Admission for treatment

MHA 1983 s3 is the civil section used to admit patients for treatment.

Admission criteria

From 3/11/08, the admission criteria are:

(a) he is suffering from [mental disorder] of a nature or degree which makes it appropriate for him to receive medical treatment in a hospital; and
(b) [repealed]
(c) it is necessary for the health or safety of the patient or for the protection of other persons that he should receive such treatment and it cannot be provided unless he is detained under this section[; and
(d) appropriate medical treatment is available for him.] ([[s3(2)).

Paperwork

As for s2:

  • Two written medical recommendations, which can be on a joint recommendation form, are required (s3(3)); one doctor must be approved under s12 by the Secretary of State as having special experience in the diagnosis or treatment of mental disorder.
  • The application, by an Approved Mental Health Professional or Nearest Relative (s11(1)). An AMHP must interview the patient in a suitable manner and satisfy himself that detention in a hospital is in all the circumstances of the case the most appropriate way of providing the care and medical treatment of which the patient stands in need (s13(2)).

Procedure

As for s2:

  • The patient must be conveyed to hospital within 14 days beginning with the date on which the patient was last examined by a registered medical practitioner before giving a medical recommendation (s6(1)(a)).
  • There must be no more than five clear days between the two medical examinations (s12(1)). I.e. If the first were on a Sunday the second must be no later than Saturday.
  • The applicant (usually AMHP, but could in theory be NR) must have personally seen the patient within the period of 14 days ending with the date of the application (s11(5)).

Involvement of NR

The AMHP must consult the person (if any) appearing to be the nearest relative before making the application - unless "such consultation is not reasonably practicable or would involve unreasonable delay" - and the s3 cannot go ahead if the NR objects (s11(4)). An objection perceived to be unreasonable could lead to displacement proceedings under s29.

Duration

It is often to said to last for 6 months; however, this is just the period it would last if the patient were not discharged sooner, or the section not renewed for a further period (s20(1)). The section can be renewed by the RC (with the co-operation of another professional from a separate profession) for a further 6-month period, and at yearly intervals thereafter (s20(2)).

Discharge routes

  • Mental Health Tribunal:
    • Applications. One application can be made to the MHT during each period of detention mentioned above (s66(2)(b) and (f)). Hearings take place approximately 5-8 weeks after the application. See Eligibility periods.
    • References. The hospital managers must refer the case to the MHT if no application is made during the first 6 months (s68(1)). They must also make a reference if there has been no MHT for 3 years (1 year if the patient is under 16) (s68(2)).
  • The nearest relative can have the patient discharged, unless barred from doing so by the RC.

Other

During the course of the section, leave may be granted by the RC under s17, and the patient may be transferred to another hospital under s19.

The patient can be forcibly medicated, and the Consent to Treatment provisions apply (s56).

Usually, when discharged, a patient is completely discharged from the provisions of the Mental Health Act, but from 3/11/08 a patient can be discharged subject to a Community Treatment Order.

See also