ABSTRACT
This chapter examines criteria and procedures for fair, accurate and therapeutically constructive involuntary detention decision-making in the context of independent review by mental health review tribunals of clinical determinations about inpatient and outpatient detention. It also identifies key criteria for involuntary detention across a number of common law jurisdictions - England, the United States, New Zealand, Australia and Canada. A distinguishing feature of the United Kingdom legislation is that discharge of an involuntarily detained patient must take place if the tribunal is satisfied of a negative. An important factor in a patient feeling confidence in the course of a tribunal hearing is their perception first that they will be listened to and that the body deciding their case is unbiased. The challenge for review tribunals is to combine legal rigour in terms of fact-finding, avoiding the pretextual dishonesty, with informality, humanity and therapeutic awareness to ensure that the patient's condition is not worsened by their experience appearing before a tribunal.
