Health Act 2001 (M HA 2001) in November 2006, there was an expectation of reduction in the overall involuntary admission rate, particularly as those with a sole diagnosis of substance misuse were specifically excluded from the definition of mental disorder. The aim of this audit cycle was to ascertain this rate and to audit the process of the referral, transfer, assessment and subsequent management of the patients whose admission orders were not completed by the consultant psychiatrists (CPs) following referral for involuntary admission to an approved centre. In addition, the authors wished to ascertain if the recommendations of Audit 2003 were implemented.Method:The Audit 2003 analysed all Temporary Patient Reception Orders sent to an approved centre in the year 2003 but whose admission orders were not completed by the CP. A protocol was drawn up to elicit information. The Re-Audit in 2008 used the same protocol. The duration of the Re-Audit was 01.11.06-31.10.07. The results were analysed using SPSS 12.Results:There is no change in the involuntary referral rate to the approved centre in Longford/Westmeath since the new legislation was enacted. The CP continues to refuse to make an order in one in three cases. Patients with a sole diagnosis of alcohol misuse continue to be referred for involuntary admission but are now presenting sober on admission. There also appears to be an increased rate of incorrectly filled forms by GPs.Conclusions:This audit indicates a need for more training for GPs and Gardai in the MHA 2001 and filling of forms.

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The emergency treatment of overdose: a problem of consent to treatment

Psychiatric Bulletin ◽

10.1192/pb.19.1.7 ◽

1995 ◽

Vol 19 (1) ◽

pp. 7-9

Author(s):

Tim Hardie ◽

Kamaldeep Bhui ◽

Phillip Brown

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Disorder ◽

Medical Treatment ◽

Emergency Treatment ◽

Civil Law ◽

Consent To Treatment ◽

Definition Of ◽

Consent To Medical Treatment ◽

Law Commission

We surveyed 119 psychiatrists to see how they would act with a patient who has taken a potentially lethal overdose, has no mental illness, and is refusing treatment. There was substantial disagreement. There may be a risk of action under civil law whether the psychiatrist decides to treat the patient without his or her consent or not. The Law Commission are examining whether mental disorder, as defined in the Mental Health Act 1983, should be used as a test of Incapacity to give consent to medical treatment. Such legislation would help doctors but may encourage a wide interpretation of the definition of mental disorder.

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