Clinical Review

ABC of mental health: Mental health and the law

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7108.590 (Published 06 September 1997) Cite this as: BMJ 1997;315:590
  1. Ann Barker

    Introduction

    The law relating to medical practice in general, and mental health in particular, is complex. This article provides a summary of the laws applying in England and Wales. Certain mental disorders are the only medical conditions for which the law permits treatment without the consent of the patient, but this can be undertaken only in a hospital or registered nursing home.

    Legal pathways to compulsory treatment or care

    Mental Health Act 1983

    Section 2, 3, or 4—Admission to hospital from the community

    Section 5—Detained by a nurse or a doctor while already an inpatient

    Section 35, 36, 37, 38, or 41—Admission on the authority of a court after an offence

    Section 47 or 48—Admission from prison on Home Office authority

    Section 135—Taken by police from a private dwelling under a magistrate's warrant

    Section 136—Taken by police from a public place to a place of safety

    National Assistance Act 1948

    Removal to suitable premises of people in need of care and attention

    Powers of Criminal Courts Act 1973

    Treatment as a condition of a probation order

    Mental Health Act 1983

    Legal authority exists for supervision in the community but not for compulsory treatment (including drug treatment)

    Most treatment of mental disorder is undertaken voluntarily, whether in the community or on an outpatient basis or during a hospital stay. Compulsory admission of a patient from the community must be for one or more legal reasons set out in the Mental Health Act. Admission for assessment or treatment of a patient with a mental disorder may be necessary for the patient's health, the patient's safety, protection of others, or all of these.

    Legal categories of mental disorder

    Mental illness—Not specified

    Psychopathic disorder—A persistent disorder of mind (not specified) resulting in abnormally aggressive or seriously irresponsible conduct

    Section 2 of the act allows for compulsory admission for assessment (and subsequent treatment), while section 3 allows for compulsory treatment when the category of mental disorder is already determined. These sections …

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