Purpose of the Mental Health Act

• Used to detain people against their will in hospital
• Protects the rights of people with a mental disorder
• Ensures those with a mental disorder receive effective care and treatment
• Overrides an individual's right to self-determination for their benefit in certain well-defined circumstances

Criteria for detention under the MHA

1. (Likely) mental disorder
   1. Mental illness
   2. Learning disability
   3. Personality disorder
2. Significantly impaired decision-making ability
   1. As a result of a mental disorder, the patient's ability to make decisions about medical treatment is significantly impaired
3. Determining treatment required (or giving treatment under STD + CTO)
4. Significant risk
   1. Health, safety, or welfare of patient
   2. Safety of others
5. Informal/voluntary care not appropriate

Different types of detention certificate

• Emergency detention order: 72 hour assessment, does not authorise treatment
  • FY2 and above, where possible a mental health officer should also agree
  • Likely mental disorder
  • No right to appeal
• Short term detention order: up to 28 days for assessment/treatment (can be extended by 3 days if extra time is needed to put together an application for a CTO or 5 days once CTO application submitted)
  • Approved medical practitioner and a mental health officer
  • Likely mental disorder
  • Right of appeal
• Compulsory treatment order: initially up to 6 months, treatment authorised for up to 2 months of detention
  • Approved medical practitioner and a mental health officer - reports from 2 independent doctors, a care plan, and MHO report
    • Mandatory tribunal - MHO makes application to the tribunal service
  • Mental disorder present
  • Right of appeal
  • Renewal at 6 months then yearly

What treatment can be given under the MHA

• Urgent treatment may be given under an emergency detention certificate in some circumstances:
  • To save the patient's life
  • To prevent serious deterioration in the patient's condition
  • To alleviate serious suffering
  • To prevent the patient from being a danger to themselves or others
  • T4 certificate completed after up to 7 days treatment
• Short term detention orders and compulsory treatment orders authorise 2 months medication, some exceptions:
  • ECT
  • Nutrition by artificial means
  • Vagus nerve stimulation
  • Transcranial magnetic stimulation
  • Any medicine given for the purpose of reducing sex drive
  • Neurosurgery

Safeguards, rights, and duties under the MHA

• Advance statement: written statement signed when the person is well regarding how they would prefer (or prefer not) to be treated if they were to become ill in the future
  • Tribunal and medical practitioner must regard this but it can be overruled