* Definitions * Section 1 of the mental health act 1983 was amended in 2007. This section of the act defines a mental disorder as ‘any disorder or disability of mind’ it goes on to state that a “learning disability” is define as a state of arrested or incomplete development of the mind which also includes impairment of intelligence and social functioning (MHOL, 2010). For the purpose of the act a person who has a learning disability is not considered to be suffering from a mental disorder nor require any hospital treatment unless their disability has been associated with “abnormal aggressive behaviour or irresponsible conduct on their part”.
Mind 2010 point out that a person could be detained without their disability without their disability being described as above under the emergency provision of section 135, which is a warrant to search and remove a patient; 136, if found in a public place, s4 assessment of emergency admission, s5, compulsory detention of an informal patients whom are already in hospital and s2 admission for assessment.
The department of health (DoH)codes of practice (2010) goes on to state When determining if a person has a disorder or disability of the mind the skills of a professional who has good clinical knowledge of what constitutes a mental disorder must be sort. * Section 2 The use of this section of the act allows a person defined under s1 of the act to be compulsory detain to a hospital or guardianship. In order for a person to be detained under this section three people must agree that you need to be detained unless there are exceptional circumstances (rethink 2010).
The People involved in this decision making process should be an Approved Mental Health Professional (AMHP) or the patients nearest relative and a doctor who has received special training and a registered medical practitioner. The DoH (2008, p3) codes of practice point out, that It is good practice for one of the doctors involved in this process to be someone who has some knowledge of the patient. Once these people have agreed that a person needs to be detained for their own safety or the safety of others; an application for a bed must be made to the hospital.
The person who makes the application must have seen the patient within the last fourteen days. Whilst the doctors must have seen the patient together or within five days of each other (rethink, 2010). Patients held under this section of the act can be detained for up to twenty- eight days and during this time there mental state should be assessed. This section of the act is used to detain a person who has not committed any criminal offences.
During the patients admission for assessment two doctors must assess and confirm that the patient is suffering from a ‘mental disorder of a nature or degree which warrants detention’ (MHA, date) in hospital for assessment which may be followed by treatment. And that it is necessary to detain such a person in the interest of their own health and safety and/or that of others for example the public. A person who has been detained under this section of the act can be discharge by a responsible clinician or a hospital manager. The patients NR can also ask for the patient be discharged however they must give72 hours notice of intent to do so.
A patient can request that their case be brought before a mental health tribunal (MHT) hearing as long as they request this within the first 14 days of their admission. A s2 admission cannot be renewed. Patients who need medical treatment following this period of assesment will then be detained under s3 of the act. * Section 3 – treatment 6 month then 6 month then renewable 12 monthly * Section 4 admission in an emergency lasts up to 72 hours * Section 5 – emergency admission to allow a person’s mental state to be assessed can only be do if recomened by a doctor and a mental health social worker must be Section 37 – hospital order.
S37 refers to a hospital order that can be imposed to hospitalise a patient who has committed an offence and is believed to be mentally unwell. It is usually imposed by a crown court. A magistrate’s court can also impose this order however this can only be done after a person has been convicted of an offense that is deemed to be punishable with a prison sentence. If the magistrates court can be satisfied that the offender has committed the offence in question they can impose the hospital order without the need to record a conviction.
The court must listen to the evidence received by two doctors and their evidence must satisfy the court that the offender is suffering from a mental illness as described under the definition above and that their detention is appropriate for medical treatment to take place. They must also assert the court that appropriate medical treatment is available for the offender and when considering to imposing the above order the courts must also take into consideration the offenders history and character; any other relevant circumstances and any other alternative methods that could be imposed.
All other avenues must also be explored before the court makes its final decision. the evidence given by the doctors must ascertain the court that hospitalisation is the most beneficial course of action to take in this offenders case (MHLO, 2010) Once the order has been imposed it initially lasts for a period of six months then renewable for another six months and then renewable yearly. Persons whom have been detained under this piece of legislation can be discharged from this section by a clinician, hospital manager or through a mental health tribunal hearing.
A patient can only request to have their case heard at a tribunal once; between the six and twelve month period and then once only in each twelve month period. A patient’s case can also be brought before a tribunal Once a 36 month period has lapsed since their last tribunal hearing (mind 2010). can only be made by the crown court and is usually made in conjunction with the s41 the purpose of the restriction order is to protect the public from serious harm. it affects leave of absesnces, transfers between hospitals and discharge. All of which require ministry of justce permission.
* Section 41 restriction order which is usually made in conjunction with a s37. can be made by the crown court that has imposed the s37 if the patient is deemed to be of serious risk to the public and if one of the detaining doctors whom made the recommendation for the hospital order gives there evidence orally in the court. This order cannot be imposed by a magistrate’s court however they can request that the case be brought before a Crown court in order to impose this restriction order. S41 of the act bares no time limit and therefore cannot be detested by the patient.
Patients detained under this order are usually referred to as restricted patients. * Section 117 This section of the act refers to the legal duty of the primary care trust or the local health board and the local social services authority where the patient is ordinarily resident; in conjunction with relevant voluntary agencies, to provide and pay for appropriate after care services for patients whom had been detained under the long- term sections of the act such as section 3, 37, 45a, 47, or 48 and patients whom have been granted leave under s17 and patients going on to supervised community treatment (SCT).
This piece of legislation does not specify what constitutes as after care services however the mental health act code of practice (2008) suggests that these services could include, among others supporting someone with their psychological needs, physical health care, day time activities or employment appropriate accommodation, crisis planning, parenting needs arising from drug, alcohol or substance misuse and help with welfare and managing money. There are also no restrictions as to what can be provided.
By assessing a person’s needs it will determine the services that need to be provided in order to meet a person’s immediate needs. And by providing these services as aftercare it could help to prevent a person from having to return to hospital. Patents that are in receipt of these services cannot be charged for them by those providing them. The legislation also states that after care services should be provided for as long as the patient is in need of them because of their mental health condition or if they remain the subject of a SCT.
This means that the services that they have been provided with cannot just be withdrawn because the individual appears to be coping well with life outside of hospital. In order for the funding body to withdraw their services a formal discharge meeting must be held which the patient must be involved in (Rethink 2010). The MHA codes of practice advises that after care service planning should begin as soon as a person has been admitted in order for these services to be ready and in place for when the person leaves hospital.
The service users and any carer that the service users has consented to should be present at this meeting. Other professional that may be involved in the care planning process such as psychiatrist, community psychiatric nurse, GP, clinical psychologist, occupational therapist, advocate, housing officer and an attorney or deputy (rethink, 2010). The after care plan should be recorded and reviewed regularly to ensure it is and has met the individuals immediate needs. The plan should not be delayed just because approval needs to be sort at a more senior level. References:
Department of Health (2008). Code of Practice: Mental Health Act 1083. London: The Stationary office. P250-256 Citing from electronic journals: HMSO. (2010) S117 of the mental health act. Available: http://www. mentalhealthlaw. co. uk/117. Last accessed 23rd Oct 2011. MIND. (2011) mental health act. Available: http://www. mind. org. uk/help/rights_and_legislation/mental_health_act_1983_an_outline_guide. Last accessed 23rd Oct 2011. DWP. (2011) mental health act. Available: http://dwp. gov. uk/publications/specialist-guides/medical-conditions/mental-health-act.
shtml. Last accessed 23rd Oct 2011 Department of health. (2011) available: http://www. dh. gov. uk/en/Healthcare/Mentalhealth/InformationontheMentalHealthAct/DH_4001816 last accessed 23rd Oct 2011 Rethink (2010) avaliable: http://www. rethink. org/living_with_mental_illness/rights_and_laws/rights_to_care_treatment/section_117_aftercare/section_117_aftercar. html last accessed 23 Oct 2011. (MHLO) Mental Health Law Online (2010) available: http://www. mentalhealthlaw. co. uk/Main_Page last accessed 23rd Oct 2011.