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Mental Health Act 2007 (c. 12)(The document as of February, 2008) Page 3 Pages: P.1 | P.2 | P.3 | P.4 | P.5 | P.6 | P.7 | P.8 | P.9 | P.10 | P.11 | P.12 | P.13 | P.14 | P.15 " (1A) Subsection (1) does not apply in relation to any form of treatment to which section 58A of that Act (electro-convulsive therapy, etc.) applies if the patient comes within subsection (7) of that section (informal patient under 18 who cannot give consent). " . 29 Withdrawal of consent(1) Section 60 of the 1983 Act (withdrawal of consent) is amended as follows. (2) After subsection (1) insert-- " (1A) Subsection (1B) below applies where-- (a) the consent of a patient to any treatment has been given for the purposes of section 57, 58 or 58A above; but (b) before the completion of the treatment, the patient ceases to be capable of understanding its nature, purpose and likely effects. (1B) The patient shall, subject to section 62 below, be treated as having withdrawn his consent, and those sections shall then apply as if the remainder of the treatment were a separate form of treatment. (1C) Subsection (1D) below applies where-- (a) a certificate has been given under section 58 or 58A above that a patient is not capable of understanding the nature, purpose and likely effects of the treatment to which the certificate applies; but (b) before the completion of the treatment, the patient becomes capable of understanding its nature, purpose and likely effects. (1D) The certificate shall, subject to section 62 below, cease to apply to the treatment and those sections shall then apply as if the remainder of the treatment were a separate form of treatment. " (3) In subsection (2), for "subsection (1)" substitute "subsections (1) to (1D)". Advocacy30 Independent mental health advocates(1) Part 10 of the 1983 Act (miscellaneous and supplementary) is amended as follows. (2) Before section 131 insert-- " 130A Independent mental health advocates(1) The appropriate national authority shall make such arrangements as it considers reasonable to enable persons ("independent mental health advocates") to be available to help qualifying patients. (2) The appropriate national authority may by regulations make provision as to the appointment of persons as independent mental health advocates. (3) The regulations may, in particular, provide-- (a) that a person may act as an independent mental health advocate only in such circumstances, or only subject to such conditions, as may be specified in the regulations; (b) for the appointment of a person as an independent mental health advocate to be subject to approval in accordance with the regulations. (4) In making arrangements under this section, the appropriate national authority shall have regard to the principle that any help available to a patient under the arrangements should, so far as practicable, be provided by a person who is independent of any person who is professionally concerned with the patient's medical treatment. (5) For the purposes of subsection (4) above, a person is not to be regarded as professionally concerned with a patient's medical treatment merely because he is representing him in accordance with arrangements-- (a) under section 35 of the Mental Capacity Act 2005; or (b) of a description specified in regulations under this section. (6) Arrangements under this section may include provision for payments to be made to, or in relation to, persons carrying out functions in accordance with the arrangements. (7) Regulations under this section-- (a) may make different provision for different cases; (b) may make provision which applies subject to specified exceptions; (c) may include transitional, consequential, incidental or supplemental provision. 130B Arrangements under section 130A(1) The help available to a qualifying patient under arrangements under section 130A above shall include help in obtaining information about and understanding-- (a) the provisions of this Act by virtue of which he is a qualifying patient; (b) any conditions or restrictions to which he is subject by virtue of this Act; (c) what (if any) medical treatment is given to him or is proposed or discussed in his case; (d) why it is given, proposed or discussed; (e) the authority under which it is, or would be, given; and (f) the requirements of this Act which apply, or would apply, in connection with the giving of the treatment to him. (2) The help available under the arrangements to a qualifying patient shall also include-- (a) help in obtaining information about and understanding any rights which may be exercised under this Act by or in relation to him; and (b) help (by way of representation or otherwise) in exercising those rights. (3) For the purpose of providing help to a patient in accordance with the arrangements, an independent mental health advocate may-- (a) visit and interview the patient in private; (b) visit and interview any person who is professionally concerned with his medical treatment; (c) require the production of and inspect any records relating to his detention or treatment in any hospital or registered establishment or to any after-care services provided for him under section 117 above; (d) require the production of and inspect any records of, or held by, a local social services authority which relate to him. (4) But an independent mental health advocate is not entitled to the production of, or to inspect, records in reliance on subsection (3)(c) or (d) above unless-- (a) in a case where the patient has capacity or is competent to consent, he does consent; or (b) in any other case, the production or inspection would not conflict with a decision made by a donee or deputy or the Court of Protection and the person holding the records, having regard to such matters as may be prescribed in regulations under section 130A above, considers that-- (i) the records may be relevant to the help to be provided by the advocate; and (ii) the production or inspection is appropriate. (5) For the purpose of providing help to a patient in accordance with the arrangements, an independent mental health advocate shall comply with any reasonable request made to him by any of the following for him to visit and interview the patient-- (a) the person (if any) appearing to the advocate to be the patient's nearest relative; (b) the responsible clinician for the purposes of this Act; (c) an approved mental health professional. (6) But nothing in this Act prevents the patient from declining to be provided with help under the arrangements. (7) In subsection (4) above-- (a) the reference to a patient who has capacity is to be read in accordance with the Mental Capacity Act 2005; (b) the reference to a donee is to a donee of a lasting power of attorney (within the meaning of section 9 of that Act) created by the patient, where the donee is acting within the scope of his authority and in accordance with that Act; (c) the reference to a deputy is to a deputy appointed for the patient by the Court of Protection under section 16 of that Act, where the deputy is acting within the scope of his authority and in accordance with that Act. 130C Section 130A: supplemental(1) This section applies for the purposes of section 130A above. (2) A patient is a qualifying patient if he is-- (a) liable to be detained under this Act (otherwise than by virtue of section 4 or 5(2) or (4) above or section 135 or 136 below); (b) subject to guardianship under this Act; or (c) a community patient. (3) A patient is also a qualifying patient if-- (a) not being a qualifying patient falling within subsection (2) above, he discusses with a registered medical practitioner or approved clinician the possibility of being given a form of treatment to which section 57 above applies; or (b) not having attained the age of 18 years and not being a qualifying patient falling within subsection (2) above, he discusses with a registered medical practitioner or approved clinician the possibility of being given a form of treatment to which section 58A above applies. (4) Where a patient who is a qualifying patient falling within subsection (3) above is informed that the treatment concerned is proposed in his case, he remains a qualifying patient falling within that subsection until-- (a) the proposal is withdrawn; or (b) the treatment is completed or discontinued. (5) References to the appropriate national authority are-- (a) in relation to a qualifying patient in England, to the Secretary of State; (b) in relation to a qualifying patient in Wales, to the Welsh Ministers. (6) For the purposes of subsection (5) above-- (a) a qualifying patient falling within subsection (2)(a) above is to be regarded as being in the territory in which the hospital or registered establishment in which he is liable to be detained is situated; (b) a qualifying patient falling within subsection (2)(b) above is to be regarded as being in the territory in which the area of the responsible local social services authority within the meaning of section 34(3) above is situated; (c) a qualifying patient falling within subsection (2)(c) above is to be regarded as being in the territory in which the responsible hospital is situated; (d) a qualifying patient falling within subsection (3) above is to be regarded as being in the territory determined in accordance with arrangements made for the purposes of this paragraph, and published, by the Secretary of State and the Welsh Ministers. 130D Duty to give information about independent mental health advocates(1) The responsible person in relation to a qualifying patient (within the meaning given by section 130C above) shall take such steps as are practicable to ensure that the patient understands-- (a) that help is available to him from an independent mental health advocate; and (b) how he can obtain that help. (2) In subsection (1) above, "the responsible person" means-- (a) in relation to a qualifying patient falling within section 130C(2)(a) above (other than one also falling within paragraph (b) below), the managers of the hospital or registered establishment in which he is liable to be detained; (b) in relation to a qualifying patient falling within section 130C(2)(a) above and conditionally discharged by virtue of section 42(2), 73 or 74 above, the responsible clinician; (c) in relation to a qualifying patient falling within section 130C(2)(b) above, the responsible local social services authority within the meaning of section 34(3) above; (d) in relation to a qualifying patient falling within section 130C(2)(c) above, the managers of the responsible hospital; (e) in relation to a qualifying patient falling within section 130C(3) above, the registered medical practitioner or approved clinician with whom the patient first discusses the possibility of being given the treatment concerned. (3) The steps to be taken under subsection (1) above shall be taken-- (a) where the responsible person falls within subsection (2)(a) above, as soon as practicable after the patient becomes liable to be detained; (b) where the responsible person falls within subsection (2)(b) above, as soon as practicable after the conditional discharge; (c) where the responsible person falls within subsection (2)(c) above, as soon as practicable after the patient becomes subject to guardianship; (d) where the responsible person falls within subsection (2)(d) above, as soon as practicable after the patient becomes a community patient; (e) where the responsible person falls within subsection (2)(e) above, while the discussion with the patient is taking place or as soon as practicable thereafter. (4) The steps to be taken under subsection (1) above shall include giving the requisite information both orally and in writing. (5) The responsible person in relation to a qualifying patient falling within section 130C(2) above (other than a patient liable to be detained by virtue of Part 3 of this Act) shall, except where the patient otherwise requests, take such steps as are practicable to furnish the person (if any) appearing to the responsible person to be the patient's nearest relative with a copy of any information given to the patient in writing under subsection (1) above. (6) The steps to be taken under subsection (5) above shall be taken when the information concerned is given to the patient or within a reasonable time thereafter. " (3) In section 134 (patients' correspondence), in subsection (3A), for paragraph (b) substitute-- " (b) "independent advocacy services" means services provided under-- (i) arrangements under section 130A above; (ii) arrangements under section 248 of the National Health Service Act 2006 or section 187 of the National Health Service (Wales) Act 2006; or (iii) arrangements of a description prescribed as mentioned in paragraph (a) above. " Accommodation, etc.31 Accommodation, etc.(1) The 1983 Act is amended as follows. (2) In section 39 (power of court to request information about hospitals), after subsection (1) insert-- " (1A) In relation to a person who has not attained the age of 18 years, subsection (1) above shall have effect as if the reference to the making of a hospital order included a reference to a remand under section 35 or 36 above or the making of an order under section 44 below. (1B) Where the person concerned has not attained the age of 18 years, the information which may be requested under subsection (1) above includes, in particular, information about the availability of accommodation or facilities designed so as to be specially suitable for patients who have not attained the age of 18 years. " (3) After section 131 insert-- " 131A Accommodation, etc. for children(1) This section applies in respect of any patient who has not attained the age of 18 years and who-- (a) is liable to be detained in a hospital under this Act; or (b) is admitted to, or remains in, a hospital in pursuance of such arrangements as are mentioned in section 131(1) above. (2) The managers of the hospital shall ensure that the patient's environment in the hospital is suitable having regard to his age (subject to his needs). (3) For the purpose of deciding how to fulfil the duty under subsection (2) above, the managers shall consult a person who appears to them to have knowledge or experience of cases involving patients who have not attained the age of 18 years which makes him suitable to be consulted. (4) In this section, "hospital" includes a registered establishment. " (4) In section 140 (the title to which becomes "Notification of hospitals having arrangements for special cases"), for the words from "for the reception" to the end substitute " -- (a) for the reception of patients in cases of special urgency; (b) for the provision of accommodation or facilities designed so as to be specially suitable for patients who have not attained the age of 18 years. " Chapter 4 Supervised community treatment32 Community treatment orders, etc(1) The 1983 Act is amended as follows. (2) After section 17 insert-- " 17A Community treatment orders(1) The responsible clinician may by order in writing discharge a detained patient from hospital subject to his being liable to recall in accordance with section 17E below. (2) A detained patient is a patient who is liable to be detained in a hospital in pursuance of an application for admission for treatment. (3) An order under subsection (1) above is referred to in this Act as a "community treatment order". (4) The responsible clinician may not make a community treatment order unless-- (a) in his opinion, the relevant criteria are met; and (b) an approved mental health professional states in writing-- (i) that he agrees with that opinion; and (ii) that it is appropriate to make the order. (5) The relevant criteria are-- (a) the patient is suffering from mental disorder of a nature or degree which makes it appropriate for him to receive medical treatment; (b) it is necessary for his health or safety or for the protection of other persons that he should receive such treatment; (c) subject to his being liable to be recalled as mentioned in paragraph (d) below, such treatment can be provided without his continuing to be detained in a hospital; (d) it is necessary that the responsible clinician should be able to exercise the power under section 17E(1) below to recall the patient to hospital; and (e) appropriate medical treatment is available for him. (6) In determining whether the criterion in subsection (5)(d) above is met, the responsible clinician shall, in particular, consider, having regard to the patient's history of mental disorder and any other relevant factors, what risk there would be of a deterioration of the patient's condition if he were not detained in a hospital (as a result, for example, of his refusing or neglecting to receive the medical treatment he requires for his mental disorder). (7) In this Act--
17B Conditions(1) A community treatment order shall specify conditions to which the patient is to be subject while the order remains in force. (2) But, subject to subsection (3) below, the order may specify conditions only if the responsible clinician, with the agreement of the approved mental health professional mentioned in section 17A(4)(b) above, thinks them necessary or appropriate for one or more of the following purposes-- (a) ensuring that the patient receives medical treatment; (b) preventing risk of harm to the patient's health or safety; (c) protecting other persons. (3) The order shall specify-- (a) a condition that the patient make himself available for examination under section 20A below; and (b) a condition that, if it is proposed to give a certificate under Part 4A of this Act in his case, he make himself available for examination so as to enable the certificate to be given. (4) The responsible clinician may from time to time by order in writing vary the conditions specified in a community treatment order. (5) He may also suspend any conditions specified in a community treatment order. (6) If a community patient fails to comply with a condition specified in the community treatment order by virtue of subsection (2) above, that fact may be taken into account for the purposes of exercising the power of recall under section 17E(1) below. (7) But nothing in this section restricts the exercise of that power to cases where there is such a failure. 17C Duration of community treatment orderA community treatment order shall remain in force until-- (a) the period mentioned in section 20A(1) below (as extended under any provision of this Act) expires, but this is subject to sections 21 and 22 below; (b) the patient is discharged in pursuance of an order under section 23 below or a direction under section 72 below; (c) the application for admission for treatment in respect of the patient otherwise ceases to have effect; or (d) the order is revoked under section 17F below, whichever occurs first. 17D Effect of community treatment order(1) The application for admission for treatment in respect of a patient shall not cease to have effect by virtue of his becoming a community patient. (2) But while he remains a community patient-- (a) the authority of the managers to detain him under section 6(2) above in pursuance of that application shall be suspended; and (b) reference (however expressed) in this or any other Act, or in any subordinate legislation (within the meaning of the Interpretation Act 1978), to patients liable to be detained, or detained, under this Act shall not include him. (3) And section 20 below shall not apply to him while he remains a community patient. (4) Accordingly, authority for his detention shall not expire during any period in which that authority is suspended by virtue of subsection (2)(a) above. 17E Power to recall to hospital(1) The responsible clinician may recall a community patient to hospital if in his opinion-- (a) the patient requires medical treatment in hospital for his mental disorder; and (b) there would be a risk of harm to the health or safety of the patient or to other persons if the patient were not recalled to hospital for that purpose. (2) The responsible clinician may also recall a community patient to hospital if the patient fails to comply with a condition specified under section 17B(3) above. (3) The hospital to which a patient is recalled need not be the responsible hospital. (4) Nothing in this section prevents a patient from being recalled to a hospital even though he is already in the hospital at the time when the power of recall is exercised; references to recalling him shall be construed accordingly. (5) The power of recall under subsections (1) and (2) above shall be exercisable by notice in writing to the patient. (6) A notice under this section recalling a patient to hospital shall be sufficient authority for the managers of that hospital to detain the patient there in accordance with the provisions of this Act. 17F Powers in respect of recalled patients(1) This section applies to a community patient who is detained in a hospital by virtue of a notice recalling him there under section 17E above. (2) The patient may be transferred to another hospital in such circumstances and subject to such conditions as may be prescribed in regulations made by the Secretary of State (if the hospital in which the patient is detained is in England) or the Welsh Ministers (if that hospital is in Wales). (3) If he is so transferred to another hospital, he shall be treated for the purposes of this section (and section 17E above) as if the notice under that section were a notice recalling him to that other hospital and as if he had been detained there from the time when his detention in hospital by virtue of the notice first began. (4) The responsible clinician may by order in writing revoke the community treatment order if-- (a) in his opinion, the conditions mentioned in section 3(2) above are satisfied in respect of the patient; and (b) an approved mental health professional states in writing-- (i) that he agrees with that opinion; and (ii) that it is appropriate to revoke the order. (5) The responsible clinician may at any time release the patient under this section, but not after the community treatment order has been revoked. (6) If the patient has not been released, nor the community treatment order revoked, by the end of the period of 72 hours, he shall then be released. (7) But a patient who is released under this section remains subject to the community treatment order. (8) In this section-- (a) "the period of 72 hours" means the period of 72 hours beginning with the time when the patient's detention in hospital by virtue of the notice under section 17E above begins; and (b) references to being released shall be construed as references to being released from that detention (and accordingly from being recalled to hospital). 17G Effect of revoking community treatment order(1) This section applies if a community treatment order is revoked under section 17F above in respect of a patient. (2) Section 6(2) above shall have effect as if the patient had never been discharged from hospital by virtue of the community treatment order. (3) The provisions of this or any other Act relating to patients liable to be detained (or detained) in pursuance of an application for admission for treatment shall apply to the patient as they did before the community treatment order was made, unless otherwise provided. (4) If, when the order is revoked, the patient is being detained in a hospital other than the responsible hospital, the provisions of this Part of this Act shall have effect as if-- (a) the application for admission for treatment in respect of him were an application for admission to that other hospital; and (b) he had been admitted to that other hospital at the time when he was originally admitted in pursuance of the application. (5) But, in any case, section 20 below shall have effect as if the patient had been admitted to hospital in pursuance of the application for admission for treatment on the day on which the order is revoked. " (3) After section 20 (the cross-heading immediately above which becomes "Duration of authority and discharge") insert-- " 20A Community treatment period(1) Subject to the provisions of this Part of this Act, a community treatment order shall cease to be in force on expiry of the period of six months beginning with the day on which it was made. (2) That period is referred to in this Act as "the community treatment period". (3) The community treatment period may, unless the order has previously ceased to be in force, be extended-- (a) from its expiration for a period of six months; (b) from the expiration of any period of extension under paragraph (a) above for a further period of one year, and so on for periods of one year at a time. (4) Within the period of two months ending on the day on which the order would cease to be in force in default of an extension under this section, it shall be the duty of the responsible clinician-- (a) to examine the patient; and (b) if it appears to him that the conditions set out in subsection (6) below are satisfied and if a statement under subsection (8) below is made, to furnish to the managers of the responsible hospital a report to that effect in the prescribed form. (5) Where such a report is furnished in respect of the patient, the managers shall, unless they discharge him under section 23 below, cause him to be informed. (6) The conditions referred to in subsection (4) above are that-- (a) the patient is suffering from mental disorder of a nature or degree which makes it appropriate for him to receive medical treatment; (b) it is necessary for his health or safety or for the protection of other persons that he should receive such treatment; (c) subject to his continuing to be liable to be recalled as mentioned in paragraph (d) below, such treatment can be provided without his being detained in a hospital; (d) it is necessary that the responsible clinician should continue to be able to exercise the power under section 17E(1) above to recall the patient to hospital; and (e) appropriate medical treatment is available for him. (7) In determining whether the criterion in subsection (6)(d) above is met, the responsible clinician shall, in particular, consider, having regard to the patient's history of mental disorder and any other relevant factors, what risk there would be of a deterioration of the patient's condition if he were to continue not to be detained in a hospital (as a result, for example, of his refusing or neglecting to receive the medical treatment he requires for his mental disorder). (8) The statement referred to in subsection (4) above is a statement in writing by an approved mental health professional-- (a) that it appears to him that the conditions set out in subsection (6) above are satisfied; and (b) that it is appropriate to extend the community treatment period. (9) Before furnishing a report under subsection (4) above the responsible clinician shall consult one or more other persons who have been professionally concerned with the patient's medical treatment. (10) Where a report is duly furnished under subsection (4) above, the community treatment period shall be thereby extended for the period prescribed in that case by subsection (3) above. 20B Effect of expiry of community treatment order(1) A community patient shall be deemed to be discharged absolutely from liability to recall under this Part of this Act, and the application for admission for treatment cease to have effect, on expiry of the community treatment order, if the order has not previously ceased to be in force. (2) For the purposes of subsection (1) above, a community treatment order expires on expiry of the community treatment period as extended under this Part of this Act, but this is subject to sections 21 and 22 below. " (4) Schedules 3 and 4 (which contain further amendments) have effect. 33 Relationship with leave of absence(1) The 1983 Act is amended as follows. (2) In section 17 (leave of absence from hospital), after subsection (2) insert-- " (2A) But longer-term leave may not be granted to a patient unless the responsible clinician first considers whether the patient should be dealt with under section 17A instead. (2B) For these purposes, longer-term leave is granted to a patient if-- (a) leave of absence is granted to him under this section either indefinitely or for a specified period of more than seven consecutive days; or (b) a specified period is extended under this section such that the total period for which leave of absence will have been granted to him under this section exceeds seven consecutive days. " (3) In Part 2 of Schedule 1 (patients subject to special restrictions), in paragraph 3 after paragraph (a) insert-- " (aa) subsections (2A) and (2B) shall be omitted; " . 34 Consent to treatment(1) Part 4 of the 1983 Act (consent to treatment) is amended as follows. (2) For section 56 substitute-- " 56 Patients to whom Part 4 applies(1) Section 57 and, so far as relevant to that section, sections 59 to 62 below apply to any patient. (2) Subject to that and to subsection (5) below, this Part of this Act applies to a patient only if he falls within subsection (3) or (4) below. (3) A patient falls within this subsection if he is liable to be detained under this Act but not if-- Pages: P.1 | P.2 | P.3 | P.4 | P.5 | P.6 | P.7 | P.8 | P.9 | P.10 | P.11 | P.12 | P.13 | P.14 | P.15 -- Back --
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