INTRODUCTION
The Law allows, on certain occasions, some interference with the rights of people who are mentally ill. In some circumstances a person who is, or is suspected to be, mentally ill may be detained against his will for the purpose of assessment or for treatment.EMERGENCIES
The patient's nearest relative, or an approved social worker, and a registered practitioner can, in cases of urgent necessity, compulsorily admit a person to hospital for assessment. If two doctors agree the patient can be detained for up to 28 days. This allows for the admission to hospital of people who appear to be so ill that they need to be in hospital, people who need to be in hospital for their own safety, and people who need to be in hospital for the safety of others.The Police may take to a place of safety people who appear to be mentally ill and in immediate need of care or control if it is necessary for the protection of the patient or of anyone else. The purpose of taking that person to a place of safety is for assessment, not for treatment. The maximum time for which a person may be detained under this provision is 72 hours, although if the assessment shows that he is ill and in need of treatment in hospital he may be detained further.
In some cases it may be necessary to enter premises to look for or remove a person who appears to be mentally ill. A Magistrate may grant a warrant which allows a constable to enter premises, if need be by force, to look for and remove such a person.
TREATMENT
Once a person has been assessed he must be discharged from hospital unless he voluntarily agrees to remain, or unless he needs to be detained in hospital for treatment. He can only be detained against his will if his nearest relative agrees, or if the County Court overrules the nearest relative on the basis that the objection to admission is wholly unreasonable.Two doctors must provide written reports to the effect that the patient is suffering from mental illness which needs to be treated in hospital, that the treatment is likely to help, and it is necessary for the health of the patient or the protection of others that he should be given that treatment.
A voluntary patient should generally be treated with his consent, but a person who has been detained in hospital may be treated without his consent. Some of the more radical forms of treatment require the patient's consent or a second opinion, or both.
GUARDIANSHIP
Some patients need continuing medical care and supervision, but do not need to be in hospital. A guardianship order may enable them to live in the community. Guardianship is where the Social Services authority has responsibility for the patient. The authority may say where the patient lives, require him to attend for medical treatment (but not give treatment without consent) and require access to the patient. A guardianship order is made administratively by the Social Services Authority.CRIMINAL COURTS
A person who is mentally ill who is convicted by a Criminal Court of an offence punishable by imprisonment may be sentenced to a hospital order or to a guardianship order. For the Court to impose a hospital order the patient must be suffering from a treatable illness.Two doctors must agree that he is ill and that it is appropriate that he be detained in hospital for treatment, and there must be a bed available for him in a hospital prepared to offer him a place. The patient is then detained and treated until well enough to be discharged.
The Crown Court has power to order the restriction of a patient's discharge it if is necessary to protect the public from serious harm. In such cases the patient may be discharged, or even granted leave of absence, only if the Secretary of State agrees.
DISCHARGE
A voluntary patient may discharge himself from hospital at any time. Patients who are detained may be discharged by the managers of the hospital, who will be advised by the medical staff treating the patient. Patients who are not detained by order of the Court may also be discharged by the patient's nearest relative. A patient who is compulsorily detained may, subject to a number of restrictions, apply to a Mental Health review Tribunal to be discharged. A patient applying to the Mental Health review Tribunal is entitled to be represented by Solicitor and Counsel and may seek public funding to pay his legal costs.When a patient is discharged from compulsory detention in hospital for treatment he is entitled to a care programme drawn up by Social Services together with the appropriate after-care.
