Intended for healthcare professionals


Changes in laws are necessary to allow patients detained under Mental Health Act to vote

BMJ 1997; 315 doi: (Published 16 August 1997) Cite this as: BMJ 1997;315:431
  1. Helen Smith, Research registrara,
  2. Martin Humphreys, Senior lecturer in forensic psychiatrya
  1. a Reaside Clinic, Birmingham B45 9BE

    Editor—Before the Representation of the People Act 1983 came into force many people with mental illness were denied the right to vote. Even after the act was passed it remained more difficult for people with mental illness to register to vote than it did for other people.1 Until recently, patients detained under the Mental Health Act had been assumed to be disenfranchised because they lacked a permanent address. Recently, the Home Office issued guidelines on the eligibility of people with mental illness to vote.2

    The day after the general election we gave a questionnaire to 89 patients detained in a regional secure unit under the Mental Health Act. We wished to determine how many understood their right to vote in the general election, how many had wished to vote, and why they had not voted. Seventy three patients (82%) responded. Of these, 67 knew that the election had taken place, but none had voted. One patient had had a proxy vote but had been told he could not use it. Half of the patients said that they would have liked to vote; 46 did not know if they were entitled to vote. Fourteen had been told that they could vote; this information was correct for four patients. Of those who thought that they could vote, nine were correct. In total, 24 may have been eligible. The remainder were excluded because they had been in hospital for more than a year or were prisoners serving sentences and thus ineligible to vote.

    A large proportion of these patients would have been eligible to vote but for various reasons had not done so.3 They were poorly advised and unaware of their rights. Most of our patients were detained under the Mental Health Act and had often spent several months in hospital. Many continued to have places of residence outside the hospital but failed to satisfy conditions for registering to vote because of the length of their stay in hospital.

    Current legislation is outdated and needs revising. Many people with mental illness, who would previously have been treated in hospital, are now managed in the community as a result of the reduction in the number of hospital beds.

    Criteria for both eligibility to vote and registering to vote should be the same regardless of whether patients are detained under the Mental Health Act or whether they are informal patients. If a patient is resident in hospital for longer than a year, then use of the hospital's address is appropriate. Patients are likely to return to the hospital's local community during rehabilitation and to be affected by political change there; thus they should participate in the election of their local constituency's representative.


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