Mental Health Act 1983
This chapter provides a general overview of the Mental Health Act 1983 (MHA) including the amendments that were made by the Mental Health Act 2007. The 1983 act covers England and Wales only. Within the British Islands there is separate legislation for Scotland, Northern Ireland, Guernsey, Jersey, and the Isle of Man. Ireland has its own mental health law. The main emphasis in this chapter is on detention under the act. Details on consent to treatment rules can be found in the Chapter 82 on the Care Quality Commission. More comprehensive coverage on the act generally can be found elsewhere.1,2,3,4
The definition of mental disorder for all short-term detentions (anything up to 28 days) is “any disorder or disability of the mind,” but a person should not be seen as suffering from a mental disorder by reason only of dependence on alcohol or drugs. The definition is deliberately very broad, and the key to its interpretation can be found in the case of Winterwerp v. The Netherlands5 in that the disorder must be a true mental disorder based on objective medical expertise and not a mere deviation from society’s norms. In this regard it is helpful that the recommendations for civil detention come from doctors, as do the first reports to court for a forensic section. Once a patient is detained on an application by an approved mental health professional (AMHP) or by order from the court, the responsible clinician (RC) will not necessarily be a doctor.