Tag: Mental Health Act 1983

What is a Place of Safety?

Published on by Andrew MarshallLeave a comment

Introduction

The term “place of safety” is used in the Mental Health Act 1983, an Act of the Parliament of the United Kingdom.

Section 136 of the Act gives police officers the power to remove an apparently mentally disordered person who is in a public place and is apparently a danger to themselves or to other people, to a “place of safety” where they may be assessed by a doctor.

Section 135 of the Act gives police powers to remove a person who is not in a public place to a place of safety after the issue of a warrant by a Justice of the Peace.

According to a unilateral statement by the Home Office, places of safety should typically be hospitals, other medical facilities, residential care homes or the home of a relative or friend of the person; police stations should only be used as a “place of safety” as a last resort.

In practice, local agreements between local authorities, NHS Trusts and police constabularies are in place, designating certain establishments as places of safety. The owners or managers of an establishment acting as a place of safety have a legal obligation to ensure that a detained person cannot leave the premises until he or she has been fully assessed, which may take up to 24 hours. Invariably, therefore, to ensure safeguarding of both the detained person and the public, places of safety are typically restricted to psychiatric hospitals and police custody suites, and tend to exclude open general hospital wards and accident and emergency departments. For the same reason, it is most unusual for friends’ or relatives’ homes to be designated places of safety.

The decision whether to detain a particular person in a psychiatric hospital or in police custody is also subject to local agreements. It is a common arrangement for people to be taken to a psychiatric hospital unless they have a history of violence or are thought to be under the influence of alcohol or recreational drugs, in which cases they would be taken into police custody.

What is a Psychiatric Hospital?

Published on by Andrew Marshall30 Comments

Introduction

Psychiatric hospitals, also known as mental health units or behavioural health units, are hospitals or wards specialising in the treatment of serious mental disorders, such as major depressive disorder, schizophrenia and bipolar disorder.

Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialise only in short-term or outpatient therapy for low-risk patients. Others may specialise in the temporary or permanent containment of patients who need routine assistance, treatment, or a specialised and controlled environment due to a psychological disorder. Patients often choose voluntary commitment, but those whom psychiatrists believe to pose significant danger to themselves or others may be subject to involuntary commitment and involuntary treatment.

Psychiatric hospitals may also be called psychiatric wards/units (or “psych” wards/units) when they are a subunit of a regular hospital.

The modern psychiatric hospital evolved from and eventually replaced the older lunatic asylum. The treatment of inmates in early lunatic asylums was sometimes brutal and focused on containment and restraint. With successive waves of reform, and the introduction of effective evidence-based treatments, most modern psychiatric hospitals emphasize treatment, and attempt where possible to help patients control their lives in the outside world, with the use of a combination of psychiatric drugs and psychotherapy. Exceptions include Japan, where many psychiatric hospitals still use physical restraints on patients, tying them to their beds for days or even months at a time, and India, where the use of restraint and seclusion is endemic.

Brief History

Modern psychiatric hospitals evolved from, and eventually replaced, the older lunatic asylum. Their development also entails the rise of organised institutional psychiatry.

Hospitals known as bimaristans were built in Persia (old name of Iran) beginning around the early 9th century, with the first in Baghdad under the leadership of the Abbasid Caliph Harun al-Rashid. While not devoted solely to patients with psychiatric disorders, they often contained wards for patients exhibiting mania or other psychological distress. Because of cultural taboos against refusing to care for one’s family members, mentally ill patients would be surrendered to a bimaristan only if the patient demonstrated violence, incurable chronic illness, or some other extremely debilitating ailment. Psychological wards were typically enclosed by iron bars owing to the aggression of some of the patients.

Western Europe would later adopt these views with the advances of physicians like Philippe Pinel at the Bicêtre Hospital in France and William Tuke at the York Retreat in England. They advocated the viewing of mental illness as a disorder that required compassionate treatment that would aid in the rehabilitation of the victim. In the Western world, the arrival of institutionalisation as a solution to the problem of madness was very much an advent of the nineteenth century. The first public mental asylums were established in Britain; the passing of the County Asylums Act 1808 empowered magistrates to build rate-supported asylums in every county to house the many ‘pauper lunatics’. Nine counties first applied, the first public asylum opening in 1812 in Nottinghamshire. In 1828, the newly appointed Commissioners in Lunacy were empowered to license and supervise private asylums. The Lunacy Act 1845 made the construction of asylums in every county compulsory with regular inspections on behalf of the Home Secretary, and required asylums to have written regulations and a resident physician.

At the beginning of the nineteenth century there were a few thousand “sick people” housed in a variety of disparate institutions throughout England, but by 1900 that figure had grown to about 100,000. This growth coincided with the growth of alienism, later known as psychiatry, as a medical specialism. The treatment of inmates in early lunatic asylums was sometimes very brutal and focused on containment and restraint.

In the late 19th and early 20th centuries, terms such as “madness”, “lunacy” or “insanity” – all of which assumed a unitary psychosis – were split into numerous “mental diseases”, of which catatonia, melancholia and dementia praecox (modern day schizophrenia) were the most common in psychiatric institutions.

In 1961 sociologist Erving Goffman described a theory of the “total institution” and the process by which it takes efforts to maintain predictable and regular behaviour on the part of both “guard” and “captor”, suggesting that many of the features of such institutions serve the ritual function of ensuring that both classes of people know their function and social role, in other words of “institutionalising” them. Asylums was a key text in the development of deinstitutionalisation.

With successive waves of reform and the introduction of effective evidence-based treatments, modern psychiatric hospitals provide a primary emphasis on treatment; and further, they attempt – where possible – to help patients control their own lives in the outside world with the use of a combination of psychiatric drugs and psychotherapy. These treatments can be involuntary. Involuntary treatments are among the many psychiatric practices which are questioned by the mental patient liberation movement. Most psychiatric hospitals now restrict internet access and any device that can take photos. In the US state of Connecticut, involuntary patients must be examined annually by a court-appointed psychiatrist. Patients may also apply for release at any time and receive a full hearing on the application.

Types

There are a number of different types of modern psychiatric hospitals, but all of them house people with mental illnesses of widely variable severity. In the United Kingdom, both crisis admissions and medium-term care are usually provided on acute admissions wards. Juvenile or youth wards in psychiatric hospitals or psychiatric wards are set aside for children or youth with mental illness. Long-term care facilities have the goal of treatment and rehabilitation within a short time-frame (two or three years). Another institution for the mentally ill is a community-based halfway house.

Crisis Stabilisation

The crisis stabilisation unit is effectively an emergency department for psychiatry, often treating suicidal, violent, or otherwise critical individuals.

Open Units

Open psychiatric units are not as secure as crisis stabilisation units. They are not used for acutely suicidal persons; instead, the focus in these units is to make life as normal as possible for patients while continuing treatment to the point where they can be discharged. However, patients are usually still not allowed to hold their own medications in their rooms because of the risk of an impulsive overdose. While some open units are physically unlocked, other open units still use locked entrances and exits, depending on the type of patients admitted.

Medium Term

Another type of psychiatric hospital is medium term, which provides care lasting several weeks. Most drugs used for psychiatric purposes take several weeks to take effect, and the main purpose of these hospitals is to monitor the patient for the first few weeks of therapy to ensure the treatment is effective.

Juvenile Wards

Juvenile wards are sections of psychiatric hospitals or psychiatric wards set aside for children or adolescents with mental illness. However, there are a number of institutions specialising only in the treatment of juveniles, particularly when dealing with drug abuse, self-harm, eating disorders, anxiety, depression or other mental illness.

Long-Term Care Facilities

In the UK, long-term care facilities are now being replaced with smaller secure units (some within the hospitals listed above). Modern buildings, modern security, and being locally situated to help with reintegration into society once medication has stabilised the condition are often features of such units. Examples of this include the Three Bridges Unit, in the grounds of St Bernard’s Hospital in West London and the John Munroe Hospital in Staffordshire. However, these modern units have the goal of treatment and rehabilitation to allow for transition back into society within a short time-frame (two or three years). However, not all patients’ treatment can meet this criterion, so the large hospitals mentioned above often retain this role.

These hospitals provide stabilisation and rehabilitation for those who are actively experiencing uncontrolled symptoms of mental disorders such as depression, bipolar disorders, eating disorders, and so on.

Halfway Houses

One type of institution for the mentally ill is a community-based halfway house. These facilities provide assisted living for an extended period of time for patients with mental illnesses, and they often aid in the transition to self-sufficiency. These institutions are considered to be one of the most important parts of a mental health system by many psychiatrists, although some localities lack sufficient funding.

Political Imprisonment

In some countries, the mental institution may be used for the incarceration of political prisoners as a form of punishment. A notable historical example was the use of punitive psychiatry in the Soviet Union and China.

Secure Units

In the UK, criminal courts or the Home Secretary can, under various sections of the Mental Health Act, order the admission of offenders for detainment in a psychiatric hospital, but the term “criminally insane” is no longer legally or medically recognised. Secure psychiatric units exist in all regions of the UK for this purpose; in addition, there are a few specialist hospitals which offer treatment with high levels of security. These facilities are divided into three main categories: High, Medium and Low Secure. Although the phrase “Maximum Secure” is often used in the media, there is no such classification. “Local Secure” is a common misnomer for Low Secure units, as patients are often detained there by local criminal courts for psychiatric assessment before sentencing.

Run by the National Health Service, these facilities which provide psychiatric assessments can also provide treatment and accommodation in a safe hospital environment which prevents absconding. Thus there is far less risk of patients harming themselves or others. The Central Mental Hospital in Dublin performs a similar function

Community Hospital Utilisation

Community hospitals across the United States regularly see mental health discharges. A study of community hospital discharge data from 2003-2011 showed that mental health hospitalisations were increasing for both children (patients aged 0-17 years) and adults (patients aged 18-64). Compared to other hospital utilisation, mental health discharges for children were the lowest while the most rapidly increasing hospitalisations were for adults under 64. Some units have been opened to provide “Therapeutically Enhanced Treatment” and so form a subcategory to the three main unit types.

The general public in the UK are familiar with the names of the High Secure Hospitals due to the frequency that they are mentioned in the news reports about the people who are sent there. Those in the UK include Ashworth Hospital in Merseyside, Broadmoor Hospital in Crowthorne, Berkshire, Rampton Secure Hospital in Retford, Nottinghamshire, and Scotland’s The State Hospital in Carstairs. Northern Ireland and the Isle of Man have their own Medium and Low Secure units but use the mainland facilities for High Secure, to which smaller Channel Islands also transfer their patients as Out of Area (Off-Island Placements) Referrals under the Mental Health Act 1983. Of the three unit types, Medium Secure is most prevalent throughout the UK. As of 2009, there were 27 women-only units in England alone. Irish units include those at prisons in Portlaise, Castelrea and Cork.

Criticism

Hungarian-born psychiatrist Thomas Szasz argued that psychiatric hospitals are like prisons unlike other kinds of hospitals, and that psychiatrists who coerce people (into treatment or involuntary commitment) function as judges and jailers, not physicians. Historian Michel Foucault is widely known for his comprehensive critique of the use and abuse of the mental hospital system in Madness and Civilisation. He argued that Tuke and Pinel’s asylum was a symbolic recreation of the condition of a child under a bourgeois family. It was a microcosm symbolizing the massive structures of bourgeois society and its values: relations of Family-Children (paternal authority), Fault–Punishment (immediate justice), Madness-Disorder (social and moral order).

Erving Goffman coined the term “Total Institution” for mental hospitals and similar places which took over and confined a person’s whole life. Goffman placed psychiatric hospitals in the same category as concentration camps, prisons, military organisations, orphanages, and monasteries. In his book Asylums Goffman describes how the institutionalisation process socialises people into the role of a good patient, someone “dull, harmless and inconspicuous”; in turn, it reinforces notions of chronicity in severe mental illness. The Rosenhan experiment of 1973 demonstrated the difficulty of distinguishing sane patients from insane patients.

Franco Basaglia, a leading psychiatrist who inspired and planned the psychiatric reform in Italy, also defined the mental hospital as an oppressive, locked and total institution in which prison-like, punitive rules are applied, in order to gradually eliminate its own contents. Patients, doctors and nurses are all subjected (at different levels) to the same process of institutionalism. American psychiatrist Loren Mosher noticed that the psychiatric institution itself gave him master classes in the art of the “total institution”: labelling, unnecessary dependency, the induction and perpetuation of powerlessness, the degradation ceremony, authoritarianism, and the primacy of institutional needs over those of the persons whom it was ostensibly there to serve: the patients.

The anti-psychiatry movement coming to the fore in the 1960s has opposed many of the practices, conditions, or existence of mental hospitals; due to the extreme conditions in them. The psychiatric consumer/survivor movement has often objected to or campaigned against conditions in mental hospitals or their use, voluntarily or involuntarily. The mental patient liberation movement emphatically opposes involuntary treatment but it generally does not object to any psychiatric treatments that are consensual, provided that both parties can withdraw consent at any time.

What is the Mental Health (Discrimination) Act 2013?

Published on by Andrew Marshall1 Comment

Introduction

The Mental Health (Discrimination) Act 2013 (introduced into Parliament as the Mental Health (Discrimination) (No. 2) Bill) is an Act of Parliament of the United Kingdom introduced to the House of Commons by Gavin Barwell, the Conservative Member of Parliament (MP) for Croydon Central.

An Act to make further provision about discrimination against people on the grounds of their mental health.

Refer to Chronology of UK Mental Health Legislation.

Relates to the Mental Health Act 1983 and the Juries Act 1974.

Background

The Bill passed its House of Commons second reading on 14 September 2012.

There are four sections of the Act.

  • Section 1 (“Members of Parliament etc”) removes from the Mental Health Act 1983 the provision that disqualifies from the House of Commons a member sectioned for over six months under that Act.
  • Section 2 (“Jurors”) qualifies the restrictions of jury members who are receiving mental health treatment.
  • Section 3 (“Company directors”) modifies Regulations in relation to the employment of director’s appointments.
  • Section 4 gives the Secretary of State power to determine when the section relating to juries take effect; the other provisions came into force with Royal Assent.

The then Leader of the Opposition, Ed Miliband, said the Bill would bring public understanding of mental health “into the 21st century”.

What was the Lunacy (Vacating of Seats) Act 1886?

Published on by Andrew Marshall1 Comment

Introduction

The Lunacy (Vacating of Seats) Act 1886 (49 Vict.c.16) was an Act of the Parliament of the United Kingdom.

It provided a mechanism for a Member of Parliament who was judged to be of unsound mind to be removed from his seat.

Refer to Chronology of UK Mental Health Legislation.

Background

There had been a number of cases of Members of Parliament who were felt, in the language of the time, to be lunatics. The most celebrated of these was John Bell the MP for Thirsk who in July 1849 was found to be insane by a commission of enquiry. It was then discovered that there was no way of depriving him of his seat and he remained a Member until his death in 1851.

In January 1886, Charles Cameron (later Sir Charles), known in the House of Commons as Dr Cameron, introduced the Lunacy (Vacating of Seats) Bill to deal with the problem. His determination was such that despite being a private members bill it went through all its Parliamentary stages with little opposition, in less than five months and received its Royal Assent on 10 May 1886, hence becoming the Lunacy (Vacating of Seats) Act 1886.

The Act

The Act was very short, barely more than a page long; and containing only three paragraphs.

It states what should happen if any member of the House of Commons should be committed to a lunatic asylum:

All those involved with the committal must send a report to the Speaker of the House of Commons or face a fine.

The Speaker should send the reports to the Commissioners in Lunacy and that two of them should visit the member and report to the Speaker. If the report is that he is of unsound mind then after six months the Speaker should request a further visit. If this second visit shows that the member is still of unsound mind then the reports are placed on the table in the House of Commons and at that point the seat of the member is declared vacant, and a byelection is called for his replacement.

Consequences

In practice there was a reluctance to call on the Act and it was only used once in the rather special circumstances of the First World War. An election was overdue and during the hostilities it was impossible to hold one. In August 1916, in these circumstances, Charles Leach, the MP for Colne Valley, was declared of unsound mind and relieved of his seat.

Repeal

The Lunacy (Vacating of Seats) Act 1886 was repealed and replaced by the Mental Health Act 1959; the Mental Health Act 1959 was itself repealed and replaced by the Mental Health Act 1983.

The section was subsequently repealed by the Mental Health (Discrimination) Act 2013.

What was the Mental Health Act 1959?

Published on by Andrew Marshall4 Comments

Introduction

The Mental Health Act 1959 was an act of the Parliament of the United Kingdom concerning England and Wales which had, as its main objectives, to abolish the distinction between psychiatric hospitals and other types of hospitals and to deinstituitionalise mental health patients and see them treated more by community care.

An Act to Repeal the Lunacy and mental Treatment Acts 1890 to 1930, and the Mental Deficiency Acts 1913 to 1938, and to make fresh provisions with respect to the treatment and care of mentally disordered persons and with respect to their property and affairs, and for purposes connected with matters aforesaid.

Refer to Chronology of UK Mental Health Legislation.

Background

The Act also defined the term mental disorder for the first time: “mental illness as distinct from learning disability. The definition was “mental illness; arrest or incomplete development of mind; psychopathic disorder; and any other disorder or disability of mind”.

At the time, 0.4% of the population of England were housed in asylums, receiving the standard treatments of the time. Their treatment was considered by the 1957 Percy Commission (A central purpose of the Percy Commission was to assess the extent to which people with mental disorders could be treated as voluntary patients.) and the act resulted from its deliberations. The act was designed to make:

  • Treatment voluntary and informal; and
  • Where compulsory give it a proper legal framework and made as a medical decision; and
  • To move treatment, where possible, away from institutional care to that in the community.

The Act repealed the Lunacy and Mental Treatment Acts 1890 to 1930 and the Mental Deficiency Acts 1913 to 1938.

One of the changes introduced by the Act was the abolishment of the category of “moral imbecile”. The category, which had been introduced in 1913, had been defined in so vague terms that it had allowed also mothers of illegitimate children, especially in case of repeated births out of wedlock, to be regarded as “moral imbeciles” and thus to be placed in an institution for defectives or to be placed under guardianship.

Refer to Mental Health Act 1983, the Royal Commission on the Law Relating to Mental Illness and Mental Deficiency (scans of original document can be found here).

What was the Criminal Lunatics Act 1800?

Published on by Andrew Marshall3 Comments

Introduction

The Criminal Lunatics Act 1800 (39 & 40 Geo 3 c 94) was an Act of the Parliament of Great Britain that required and established a set procedure for the indefinite detention of mentally ill offenders. It was passed through the House of Commons in direct reaction to the trial of James Hadfield, who attempted to assassinate King George III.

Refer to Chronology of UK Mental Health Legislation.

Background

Before 1800, if a defendant was acquitted on the grounds of insanity, he was simply allowed to go free because there was no law in place that allowed the government to detain him. If the judge presiding over the case thought that it would be dangerous to release the defendant and wanted him detained, a separate civil commitment hearing had to be held before the person could be incarcerated. In some cases, the authorities were able to use the Vagrancy Act of 1744 to confine criminals, but in the majority of cases the defendants were sent home or put into the care of their family.

Because a ruling in favour of a plea of insanity was basically equated with a verdict of not guilty, it was generally very difficult to obtain. The consensus among law officials of the time was that madness had to be “obvious and overwhelming” before a plea of insanity would be accepted as a defence. If it could be successfully argued that a lunatic committed a crime during a brief moment of sanity, then it was considered acceptable to convict the defendant, allowing the authorities to detain that person for the good of society.

Trial of James Hadfield

In May 1800, James Hadfield attempted to assassinate King George III at the Drury Lane Theatre. His statement at the time of his arrest was: “It is not over yet – there is a great deal more and worse to be done” which the prosecution used to argue that he was sane enough to plan the event and then carry it to fruition. Later, however, Hadfield changed his story and maintained that he had “not attempted to kill the King”.

Because the intended victim was the King of Great Britain, James Hadfield was charged with treason. This charge proved to be critical in determining the result of his case because it entitled him to several rights that were not given to criminals who had attempted to kill an ordinary person. First of all, the testimony of two witnesses, instead of just one, was needed to prove him guilty, since this was not an ordinary crime (The Treason Act 1800 was passed in July 1800 to make treason by attempting to kill the King subject to the same rules of evidence and procedure as a normal murder trial). Second and more importantly, he could demand that the court provide him with two defence counsels that would argue his case for him, instead of having to act as his own defence. Hadfield chose Thomas Erskine as his chief counsel. At the time, Erskine was regarded as the best lawyer in England.

Despite attempts by the prosecution to emphasise the standard strict criteria for madness, Erskine succeeded in convincing the judge and jury that Hadfield had only appeared to make an attempt on the King’s life in an effort to get himself killed, in accordance with his delusional belief that he must die at the hands of others. The verdict of not guilty was secured.

Surprisingly, this result of the trial did not bring about a public outrage, possibly since no harm had actually come to the King. However, according to the Vagrancy Acts of 1714 and 1744, Hadfield could only be held until he had recovered his mind and the concern was that he would be released in a period of lucidity and make another attempt on the King’s life at a later date. In order to legally confine him, the Criminal Lunatics Bill of 1800 was hastily sent to the House of Commons.

The Act

No more than four days after the trial of James Hadfield, the prosecution proposed “A Bill for Regulating Trials for High Treason and Misprision of High Treason in certain cases, and for the Safe Custody of Insane Persons Charged with Offences”. This bill included both what was to become the Criminal Lunatics Act 1800 and the Treason Act 1800, but the two sections were separated the day after the initial bill was presented to Parliament.

The terms of the Criminal Lunatics Act applied to people charged with treason, murder, or felony who were acquitted on the grounds of insanity or who appeared to be insane when apprehended, brought in for arraignment, or summoned for discharge due to a lack of prosecution. The procedure for dealing with these people read as follows: “If [the jury] shall find that such person was insane at the time of the committing such offence, the court before whom such trial shall be had, shall order such person to be kept in strict custody, in such place and in such manner as to the court shall seem fit, until His Majesty’s pleasure shall be known.” In essence, the Criminal Lunatics Act required the detention of someone who had committed a crime in a bout of insanity rather than leaving it to the discretion of the judge and jury.

Repeal

The Act was repealed by the Statute Law (Repeals) Act 1981. Currently, detention of mentally ill offenders is regulated by the Mental Health Act 1983, sections 35-41 and 47-49.

Section 1

This section was repealed for England and Ireland, by section 4 of the Trial of Lunatics Act 1883 (46 & 47 Vict c 38); and for Scotland by section 1 of, and Schedule 1 to, the Statute Law Revision Act 1948.

What is Diminished Responsibility in English Law?

Published on by Andrew Marshall4 Comments

Introduction

In English law, diminished responsibility is one of the partial defences that reduce the offence from murder to manslaughter if successful (termed “voluntary” manslaughter for these purposes).

This allows the judge sentencing discretion, e.g. to impose a hospital order under section 37 of the Mental Health Act 1983 to ensure treatment rather than punishment in appropriate cases. Thus, when the actus reus (Latin for “guilty act”) of death is accompanied by an objective or constructive version of mens rea (Latin for “guilty mind”), the subjective evidence that the defendant did intend to kill or cause grievous bodily harm because of a mental incapacity will partially excuse his conduct. Under s.2(2) of the Homicide Act 1957 the burden of proof is on the defendant to the balance of probabilities. The M’Naghten Rules lack a volitional limb of “irresistible impulse”; diminished responsibility is the volitional mental condition defence in English criminal law.

Refer to Chronology of UK Mental Health Legislation, Insanity Defence, and Diminished Responsibility (General).

The Statutory Provision

Section 2 of the Homicide Act 1957 states: (1) Where a person kills or is party to a killing of another, he shall not be convicted of murder if he was suffering from an abnormality of mental functioning which:

(a) arose from a medical condition;
(b) substantially impaired D’s ability to do one or more of the things mentioned in subsection (1A); and
(c) provides an explanation for D’s acts and omissions in doing or being a party to the killing.

(1A) Those things are:

(a) to understand the nature of D’s conduct;
(b) to form a rational judgment; and
(c) to exercise self-control.

(1B) For the purposes of subsection (1)(c), an abnormality of mental functioning provides and explanation of D’s conduct if it causes, or is a significant contributory factor in causing, D to carry out that conduct.

The defence has recently been amended by s. 52 of the Coroners and Justice Act 2009, which came into force on 4 October 2010.

How Substantial must the Impairment Be?

R v Golds1 provides a recent authority from the Court of Appeal Criminal Division on how the courts will interpret the term ‘substantial’. At paragraph [55] of Elias LJ’s judgement (following the paragraphing from the neutral citation given below) two senses of the word ‘substantial’ are identified: (i) something substantial is more than something which is merely trivial or minimal owing to the fact that it has “substance”, or (ii) something substantial is big or large (e.g. in the sense that a substantial salary is a large one). At paragraph [72] Elias LJ concludes by opining that the court should (i) leave interpretation of the word ‘substantial’ to the jury, but if asked for further help should (ii) direct them under the second meaning of the term (i.e. substantial meaning big).

Diminished Responsibility and Voluntary Intoxication

Voluntary intoxication will not satisfy the criterion that there must be an abnormality of mental functioning arising from a recognised medical condition (s.2(1)(a) Homicide Act 1957) and therefore cannot be relied upon as grounds for the partial defence2. However a person suffering from alcoholism that has led to an abnormality of mental function may have access to the partial defence3. In R v Gittens4 a defendant who suffered from depression killed his wife and stepdaughter after drinking and taking drugs for medication. The direction to a jury facing both diminished responsibility and drunkenness should be:

  • Would the defendant have killed as he did if he had not been drunk?
    • and if the answer to that is yes,
  • Was he suffering from diminished responsibility when he did so?

The more chronic forms of alcoholism and the long-term use of heroin and cocaine (see R v Sanderson5) can become a relevant factor where a craving for drink or drugs causes an abnormality of mind. This must be distinguished from the situation in which the abnormality of mind causes a craving for drink or drugs . R v Tandy6 held that where a defendant could show that she was suffering from an abnormality of the mind, that it was induced by disease (namely alcoholism), and that it substantially impaired her responsibility for her actions, then the defence of diminished responsibility would be made out. In the actual case, the craving for alcohol did not render the use of alcohol involuntary. The defendant was in control when she began drinking, and the state of mind in which she killed her daughter was merely induced by the alcohol. In R v Dietschmann,7 the House of Lords held that where a defendant suffers from an abnormality of mind within s2(1) also consumes alcohol before the killing, the jury should find him or her guilty of manslaughter if they are satisfied that, notwithstanding the alcohol consumed and its effect, the abnormality of mind substantially impaired the mental responsibility for the fatal acts. The sub-section does not require the abnormality of mind to be the sole cause of the defendant’s acts; even if the defendant would not have killed if he had not consumed alcohol, the causative effect of the alcohol does not prevent an abnormality of mind suffered by the defendant from substantially impairing his mental responsibility for the fatal acts. Dietschmann was later applied by the Court of Appeal in R v Hendy8.

References

  1. R v Golds[2014] EWCA Crim 748.
  2. R v Fenton (1975) 61 Cr App Rep 261.
  3. R v Tandy [1989] 1 WLR 350.
  4. R v Gittens (1984) QB 698.
  5. R v Sanderson (1994) 98 Cr. App. R. 325.
  6. R v Tandy (1989) 1 AER 267.
  7. R v Dietschmann [2003] UKHL 10.
  8. R v Hendy [2006] EWCA Crim 819.

What is the Mental Health Review Tribunal (England and Wales)?

Published on by Andrew Marshall2 Comments

Introduction

In England, the First-tier Tribunal (Mental Health), more commonly known as the Mental Health Tribunal, is an independent quasi-judicial body established to safeguard the rights of persons subject to the Mental Health Act 1983. It provides for consideration of appeals against the medical detention or forced treatment of a person who was deemed to be suffering from a mental disorder that was associated with a risk to the health or safety of that person or others.

Prior to an overhaul of the tribunal system in 2008, its functions were carried out by the Mental Health Review Tribunal, which was a standalone body. In 2008 the Mental Health Review Tribunal was formally abolished as a standalone body and merged with the Health and Social Care Chamber of the newly established First-tier Tribunal (FTT). A new Upper Tribunal was also created, which hears appeals against decisions by the FTT. In Wales, the corresponding body is the Mental Health Review Tribunal for Wales.

Refer to Chronology of UK Mental Health Legislation and Mental Health Tribunal for Scotland.

Tribunal Hearings

Mental Health Tribunals are independent quasi-judicial bodies that operate under the provisions of the Mental Health Act 1983 and the Mental Health Review Tribunal Rules 1983. A Tribunal’s main purpose is to review the case of a patient detained under the Mental Health Act and to direct the discharge of any patient for whom the statutory criteria for discharge have been satisfied. In some cases, the Tribunal also has the discretion to discharge a patient who does not meet the statutory criteria. Such cases usually involve making a balanced judgement on a number of serious issues such as the freedom of the individual, the protection of the public and the best interests of the patient.

Tribunal Panel Members

The Lord Chancellor makes appointments to the panels of members for each region. In the case of medical and specialist members, the Secretary of State for Health (for cases in England) or the Secretary of State for Wales is also consulted. The Regional Chairperson’s appoint the members who are to sit at a particular hearing and there must be a legal member, a medical member and a specialist member appointed for each Tribunal hearing to form a legal quorum. In the event that one or two members are not present, the third member can technically open the tribunal and then immediately adjourn the hearing until another two members are able to attend. Any decisions formed by the tribunal are that of the tribunal, rather than the particular judicial member. There will be no dissenting judgement.

Role of the Legal Member (Legal Judge)

The legal member’s role is to preside (i.e. take the chair) at all tribunal hearings. They are known as the president and will sign all decisions, documents, recommendations and judgments as the president, on behalf of the whole tribunal. Their responsibilities also include making sure that the proceedings are conducted fairly, that the legal requirements of the Mental Health Act 1983 are properly observed within the rule of law and advise on any questions of law which may arise. They are also responsible, in consultation with other judges of the Tribunal, for drafting the reasons for the decision, and for signing the record of the decision. The legal members are required to have “such legal experience, as the Lord Chancellor considers suitable”. They are normally senior legal practitioners such as solicitors or barristers, but in ‘restricted patient panel’ (RPP) cases (also known as forensic cases) the level must be that of a Circuit Judge or higher. A small number of Recorders, who are also Queen’s Counsel might sit as RPP members.

Role of the Specialist Member (Specialist Judge)

The specialist member undertakes a check and balance role to the Tribunal under the Tribunal Rules. They will be a professional outside the legal and medical profession, but might hold legal or healthcare qualifications. Most specialist judges are senior or experienced practitioners or therapists with at least 5-7 years standing and will hold a range of experience within the mental health sector. Most specialist members are educated to postgraduate level in mental health, they may hold an advanced degree in psychology or forensics in RPP cases. The specialist judge will have extensive background knowledge of professional practice within the mental health field, health and/or social services. Members can be drawn from the NHS, voluntary organisations, adult social services or the private health sector. Specialist judges may also be mental health social workers, probation officers, approved mental health professionals, psychologists, mental health nurses and occupational therapists. They will be able to offer information to the other judges of the Tribunal on matters relating to health and social care matters and often healthcare legal matters in context (i.e. Codes of Practice, best practice etc.). Generally, specialist judges are appointed in office for a term of 5 years and this is reviewed every 5 years until the age of 70, which is the statutory retirement age for all judges.

Role of the Medical Member (Medical Judge)

The medical member has a dual role to perform. They are required by the Tribunal Rules to carry out an examination of the patient before the hearing and to take any steps that they consider necessary to form an opinion of the patient’s mental condition. In England, the pre-medical examination is not a requirement to hear a case. At the hearing they, together with the other judges, have the judicial responsibility of deciding whether or not the patient should continue to be detained or remain on a community treatment order. If the medical member’s opinion of the patient differs significantly from other medical witnesses then this should be made known at the beginning of the hearing. This is because it would be unfair and contrary to a basic principle of natural justice if the Tribunal members were to take notice of information that had not been shared with all the other parties at the hearing. The medical member is invariably a consultant psychiatrist of several years’ standing. He or she will be able to advise the other members of the Tribunal on any medical matters. Medical members are generally senior doctors, with at least 7 years experience and are often drawn in from Consultant level. Generally, medical judges are appointed in office for a term of 5 years and this is reviewed every 5 years until the age of 70, which is the statutory retirement age for all judges.

Course of the Tribunal

Tribunals normally sit in private and take place in the hospital or community unit where the patient is detained. Physical location aside, the tribunals resemble court hearings, during which appropriate witnesses are invited to speak in turn. These include the detained person, their solicitor, the member of the multi-disciplinary team responsible for the detained person’s care in hospital, known as the Responsible Clinician (RC, usually a consultant psychiatrist), a representative of the nursing staff at the hospital and the Approved Mental Health Professional (AMHP). Additionally, the RC and AMHP (or more frequently the patient’s care coordinator) are required to submit written reports on the person’s state of health to the Tribunal in advance of the hearing. Sometimes the primary inpatient nurse for the patient may also submit a written report.

How the Decision is Made

Each member of the Tribunal is entitled to an equal voice on questions of law, procedure and substance. All the members participate in the making of decisions and, although the legal member is expected to draft and sign the written record, this is done only after taking into account the contributions of the other members. If the members do not all agree then a decision of the majority of members of the Tribunal is taken as the decision of the Tribunal.

The Tribunal will consider the case and the patient as presented on the day. The Tribunal cannot question the circumstances that gave rise to the detention. The Tribunal decides whether or not to end the patient’s detention in hospital. The Tribunal has the power to order a deferred discharge which may be conditional (for example that an aftercare package is put in place).

Decisions of the Tribunal can be appealed to the Administrative Appeals Chamber of the Upper Tribunal, or to the High Court, by way of Judicial Review.

Organisation and Oversight

The Bodies

Technically the Mental Health Review Tribunal consists of two distinct bodies, within a single non-departmental public body.

  • The first body is the Judicial Tribunal itself with the responsibility for hearing applications or references concerning people detained under the Mental Health Act 1983.
    • The Tribunal members are appointed by the Ministry of Justice.
    • There is a Liaison Judge appointed to the Tribunal to lead its development.
  • The second body is the Mental Health Review Tribunal Secretariat.
    • This is staffed by members of the Department of Health, and has responsibility for the administration of the Tribunals.

Regional Chairperson

There is a Regional Chairperson appointed for each of the two Tribunal regions (the North Region and the South Region), based in London and Manchester. Regional Chairperson’s responsibilities include appointing members to particular hearings, ensuring that all the statutory requirements are complied with, making judicial decisions and giving such directions as are necessary to ensure the speedy and just determination of every case. Regional Chairperson’s are also responsible for organising training for members, for overseeing the members’ appraisal and mentoring scheme and for handling complaints about a member’s conduct.

Organisation of the Tribunal

The Secretary of State for Health is responsible for meeting the expenses of Tribunals in England and for providing accommodation and staff. Administration is carried out at the Secretariat offices in Leicester. The Welsh Assembly has similar responsibilities for Tribunals in Wales and administration is carried out at the Secretariat office in Cardiff. All the Secretariat staff are civil servants and are completely independent of the hospital authorities. The Regional Chairperson and the Secretariat work closely together to make sure that the whole Tribunal process is closely managed. The role of the Home Office is confined to cases involving ‘restricted patients’.

Tribunals operate independently of all Government Departments.

Fairness of Decisions

A study in 2017 by Jewell and Colleagues, looked at the correlation between a number of predictors and the outcome of the MHRT decisions: The study commented that their “findings imply that decisions at MHRT are not biased in terms of age, sex, ethnicity, mental health diagnosis, or even index offence”, rather its findings “suggest that by reducing levels of agitated behaviour, verbal aggression and physical violence on the ward, working towards being granted unescorted community leave, and specifically targeting items on the HCR-20 risk assessment” patients can increase their chance of discharge.

Reference

Jewell, A., Dean, K., Fahy, T. & Cullen, A.E. (2017) Predictors of Mental Health Review Tribunal (MHRT) outcome in a forensic inpatient population: a prospective cohort study. BMC Psychiatry. Springer Science and Business Media LLC. 17(1). doi:10.1186/s12888-016-1188-8.

Chronology of UK Mental Health Legislation

Published on by Andrew Marshall42 Comments

INTRODUCTION

The below Tables provide a chronological overview of mental health legislation within the United Kingdom.

It outlines legislation that has an impact (directly and/or indirectly) on mental health topics etc.

I like to be thorough, so if there is anything we have missed please let us know.

Look here for a general overview of Mental Health Law.

Legislation Type

  • UK Statutory Instruments (251).
  • Scottish Statutory Instruments (88).
  • Northern Ireland Statutory Rules (45).
  • Northern Ireland Statutory Rules and Orders (37).
  • Wales Statutory Instruments (21).
  • UK Public General Acts (15).
  • Acts of the Scottish Parliament (3).
  • Northern Ireland Orders in Council (2).
  • Acts of the Northern Ireland Assembly (1).
  • Measures of the National Assembly for Wales (1).

Notes

  • The above only include legislation between 1932 and present.
  • Correct as at: 09 May 2021.
  • You can find specific details of legislation @ https://www.legislation.gov.uk/.

Public Bodies

Public BodyLegislationRemarks
Commissioners in Lunacy for IrelandLunacy (Ireland) Act 18211. Established to oversee asylums and the welfare of mentally ill people in Ireland.
Commissioners in LunacyLunacy Act 18451. Established to oversee asylums and the welfare of mentally ill people in England and Wales.
2. It succeeded the Metropolitan Commissioners in Lunacy.
Commissioners in Lunacy for ScotlandLunacy (Scotland) Act 18571. Established to oversee asylums and the welfare of mentally ill people in Scotland.
Board of Control for Lunacy and Mental DeficiencyMental Deficiency Act 19131. Replaced the Commissioners in Lunacy.
General Board of Control for ScotlandMental Deficiency and Lunacy (Scotland) Act 19131. Replaced the Commissioners in Lunacy for Scotland.
Mental Health Review Tribunal (England and Wales)Mental Health Act 1983 & Mental Health Review Tribunal Rules 19831. Mental Health Review Tribunal for Wales.
Mental Health Tribunal for ScotlandMental Health (Care and Treatment) (Scotland) Act 2003
Mental Welfare Commission for ScotlandMental Health (Care and Treatment) (Scotland) Act 20031. Originally established by the Mental Health (Scotland) Act 1960.
2. A non-departmental public body (NDPB).

Other

OtherLegislationRemarks
Diminished Responsibility (in English Law)M’Naghten Rules1. Refer also to Insanity Defence.
Fixated Threat Assessment Centre (FTAC)N/A1. FTAC was set up in 2006, and is jointly managed by the Home Office, the Department of Health and Metropolitan Police Service.
Percy Commission (1957)1. Refer to Mental Health Act 1959.

CHRONOLOGY OF LEGISLATION

1700s

Legislation
(Title)		Legislation TypeRemarks
Madhouses Act 1774UK Public General Acts1. Established a group of five commissioners from the Royal College of Physicians that dealt with licenses for premises to hold mentally ill people (Justices of the peace dealt with the rest of England and Wales).
2. The Act also made it a requirement that any person detained in one of the madhouses, must have a signed certificate from a doctor, confirming their mental illness.
3. There were amendments in 1828 and 1832.
4 It remained in force until repealed by the Madhouses Act 1828.
Madhouse Continuation Act 1779UK Public General Acts1. The Madhouses Act 1774 was continued for a further seven years by the Madhouse Continuation Act 1779 (19 Geo. 3 c.15).
Law Perpetuation Act 1786UK Public General Acts1. The Madhouses Act 1774 was then continued indefinitely by the Madhouse Law Perpetuation Act 1786 (26 Geo. 3 c.91).

1800s

Legislation
(Title)		Legislation TypeRemarks
Criminal Lunatics Act 1800UK Public General Acts1. Passed with retrospective effect following the acquittal of James Hadfield, mandated detention at the regent’s pleasure (indefinitely) even for those who, although insane at the time of the offence, were now sane.
2. Repealed by the Statute Law (Repeals) Act 1981.
3. Section 1 was repealed for England and Ireland, by section 4 of the Trial of Lunatics Act 1883 (46 & 47 Vict c 38); and for Scotland by section 1 of, and Schedule 1 to, the Statute Law Revision Act 1948.
County Asylums Act 1808 UK Public General Acts 1. Also known as Mr. Wynn’s Act, after Charles Watkin Williams-Wynn, a Welsh member of parliament for Montgomeryshire, who promoted the act.
Marriage of Lunatics Act 1811UK Public General Acts1. Repealed by the Assisted Decision-Making (Capacity) Act 2015.
Madhouses (Scotland) Act 1815UK Public General Acts
Criminal Lunatics Amendment Act 1815UK Public General Acts
Irish Lunatic Asylums for the Poor Act 1817UK Public General Acts
Pauper Lunatics Act 1819UK Public General Acts
Lunacy (Ireland) Act 1821UK Public General Acts1. Refer to Lunacy Regulation (Ireland) Act 1871.
2. Aspects of this legislation remained in force until repealed by the Assisted Decision Making (Capacity) Act 2015.
County Asylums Act 1828UK Public General Acts1. Addressed concerns with the administration of asylums and the slow creation of county asylums within Britain.
Madhouses Act 1828UK Public General Acts1. Repealed the Madhouses Act 1774.
Chancery Lunatics Property Act 1828UK Public General Acts
Madhouses Act 1832UK Public General Acts
Criminal Lunatics (Ireland) Act 1838UK Public General Acts
Trial of Lunatics Act 18831. Repealed Section 1 of the Criminal Lunatics Act 1800 (for England and Ireland via Section 4).
County Asylums Act 1845UK Public General Acts1. Amended by the County Asylums Act 1853.
2. Repealed by the Lunacy Act 1890.
Lunacy Act 1845UK Public General Acts1. The Lunacy Act 1845 and the County Asylums Act 1845 were the next forward motions in ‘caring’ for people with mental health.
2. These acts ensured that there was an asylum for each county to deal with mentally ill people and it gave them the power to detain people that were not of “sound mind”.
3. The Lunacy Commission (see Public Bodies Table above) was created to oversee the asylums and ultimately check they were running appropriately.
4. Repealed by the Lunacy Act 1890.
County Asylums Act 18531. Also known as Lunatic Asylums Act 1853.
2. Amended the County Asylums Act 1845.
3. Repealed the Lunacy Act 1845.
4. Repealed by the Lunacy Act 1890.
Lunacy (Scotland) Act 1857UK Public General Acts
Lunacy Regulation (Ireland) Act 1871UK Public General Acts
Idiots Act 1886UK Public General Acts1. Repealed by the Mental Deficiency Act 1913.
Lunacy (Vacating of Seats) Act 1886UK Public General Acts1. Repealed by the Mental Health Act 1959.
2. The section was subsequently repealed by the Mental Health (Discrimination) Act 2013.
Lunacy Act 1890UK Public General Acts1. The Lunacy Act 1845 and the County Asylums Act 1845 were later repealed by the Lunacy Act 1890 which made small changes, and the Lunacy Commission were handed more powers and renamed the “Board of Control” in the Mental Deficiency Act 1913.
2. The Board of Control would later be altered in the Mental Health Act 1930 and the National Health Service Act 1946.

1900 to 1947

Legislation
(Title)		Legislation TypeRemarks
Mental Deficiency Act 1913UK Public General Acts1. Repealed by the Mental Health Act 1959.
Mental Deficiency and Lunacy (Scotland) Act 1913UK Public General Acts
Mental Treatment Act 1930UK Public General Acts1. Repealed by the Mental Health Act 1959.
The Mental Treatment Regulations (Northern Ireland) 1932Northern Ireland Statutory Rules and Orders
The Mental Treatment (Registration of Institutions and Houses) Fees Regulations (Northern Ireland) 1932Northern Ireland Statutory Rules and Orders
The Mental Treatment Regulations (Northern Ireland) 1934Northern Ireland Statutory Rules and Orders

1948

Legislation TitleLegislation TypeRemarks
The Mental Health (Transfer of Functions) Order (Northern Ireland) 1948Northern Ireland Statutory Rules and Orders
The Mental Health (Appointed Day) Order (Northern Ireland) 1948Northern Ireland Statutory Rules and Orders
The Mental Health (Appointed Day) (No. 2) Order (Northern Ireland) 1948Northern Ireland Statutory Rules and Orders
The Mental Health (Transfer of Functions) (No. 2) Order (Northern Ireland) 1948Northern Ireland Statutory Rules and Orders
The Mental Health (Appointed Day) (No. 3) Order (Northern Ireland) 1948Northern Ireland Statutory Rules and Orders
The Mental Health (No. 1) Regulations (Northern Ireland) 1948Northern Ireland Statutory Rules and Orders
The Mental Health (No. 2) Regulations (Northern Ireland) 1948Northern Ireland Statutory Rules and Orders

1949

Legislation TitleLegislation TypeRemarks
The Mental Health Services Capital Fund Regulations (Northern Ireland) 1949Northern Ireland Statutory Rules and Orders
The Mental Health (Institutions) Order (Northern Ireland) 1949Northern Ireland Statutory Rules and Orders
The Mental Health (No. 5) Regulations (Northern Ireland) 1949Northern Ireland Statutory Rules and Orders

1950

Legislation TitleLegislation TypeRemarks
The Mental Health (Qualifications of Medical Officers and Medical Practitioners) Regulations (Northern Ireland) 1950Northern Ireland Statutory Rules and Orders
The Mental Health (Institutions) Order (Northern Ireland) 1950Northern Ireland Statutory Rules and Orders
The Mental Health (Fees for Medical Certificates) Regulations (Northern Ireland) 1950Northern Ireland Statutory Rules and Orders

1951

Legislation TitleLegislation TypeRemarks
The Mental Health (Charge for Mid-day Meal at Instruction and Occupation Centres) Regulations (Northern Ireland) 1951Northern Ireland Statutory Rules and Orders

1954

Legislation TitleLegislation TypeRemarks
The Mental Health (Qualifications of Medical Officers and Medical Practitioners) (Amendment) Regulations (Northern Ireland) 1954Northern Ireland Statutory Rules and Orders

1957

Legislation TitleLegislation TypeRemarks
The Mental Health (Institutions) Order (Northern Ireland) 1957Northern Ireland Statutory Rules and Orders

1958

Legislation TitleLegislation TypeRemarks
The Mental Health (Institutions) Order (Northern Ireland) 1958Northern Ireland Statutory Rules and Orders

1959

Legislation TitleLegislation TypeRemarks
Mental Health Act 1959UK Public General Acts1. The Mental Health Act 1959 was the first parliamentary Act on mental health that started treating the subject more seriously.
2. This was the first legal move to treat mental health issues similarly to physical illness (or as close as possible).
3. It also removed promiscuity or other immoral conduct as grounds for detention.
4. However, although this act was a great first step, there were, unfortunately, grey areas that needed clarifying.
5. There was confusion whether a legal detaining order for a person gave the hospital power to treat them against their will.
6. Moving into the 1970’s, it was becoming more obvious that a specific legal framework was required regarding medical treatments for mental health, such as psychiatric medication, electro convulsion therapy, and psychotherapy.
7. Repealed the Lunacy and Mental Treatment Acts 1890 to 1930 and the Mental Deficiency Acts 1913 to 1938.
8. Repealed by the Mental Health Act 1983.

1960

Legislation TitleLegislation TypeRemarks
The Mental Health Review Tribunal Rules, 1960UK Statutory Instruments
Mental Health (Scotland) Act 1960UK Public General Acts1. Established the Mental Welfare Commission for Scotland.

1961

Legislation TitleLegislation TypeRemarks
The Mental Health Act (Northern Ireland) 1961 (Commencement) Order (Northern Ireland) 1961Northern Ireland Statutory Rules and Orders

1962

Legislation TitleLegislation TypeRemarks
The Mental Health (Special Care Scheme Approval) Order (Northern Ireland) 1962Northern Ireland Statutory Rules and Orders
The Mental Health Act 1961 (Commencement No. 2) Order (Northern Ireland) 1962Northern Ireland Statutory Rules and Orders
The Mental Health (Formal Procedures) Regulations (Northern Ireland) 1962Northern Ireland Statutory Rules and Orders
The Mental Health (Payment of Fees) Regulations (Northern Ireland) 1962Northern Ireland Statutory Rules and Orders
The Mental Health Review Tribunal Rules (Northern Ireland) 1962Northern Ireland Statutory Rules and Orders
The Mental Health (Formal Procedures) (Amendment) Regulations (Northern Ireland) 1962Northern Ireland Statutory Rules and Orders

1963

Legislation TitleLegislation TypeRemarks
The Mental Health Act 1961 (Commencement) Order (Northern Ireland) 1963 Northern Ireland Statutory Rules and Orders
The Mental Patients’ Affairs (Amendment) Order (Northern Ireland) 1963Northern Ireland Statutory Rules and Orders

1964

Legislation TitleLegislation TypeRemarks
Criminal Procedure (Insanity) Act 1964 UK Public General Acts1. Refer to Trial of Lunatics Act 1883.

1965

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1965Northern Ireland Statutory Rules and Orders

1967

Legislation TitleLegislation TypeRemarks
The Mental Health (Abolition of Charge for Mid-day Meal at Instruction and Occupation Centres) Regulations (Northern Ireland) 1967Northern Ireland Statutory Rules and Orders

1970

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1970Northern Ireland Statutory Rules and Orders
The Mental Health (Payment of Fees) Regulations (Northern Ireland) 1970Northern Ireland Statutory Rules and Orders

1971

Legislation TitleLegislation TypeRemarks
The Mental Patients’ Affairs (Amendment) Order (Northern Ireland) 1971Northern Ireland Statutory Rules and Orders
The Mental Health (Hospital and Guardianship) (Welsh Forms) Regulations 1971UK Statutory Instruments
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1971Northern Ireland Statutory Rules and Orders

1973

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1973Northern Ireland Statutory Rules and Orders
The Mental Health (Payment of Fees) Regulations (Northern Ireland) 1973Northern Ireland Statutory Rules and Orders

1974

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1974Northern Ireland Statutory Rules

1975

Legislation TitleLegislation TypeRemarks
The Mental Health (Guardianship) (Scotland) Amendment Regulations 1975UK Statutory Instruments
The Mental Health (Amendment) Act 1975 (Commencement) Order 1975UK Statutory Instruments
The Mental Health (Hospital and Guardianship) Amendment Regulations 1975UK Statutory Instruments

1976

Legislation TitleLegislation TypeRemarks
The Mental Health Review Tribunal (Amendment) Rules 1976Northern Ireland Statutory Rules

1978

Legislation TitleLegislation TypeRemarks
The County Court (Mental Health Act) Rules (Northern Ireland) 1978Northern Ireland Statutory Rules

1979

Legislation TitleLegislation TypeRemarks
The County Court (Mental Health Act) (Amendment) Rules (Northern Ireland) 1979Northern Ireland Statutory Rules
The Mental Health (Constitution of State Hospital Management Committee) (Scotland) Amendment Order 1979UK Statutory Instruments

1981

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1981Northern Ireland Statutory Rules
The Mental Health (Payment of Fees) (Amendment No. 2) Regulations (Northern Ireland) 1981Northern Ireland Statutory Rules
The Nursing Homes and Mental Nursing Homes Regulations 1981UK Statutory Instruments

1982

Legislation TitleLegislation TypeRemarks
Mental Health (Amendment) Act 1982UK Public General Acts

1983

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1983Northern Ireland Statutory Rules
The Mental Health (Amendment) Act 1982 (Commencement No. 1) Order 1983UK Statutory Instruments
The Mental Health (Nurses) Order 1983UK Statutory Instruments
The Mental Health Act Commission (Establishment and Constitution) Order 1983UK Statutory Instruments
The Mental Health (Hospital, Guardianship and Consent to Treatment) Regulations 1983UK Statutory Instruments
The Mental Health Act Commission Regulations 1983UK Statutory Instruments
The Nursing Homes and Mental Nursing Homes (Amendment) Regulations 1983UK Statutory Instruments
The Mental Health Review Tribunal Rules 1983UK Statutory Instruments
The Health Service Commissioner for England (Mental Health Act Commission) Order 1983UK Statutory Instruments
The Mental Health (Amendment) (Scotland) Act 1983 (Commencement No. 1) Order 1983UK Statutory Instruments
The Nurses, Midwives and Health Visitors (Mental Health Committee of the Welsh National Board) Order 1983UK Statutory Instruments
The Mental Health (Amendment) (Scotland) Act 1983 (Commencement No. 2) Order 1983UK Statutory Instruments
Mental Health Act 1983UK Public General Acts1. This Act was brought in to try and tackle these legal requirements (noted in the Mental Health Act 1959 Table).
2. It implements controls on treatments for mental disorders, specifically including mood altering drugs, electro convulsion therapy, and surgery, making it clearer what treatment a hospital could give to a detained patient.
3. It also introduced social workers, who were specially trained in mental health care and also demanded the aftercare (by local health services) of mental health patients who were released from detainment.
4. Mental Health Act 1983 Code of Practice (1983, revised in 1999).
5. Amended many times, notably in:
a. 1995;
b. 2001 (via remedial order, issued on the grounds of incompatibility with the European Convention of Human Rights under the Human Rights Act 1998 section 4);
c. 2007 (Mental Health 2007 Act); and
d. 2017 via the Policing and Crime Act 2017.

1984

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1984Northern Ireland Statutory Rules
The Mental Health (Prescription of Class of Nurse) (Scotland) Order 1984UK Statutory Instruments
The Mental Health Act 1983 Commencement Order 1984UK Statutory Instruments
The Mental Health (Specified Treatments, Guardianship Duties etc.) (Scotland) Regulations 1984UK Statutory Instruments
The Mental Health (Prescribed Forms) (Scotland) Regulations 1984UK Statutory Instruments
The Nursing Homes and Mental Nursing Homes Regulations 1984UK Statutory Instruments
Mental Health (Scotland) Act 1984UK Public General Acts1. Amended by the Mental Health (Public Safety and Appeals) (Scotland) Act 1999.
2. Largely replaced by the Mental Health (Care and Treatment) (Scotland) Act 2003.

1985

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1985Northern Ireland Statutory Rules
The Isles of Scilly (Mental Health) Order 1985UK Statutory Instruments

1986

Legislation TitleLegislation TypeRemarks
The Mental Health (Payment of Fees) (Amendment) Regulations (Northern Ireland) 1986Northern Ireland Statutory Rules
The Mental Health (1986 Order) (Commencement No. 1) Order (Northern Ireland) 1986Northern Ireland Statutory Rules
The Mental Health (Nurses, Guardianship, Consent to Treatment and Prescribed Forms) Regulations (Northern Ireland) 1986Northern Ireland Statutory Rules
The Mental Health Review Tribunal (Northern Ireland) Rules (Northern Ireland) 1986Northern Ireland Statutory Rules
The Mental Health (1986 Order) (Commencement No. 2) Order (Northern Ireland) 1986Northern Ireland Statutory Rules
The Mental Health (Scotland) Act 1984 (Appointed Day) Order 1986UK Statutory Instruments
The Nursing Homes and Mental Nursing Homes (Amendment) Regulations 1986UK Statutory Instruments
Act of Sederunt (Mental Health (Scotland) Act 1984) 1986UK Statutory Instruments
The Mental Health (Northern Ireland) Order 1986Northern Ireland Orders in Council1. Amended by the Mental Health (Amendment) (Northern Ireland) Order 2004.
2. Will be repealed, for anyone over 16, by the Mental Capacity Act (NI) 2016.
The Mental Health (Northern Ireland Consequential Amendments) Order 1986UK Statutory Instruments

1988

Legislation TitleLegislation TypeRemarks
The Mental Health (1986 Order) (Commencement No. 3) Order (Northern Ireland) 1988Northern Ireland Statutory Rules
The Nursing Homes and Mental Nursing Homes (Amendment) Regulations 1988UK Statutory Instruments

1990

Legislation TitleLegislation TypeRemarks
The Mental Health (1986 Order) (Commencement No. 4) Order (Northern Ireland) 1990Northern Ireland Statutory Rules
The Nursing Homes and Mental Nursing Homes (Amendment) Regulations 1990UK Statutory Instruments
The Cornwall and Isles of Scilly Mental Handicap National Health Service Trust (Establishment) Order 1990UK Statutory Instruments
The Mental Health Foundation of Mid Staffordshire National Health Service Trust (Establishment) Order 1990UK Statutory Instruments
The Newcastle Mental Health National Health Service Trust (Establishment) Order 1990UK Statutory Instruments
The West Dorset Mental Health National Health Service Trust (Establishment) Order 1990UK Statutory Instruments

1991

Legislation TitleLegislation TypeRemarks
The Bath Mental Health Care National Health Service Trust (Establishment) Order 1991UK Statutory Instruments
The North East Essex Mental Health National Health Service Trust (Establishment) Order 1991UK Statutory Instruments
The Nursing Homes and Mental Nursing Homes (Amendment) Regulations 1991UK Statutory Instruments
Mental Health (Detention) (Scotland) Act 1991UK Public General Acts1. Repealed.

1992

Legislation TitleLegislation TypeRemarks
The Mental Health (Nurses, Guardianship, Consent to Treatment and Prescribed Forms) (Amendment) Regulations (Northern Ireland) 1992Northern Ireland Statutory Rules
The Mental Health (Detention) (Scotland) Act 1991 (Commencement) Order 1992UK Statutory Instruments
The West Dorset Mental Health National Health Service Trust (Transfer of Trust Property) Order 1992UK Statutory Instruments
The Mental Health Foundation of Mid Staffordshire National Health Service Trust (Transfer of Trust Property) Order 1992UK Statutory Instruments
The Southern Derbyshire Mental Health National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The South Lincolnshire Community and Mental Health Services National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The Leeds Community and Mental Health Services Teaching National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The Hounslow and Spelthorne Community and Mental Health National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The Riverside Mental Health National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The Northumberland Mental Health National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The South Cumbria Community and Mental Health National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The South West Durham Mental Health National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The South Tees Community and Mental Health National Health Service Trust (Establishment) Order 1992UK Statutory Instruments
The Shropshire’s Mental Health National Health Service Trust (Establishment) Order 1992UK Statutory Instruments

1993

Legislation TitleLegislation TypeRemarks
The North West London Mental Health National Health Service Trust (Establishment) Order 1993UK Statutory Instruments
The Mental Health (HSS Trusts – Consequential Amendment) Regulations (Northern Ireland) 1993Northern Ireland Statutory Rules
The Shropshire’s Mental Health National Health Service Trust (Establishment) Amendment Order 1993UK Statutory Instruments
The Cornwall and Isles of Scilly Mental Handicap National Health Service Trust (Change of Name) Order 1993UK Statutory Instruments
The Mental Health Foundation of Mid Staffordshire National Health Service Trust (Change of Name) Order 1993UK Statutory Instruments
The Mental Health (Nurses) Amendment Order 1993UK Statutory Instruments
The Mental Health (Hospital, Guardianship and Consent to Treatment) Amendment Regulations 1993UK Statutory Instruments
The Bath Mental Health Care National Health Service Trust (Transfer of Trust Property) Order 1993UK Statutory Instruments
The Leicestershire Mental Health Service National Health Service Trust (Establishment) Order 1993UK Statutory Instruments
The Oxfordshire Mental Healthcare National Health Service Trust (Establishment) Order 1993UK Statutory Instruments
The South Warwickshire Mental Health National Health Service Trust (Establishment) Order 1993UK Statutory Instruments
The Mental Health Services of Salford National Health Service Trust (Establishment) Order 1993UK Statutory Instruments
The South East London Mental Health National Health Service Trust (Establishment) Order 1993UK Statutory Instruments
The Norfolk Mental Health Care National Health Service Trust (Establishment) Order 1993UK Statutory Instruments
The Mid Essex Community and Mental Health National Health Service Trust (Establishment) Order 1993UK Statutory Instruments
The Glasgow Community and Mental Health Services National Health Service Trust (Establishment) Order 1993UK Statutory Instruments

1994

Legislation TitleLegislation TypeRemarks
The Glasgow Community and Mental Health Services National Health Service Trust (Change of Name) (Establishment) Amendment Order 1994UK Statutory Instruments
The South Birmingham Mental Health National Health Service Trust (Establishment) Order 1994UK Statutory Instruments
The Northern Birmingham Mental Health National Health Service Trust (Establishment) Order 1994UK Statutory Instruments
The East Surrey Learning Disability and Mental Health Service National Health Service Trust (Establishment) Order 1994UK Statutory Instruments
The Heathlands Mental Health National Health Service Trust (Establishment) Order 1994UK Statutory Instruments
The Mental Health (Nurses, Guardianship, Consent to Treatment and Prescribed Forms) (Amendment) Regulations (Northern Ireland) 1994Northern Ireland Statutory Rules
The North West London Mental Health National Health Service Trust (Transfer of Trust Property) Order 1994UK Statutory Instruments
The South Tees Community and Mental Health National Health Service Trust (Transfer of Trust Property) Order 1994UK Statutory Instruments
The West Dorset Mental Health National Health Service Trust Dissolution Order 1994UK Statutory Instruments
The South East London Mental Health National Health Service Trust (Change of Name and Miscellaneous Amendments) Order 1994UK Statutory Instruments
The Newcastle Mental Health National Health Service Trust Dissolution Order 1994UK Statutory Instruments
The North East Essex Mental Health National Health Service Trust (Transfer of Trust Property) Order 1994UK Statutory Instruments
The Southern Derbyshire Mental Health National Health Service Trust (Transfer of Trust Property) Order 1994UK Statutory Instruments
The Leeds Community and Mental Health Services Teaching National Health Service Trust (Transfer of Trust Property) Order 1994UK Statutory Instruments
The Shropshire’s Mental Health National Health Service Trust (Transfer of Trust Property) Order 1994UK Statutory Instruments
The Mental Health (Class of Nurse) (Scotland) Order 1994UK Statutory Instruments
The South West Durham Mental Health National Health Service Trust (Transfer of Trust Property) Order 1994UK Statutory Instruments
The South Lincolnshire Community and Mental Health Services National Health Service Trust (Transfer of Trust Property) Order 1994UK Statutory Instruments
The Bournewood Community and Mental Health National Health Service Trust (Establishment) Order 1994UK Statutory Instruments
The Black Country Mental Health National Health Service Trust (Establishment) Order 1994UK Statutory Instruments
Mental Health (Amendment) Act 1994UK Public General Acts1. Repealed.

1995

Legislation TitleLegislation TypeRemarks
The Hounslow and Spelthorne Community and Mental Health National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The East Surrey Learning Disability and Mental Health Service National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The Mental Health (State Hospital Management Committee, State Hospital, Carstairs) (Scotland) Transfer and Dissolution Order 1995UK Statutory Instruments
The Mid Essex Community and Mental Health National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The Norfolk Mental Health Care National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The Leicestershire Mental Health Service National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The South Cumbria Community and Mental Health National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The Northern Birmingham Mental Health National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The South Warwickshire Mental Health National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The East Surrey Learning Disability and Mental Health Service National Health Service Trust (Change of Name) Order 1995UK Statutory Instruments
The Mental Health Services of Salford National Health Service Trust (Transfer of Trust Property) Order 1995UK Statutory Instruments
The Mental Health Act Commission (Amendment) Regulations 1995UK Statutory Instruments
Mental Health (Patients in the Community) Act 1995UK Public General Acts

1996

Legislation TitleLegislation TypeRemarks
The Mental Health (After-care under Supervision) Regulations 1996UK Statutory Instruments
The Mental Health (Patients in the Community) (Transfers from Scotland) Regulations 1996UK Statutory Instruments
The Mental Health Review Tribunal (Amendment) Rules 1996UK Statutory Instruments
The Mental Health Review Tribunals (Regions) Order 1996UK Statutory Instruments
The Mental Health (Hospital, Guardianship and Consent to Treatment) (Amendment) Regulations 1996UK Statutory Instruments
The Mental Health (Patients in the Community) (Transfer from England and Wales to Scotland) Regulations 1996UK Statutory Instruments
The Mental Health (Prescribed Forms) (Scotland) Regulations 1996UK Statutory Instruments
The South West Durham Mental Health National Health Service Trust Dissolution Order 1996UK Statutory Instruments
The Heathlands Mental Health National Health Service Trust (Transfer of Trust Property) Order 1996UK Statutory Instruments
The Oxfordshire Mental Healthcare National Health Service Trust (Transfer of Trust Property) Order 1996UK Statutory Instruments
Act of Sederunt (Mental Health Rules) 1996UK Statutory Instruments
The Leeds Community and Mental Health Services Teaching National Health Service Trust (Transfer of Trust Property) Order 1996UK Statutory Instruments
The Mid Essex Community and Mental Health National Health Service Trust (Establishment) Amendment Order 1996UK Statutory Instruments

1997

Legislation TitleLegislation TypeRemarks
The Black Country Mental Health National Health Service Trust (Transfer of Trust Property) Order 1997UK Statutory Instruments
The Mental Health (Hospital, Guardianship and Consent to Treatment) Amendment Regulations 1997UK Statutory Instruments
The South Lincolnshire Community and Mental Health Services National Health Service Trust (Establishment) Amendment Order 1997UK Statutory Instruments

1998

Legislation TitleLegislation TypeRemarks
The Leeds Community and Mental Health Services Teaching National Health Service Trust (Establishment) Amendment Order 1998UK Statutory Instruments
The Mental Health (Nurses, Guardianship, Consent to Treatment and Prescribed Forms) (Amendment) Regulations (Northern Ireland) 1998Northern Ireland Statutory Rules
The Shropshire’s Community and Mental Health Services National Health Service Trust (Establishment) Order 1998UK Statutory Instruments
The Dissolution of the North Downs Community Health National Health Service Trust and the Heathlands Mental Health National Health Service Trust Order 1998UK Statutory Instruments
The Dissolution of the South Warwickshire Health Care National Health Service Trust and the South Warwickshire Mental Health National Health Service Trust Order 1998UK Statutory Instruments
The Shropshire’s Mental Health National Health Service Trust (Dissolution) Order 1998UK Statutory Instruments
The South Cumbria Community and Mental Health National Health Service Trust (Dissolution) Order 1998UK Statutory Instruments
The Lewisham and Guy’s Mental Health National Health Service Trust (Transfers of Trust Property) Order 1998UK Statutory Instruments
The Residential Care Homes and the Nursing Homes and Mental Nursing Homes (Amendment) Regulations 1998UK Statutory Instruments
The Black Country Mental Health National Health Service Trust (Establishment) Amendment Order 1998UK Statutory Instruments
The Mental Health Review Tribunal (Amendment) Rules 1998UK Statutory Instruments
The Oxfordshire Mental Healthcare National Health Service Trust (Establishment) Amendment Order 1998UK Statutory Instruments
The Mental Health Review Tribunals (Regions) Order 1998UK Statutory Instruments
The Leeds Community and Mental Health Services Teaching National Health Service Trust (Establishment) Amendment (No. 2) Order 1998UK Statutory Instruments
The Mental Health (Hospital, Guardianship and Consent to Treatment) Amendment Regulations 1998UK Statutory Instruments
The Mental Health (Nurses) Order 1998UK Statutory Instruments
The Riverside Mental Health, the North West London Mental Health and the West London Healthcare National Health Service Trusts (Dissolution) Order 1998UK Statutory Instruments
The Ealing, Hammersmith and Fulham Mental Health National Health Service Trust (Establishment) Order 1998UK Statutory Instruments
The Brent, Kensington & Chelsea and Westminster Mental Health National Health Service Trust (Establishment) Order 1998UK Statutory Instruments
The Leicestershire Mental Health Service and the Fosse Health, Leicestershire Community National Health Service Trusts (Dissolution) Order 1998UK Statutory Instruments

1999

Legislation TitleLegislation TypeRemarks
Superannuation (Secretary to The Mental Health Commission) Order (Northern Ireland) 1999Northern Ireland Statutory Rules
The South Lincolnshire Community and Mental Health Services National Health Service Trust (Establishment) Amendment Order 1999UK Statutory Instruments
The Hartlepool and East Durham, the North Tees Health and the South Tees Community and Mental Health National Health Service Trusts (Dissolution) Order 1999UK Statutory Instruments
The Bath Mental Health Care National Health Service Trust (Establishment) Amendment Order 1999UK Statutory Instruments
The Bethlem and Maudsley, the Lambeth Healthcare, the Lewisham and Guy’s Mental Health and the Optimum Health Services National Health Service Trusts (Dissolution) Order 1999UK Statutory Instruments
The South Birmingham Mental Health National Health Service Trust (Establishment) Amendment Order 1999UK Statutory Instruments
The Northern Birmingham Mental Health National Health Service Trust (Establishment) Amendment Order 1999UK Statutory Instruments
The South Birmingham Mental Health National Health Service Trust (Transfers of Trust Property) Order 1999UK Statutory Instruments
The Worcestershire Community and Mental Health National Health Service Trust (Establishment) Order 1999UK Statutory Instruments
Mental Health (Public Safety and Appeals) (Scotland) Act 1999Acts of the Scottish Parliament1. It amended the Mental Health (Scotland) Act 1984.
2. Repealed by the Mental Health (Care and Treatment) (Scotland) Act 2003.
Mental Health (Amendment) (Scotland) Act 1999UK Public General Acts1. Repealed.

2000

Legislation TitleLegislation TypeRemarks
The South Essex Mental Health and Community Care National Health Service Trust (Establishment) Order 2000UK Statutory Instruments
The East London and The City Mental Health National Health Service Trust (Establishment) Order 2000UK Statutory Instruments
The Avon and Western Wiltshire Mental Health Care National Health Service Trust (Transfer of Trust Property) Order 2000UK Statutory Instruments
The North East London Mental Health National Health Service Trust (Establishment) Order 2000UK Statutory Instruments
The East London and The City Mental Health National Health Service Trust (Establishment) Amendment Order 2000UK Statutory Instruments
The West London Mental Health National Health Service Trust (Establishment) Order 2000UK Statutory Instruments
Adults with Incapacity (Scotland) Act 2000Acts of the Scottish Parliament

2001

Legislation TitleLegislation TypeRemarks
Superannuation (Chief Executive to the Mental Health Commission) Order (Northern Ireland) 2001Northern Ireland Statutory Rules
The Newcastle, North Tyneside and Northumberland Mental Health National Health Service Trust (Establishment) Order 2001UK Statutory Instruments
The Newcastle City Health and the Northumberland Mental Health National Health Service Trusts (Dissolution) Order 2001UK Statutory Instruments
The Avon and Western Wiltshire Mental Health Care National Health Service Trust (Change of Name) Order 2001UK Statutory Instruments
The North Essex Mental Health Partnership National Health Service Trust (Establishment) Order 2001UK Statutory Instruments
The Buckinghamshire Mental Health National Health Service Trust (Establishment) Order 2001UK Statutory Instruments
The North Cumbria Mental Health and Learning Disabilities National Health Service Trust (Establishment) Order 2001UK Statutory Instruments
The Essex and Herts Community, the Mid Essex Community and Mental Health, and the North East Essex Mental Health National Health Service Trusts (Dissolution) Order 2001UK Statutory Instruments
The Camden and Islington Mental Health National Health Service Trust (Establishment) Order 2001UK Statutory Instruments
The Barnet, Enfield and Haringey Mental Health National Health Service Trust (Establishment) Order 2001UK Statutory Instruments
The Southern Derbyshire Mental Health National Health Service Trust Change of Name and (Establishment) Amendment Order 2001UK Statutory Instruments
The Ealing, Hammersmith and Fulham Mental Health National Health Service Trust (Dissolution) Order 2001UK Statutory Instruments
The Mental Health Act 1983 (Remedial) Order 2001UK Statutory Instruments

2002

Legislation TitleLegislation TypeRemarks
The Shropshire’s Community & Mental Health Services National Health Service Trust (Transfer of Trust Property) Order 2002UK Statutory Instruments
The Cambridgeshire and Peterborough Mental Health Partnership National Health Service Trust (Establishment) and the Lifespan Health Care Cambridge National Health Service Trust and the North West Anglia Health Care National Health Service Trust (Dissolution) Order 2002UK Statutory Instruments
The Manchester Mental Health and Social Care Trust (Establishment) Order 2002UK Statutory Instruments
The Southern Derbyshire Mental Health National Health Service Trust Change of Name and (Establishment) Amendment Order and the Community Health Care Service (North Derbyshire) National Health Service Trust (Dissolution) Order 2002UK Statutory Instruments
The South West Yorkshire Mental Health National Health Service Trust (Establishment) and the Wakefield and Pontefract Community National Health Service Trust (Dissolution) Order 2002UK Statutory Instruments
The South of Tyne and Wearside Mental Health National Health Service Trust (Establishment) and the Priority Healthcare Wearside National Health Service Trust (Dissolution) Order 2002UK Statutory Instruments
The Bournewood Community and Mental Health National Health Service Trust Change of Name Order 2002UK Statutory Instruments
The Worcestershire Community and Mental Health National Health Service Trust Change of Name and (Establishment) Amendment Order 2002UK Statutory Instruments
The Brent, Kensington, Chelsea and Westminster Mental Health National Health Service Trust Change of Name and (Establishment) Amendment Order 2002UK Statutory Instruments
The Camden and Islington Mental Health National Health Service Trust (Establishment) Amendment Order 2002UK Statutory Instruments
The South Essex Mental Health and Community Care National Health Service Trust Change of Name and (Establishment) Amendment Order 2002UK Statutory Instruments
The Leeds Community and Mental Health Services Teaching National Health Service Trust (Change of Name) Order 2002UK Statutory Instruments
The Cambridgeshire and Peterborough Mental Health Partnership National Health Service Trust (Establishment) and the Lifespan Health Care Cambridge National Health Service Trust and the North West Anglia Health Care National Health Service Trust (Dissolution) Amendment Order 2002UK Statutory Instruments

2003

Legislation TitleLegislation TypeRemarks
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Commencement No. 1) Order 2003Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Consequential Modification) Order 2003Scottish Statutory Instruments
The Birmingham and Solihull Mental Health National Health Service Trust (Establishment) and the Northern Birmingham Mental Health National Health Service Trust and South Birmingham Mental Health National Health Service Trust (Dissolution) Order 2003UK Statutory Instruments
The South Birmingham Mental Health National Health Service Trust (Transfer of Trust Property) Order 2003UK Statutory Instruments
The Northern Birmingham Mental Health National Health Service Trust (Transfer of Trust Property) Order 2003UK Statutory Instruments
The Bolton, Salford and Trafford Mental Health National Health Service Trust (Establishment) and the Mental Health Services of Salford National Health Service Trust (Dissolution) Order 2003UK Statutory Instruments
The Black Country Mental Health National Health Service Trust (Change of Name) and (Establishment) Amendment Order 2003UK Statutory Instruments
The Mental Health (Correspondence of Patients, Patient Advocacy and Liaison Services) Regulations 2003UK Statutory Instruments
The Mental Health Review Tribunals (Regions) Order 2003UK Statutory Instruments
The Delayed Discharges (Mental Health Care) (England) Order 2003UK Statutory Instruments
The Cambridgeshire and Peterborough Mental Health Partnership National Health Service Trust (Establishment) and the Lifespan Health Care Cambridge National Health Service Trust and the North West Anglia Health Care National Health Service Trust (Dissolution) Amendment Order 2003UK Statutory Instruments
Mental Health (Care and Treatment) (Scotland) Act 2003Acts of the Scottish Parliament1. It largely replaces the Mental Health (Scotland) Act 1984.
2. Repealed the Mental Health (Public Safety and Appeals) (Scotland) Act 1999).

2004

Legislation TitleLegislation TypeRemarks
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Commencement No. 2) Order 2004Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Disqualification) Regulations 2004Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Appointment of President) Regulations 2004Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Appointment of Legal Members) Regulations 2004Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Commencement No. 3) Order 2004Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Delegation of the President’s Functions) Regulations 2004Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Appointment of Medical Members) Regulations 2004Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Appointment of General Members) Regulations 2004Scottish Statutory Instruments
The Mental Health (Advance Statements) (Prescribed Class of Persons) (Scotland) Regulations 2004Scottish Statutory Instruments
The Mental Health (Patient Representation) (Prescribed Persons) (Scotland) Regulations 2004Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Disciplinary Committee) Regulations 2004Scottish Statutory Instruments
The Mental Health (Advance Statements) (Prescribed Class of Persons) (Scotland) (No. 2) Regulations 2004Scottish Statutory Instruments
The Mental Health (Patient Representation) (Prescribed Persons) (Scotland) (No. 2) Regulations 2004Scottish Statutory Instruments
The North West Surrey Mental Health National Health Service Partnership Trust (Transfer of Trust Property) Order 2004UK Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 Modification Order 2004Scottish Statutory Instruments
The North Essex Mental Health Partnership National Health Service Trust (Transfer of Trust Property) Order 2004UK Statutory Instruments
The Mental Health (Amendment) (Northern Ireland) Order 2004Northern Ireland Orders in Council
The Norfolk Mental Health Care National Health Service Trust (Change of Name) (Establishment) Amendment Order 2004UK Statutory Instruments
The South Essex Mental Health and Community Care National Health Service Trust (Establishment) Amendment Order 2004UK Statutory Instruments

2005

Legislation TitleLegislation TypeRemarks
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Commencement No. 4) Order 2005Scottish Statutory Instruments
The Mental Health (Fee Payable to Designated Medical Practitioners) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Welfare Commission for Scotland (Prescribed Persons) Regulations 2005Scottish Statutory Instruments
The Mental Welfare Commission for Scotland (Authorised Persons) Regulations 2005Scottish Statutory Instruments
The Mental Health (Provision of Information to Patients) (Prescribed Times) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Welfare Commission for Scotland (Appointment of Medical Commissioners) Regulations 2005Scottish Statutory Instruments
The Mental Health (Conflict of Interest) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Medical treatment subject to safeguards) (Section 234) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Medical treatment subject to safeguards) (Section 237) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Content and amendment of care plans) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Social Circumstances Reports) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Content and amendment of Part 9 care plans) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Compulsion orders – documents and reports to be submitted to the Tribunal) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Compulsory treatment orders – documents and reports to be submitted to the Tribunal) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Commencement No. 4) Amendment Order 2005Scottish Statutory Instruments
The Mental Health (Conflict of Interest) (Scotland) (No. 2) Regulations 2005Scottish Statutory Instruments
The Mental Health (Removal Order) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Safeguards for Certain Informal Patients) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Specified Persons’ Correspondence) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Welfare Commission for Scotland (Procedure and Delegation of Functions) Regulations 2005Scottish Statutory Instruments
The Mental Health (Fee Payable to Designated Medical Practitioners) (Scotland) (No. 2) Regulations 2005Scottish Statutory Instruments
The Mental Health (Period for Appeal) Regulations 2005Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Code of Practice) Order 2005Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Practice and Procedure) Rules 2005Scottish Statutory Instruments
The Mental Health (Period for Appeal) (Scotland) (No. 2) Regulations 2005Scottish Statutory Instruments
The Mental Welfare Commission for Scotland (Procedure and Delegation of Functions) (No. 2) Regulations 2005Scottish Statutory Instruments
The Mental Health (Certificates for Medical Treatment) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Form of Documents) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Modification of Subordinate Legislation) Order 2005Scottish Statutory Instruments
The Mental Health (Class of Nurse) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Class of Nurse) (Scotland) Revocation Order 2005Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Transitional and Savings Provisions) Order 2005Scottish Statutory Instruments
Act of Adjournal (Criminal Procedure Rules Amendment No. 4) (Mental Health (Care and Treatment) (Scotland) Act 2003) 2005Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Commencement No. 4) Amendment (No. 2) Order 2005Scottish Statutory Instruments
The Mental Health (Absconding by mentally disordered offenders) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Safety and Security) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Modification of Enactments) Order 2005Scottish Statutory Instruments
The Mental Health (Definition of Specified Person: Correspondence) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Cross border transfer: patients subject to detention requirement or otherwise in hospital) (Scotland) Regulations 2005Scottish Statutory Instruments
The Mental Health (Use of Telephones) (Scotland) Regulations 2005Scottish Statutory Instruments
The Surrey and Borders Partnership National Health Service Trust (Establishment) and the North West Surrey Mental Health National Health Service Partnership Trust, the Surrey Hampshire Borders National Health Service Trust and the Surrey Oaklands National Health Service Trust (Dissolution) Order 2005UK Statutory Instruments
Act of Sederunt (Summary Applications, Statutory Applications and Appeals etc. Rules) Amendment (Mental Health (Care and Treatment) (Scotland) Act 2003) 2005Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Practice and Procedure) (No. 2) Rules 2005Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Consequential Provisions) Order 2005UK Statutory Instruments
Mental Capacity Act 2005UK Public General Acts

2006

Legislation TitleLegislation TypeRemarks
The Mental Health (Recall or Variation of Removal Order) (Scotland) Regulations 2006Scottish Statutory Instruments
The Mental Health (Form of Documents) (Scotland) Regulations 2006Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Practice and Procedure) (No. 2) Amendment Rules 2006Scottish Statutory Instruments
The Mental Health (Relevant Health Board for Patients Detained in Conditions of Excessive Security) (Scotland) Regulations 2006Scottish Statutory Instruments
The Mental Health (Care and Treatment) (Scotland) Act 2003 (Transitional and Savings Provisions) Amendment Order 2006Scottish Statutory Instruments
The Buckinghamshire Mental Health National Health Service Trust (Dissolution) Order 2006UK Statutory Instruments
The Oxfordshire Mental Healthcare National Health Service Trust (Change of Name) (Establishment) Amendment Order 2006UK Statutory Instruments
The Northumberland, Tyne and Wear National Health Service Trust (Establishment) and the South of Tyne and Wearside Mental Health National Health Service Trust, the Northgate and Prudhoe National Health Service Trust and the Newcastle, North Tyneside and Northumberland Mental Health National Health Service Trust (Dissolution) Order 2006UK Statutory Instruments
The Mental Capacity Act 2005 (Independent Mental Capacity Advocates) (General) Regulations 2006UK Statutory Instruments
The Education (Disqualification Provisions: Bankruptcy and Mental Health) (England) Regulations 2006UK Statutory Instruments
The Mental Capacity Act 2005 (Appropriate Body) (England) Regulations 2006UK Statutory Instruments
The Mental Capacity Act 2005 (Commencement No.1) Order 2006UK Statutory Instruments
The Mental Capacity Act 2005 (Independent Mental Capacity Advocates) (Expansion of Role) Regulations 2006UK Statutory Instruments
The Mental Capacity Act 2005 (Commencement No.1) (Amendment) Order 2006UK Statutory Instruments
The Mental Capacity Act 2005 (Appropriate Body) (England) (Amendment) Regulations 2006UK Statutory Instruments

2007

Legislation TitleLegislation TypeRemarks
The Mental Health (Safety and Security) (Scotland) Amendment Regulations 2007Scottish Statutory Instruments
The Mental Capacity Act 2005 (Commencement No.1) (England and Wales) Order 2007UK Statutory Instruments
The Mental Capacity Act 2005 (Loss of Capacity during Research Project) (England) Regulations 2007UK Statutory Instruments
The Mental Capacity Act 2005 (Appropriate Body) (Wales) Regulations 2007Wales Statutory Instruments
The Mental Capacity Act 2005 (Loss of Capacity during Research Project) (Wales) Regulations 2007Wales Statutory Instruments
The Mental Capacity Act 2005 (Independent Mental Capacity Advocates) (Wales) Regulations 2007Wales Statutory Instruments
Mental Capacity Act 2005 (Commencement) (Wales) Order 2007Wales Statutory Instruments
The East London and The City Mental Health National Health Service Trust (Change of Name)(Establishment) Amendment Order 2007UK Statutory Instruments
The North Cumbria Mental Health and Learning Disabilities National Health Service Trust (Change of Name) (Establishment) Amendment Order 2007UK Statutory Instruments
The Mental Capacity Act 2005 (Commencement No.2) Order 2007UK Statutory Instruments
The Mental Capacity Act 2005 (Transitional and Consequential Provisions) Order 2007UK Statutory Instruments
The Mental Capacity Act 2005 (Transfer Of Proceedings) Order 2007UK Statutory Instruments
The Mental Health Act 2007 (Commencement No.1) Order 2007UK Statutory Instruments
The Mental Health Act 2007 (Commencement No.2) Order 2007UK Statutory Instruments
The Mental Health Act 2007 (Commencement No.3) Order 2007UK Statutory Instruments
Mental Health Act 2007UK Public General Acts1. Largely came into force in 2008.
2. The 2007 Act just amended the Mental Health Act 1983, it did not replace it.

2008

Legislation TitleLegislation TypeRemarks
The Mental Health (Cross-border Visits) (Scotland) Regulations 2008Scottish Statutory Instruments
The Mental Health (Certificates for Medical Treatment) (Scotland) Amendment Regulations 2008Scottish Statutory Instruments
The Mental Health (Absconding Patients from Other Jurisdictions) (Scotland) Regulations 2008Scottish Statutory Instruments
The Mental Health (England and Wales Cross-border transfer: patients subject to requirements other than detention) (Scotland) Regulations 2008Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Practice and Procedure) (No. 2) Amendment Rules 2008Scottish Statutory Instruments
The Mental Health Act 2007 (Commencement No. 4) Order 2008UK Statutory Instruments
The Mental Health Act 2007 (Commencement No. 5 and Transitional Provisions) Order 2008UK Statutory Instruments
The Mental Health (Hospital, Guardianship and Treatment) (England) Regulations 2008UK Statutory Instruments
The Mental Health (Mutual Recognition) Regulations 2008UK Statutory Instruments
The Mental Health (Conflicts of Interest) (England) Regulations 2008UK Statutory Instruments
The Mental Health (Approved Mental Health Professionals) (Approval) (England) Regulations 2008UK Statutory Instruments
The Mental Health (Nurses) (England) Order 2008UK Statutory Instruments
The Mental Health Act 2007 (Commencement No. 6 and After-care under Supervision: Savings, Modifications and Transitional Provisions) Order 2008UK Statutory Instruments
The Mental Capacity (Deprivation of Liberty: Appointment of Relevant Person’s Representative) Regulations 2008UK Statutory Instruments
The Cambridgeshire and Peterborough Mental Health Partnership National Health Service Trust (Transfer of Trust Property) Order 2008UK Statutory Instruments
The Mental Capacity (Deprivation of Liberty: Standard Authorisations, Assessments and Ordinary Residence) Regulations 2008UK Statutory Instruments
The Mental Health Act 2007 (Commencement No. 7 and Transitional Provisions) Order 2008UK Statutory Instruments
The Mental Capacity (Deprivation of Liberty: Appointment of Relevant Person’s Representative) (Amendment) Regulations 2008UK Statutory Instruments
The Dudley and Walsall Mental Health Partnership National Health Service Trust (Establishment) Order 2008UK Statutory Instruments
The Mental Health (Approval of Persons to be Approved Mental Health Professionals) (Wales) Regulations 2008Wales Statutory Instruments
The Mental Health (Independent Mental Health Advocates) (Wales) Regulations 2008Wales Statutory Instruments
The Mental Health (Hospital, Guardianship, Community Treatment and Consent to Treatment) (Wales) Regulations 2008Wales Statutory Instruments
The Mental Health (Conflicts of Interest) (Wales) Regulations 2008Wales Statutory Instruments
The Mental Health (Nurses) (Wales) Order 2008Wales Statutory Instruments
The Mental Health (Hospital, Guardianship and Treatment) (England) (Amendment) Regulations 2008UK Statutory Instruments
The Mental Health Act 2007 (Commencement No. 8 and Transitional Provisions) Order 2008UK Statutory Instruments
The Mental Health Review Tribunal for Wales Rules 2008UK Statutory Instruments
The Mental Health Act 2007 (Commencement No.9) Order 2008UK Statutory Instruments
The Mental Health Act 2007 (Consequential Amendments) Order 2008UK Statutory Instruments
The Mental Health Act 1983 (Independent Mental Health Advocates) (England) Regulations 2008UK Statutory Instruments

2009

Legislation TitleLegislation TypeRemarks
The Mental Health Act 2007 (Commencement No.10 and Transitional Provisions) Order 2009UK Statutory Instruments
The Mental Capacity (Deprivation of Liberty: Appointment of Relevant Person’s Representative) (Wales) Regulations 2009Wales Statutory Instruments
The Mental Health Tribunal for Scotland (Appointment of Medical Members) Amendment Regulations 2009Scottish Statutory Instruments
The Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust (Transfer of Trust Property) Order 2009UK Statutory Instruments
The Dudley and Walsall Mental Health Partnership National Health Service Trust (Originating Capital) Order 2009UK Statutory Instruments
The Mental Capacity (Deprivation of Liberty: Assessments, Standard Authorisations and Disputes about Residence) (Wales) Regulations 2009Wales Statutory Instruments
The Mental Capacity (Deprivation of Liberty: Monitoring and Reporting; and Assessments -Amendment) Regulations 2009UK Statutory Instruments
The Mental Health and Mental Capacity (Advocacy) Amendment (England) Regulations 2009UK Statutory Instruments

2010

Legislation TitleLegislation TypeRemarks
The Mental Health Review Tribunal (Amendment) Rules (Northern Ireland) 2010Northern Ireland Statutory Rules
The Mental Health Act 2007 (Commencement No.11) Order 2010UK Statutory Instruments
The Mental Welfare Commission for Scotland (Qualifications, Training and Experience of Medical Visitors) Regulations 2010Scottish Statutory Instruments
The Bedfordshire and Luton Mental Health and Social Care Partnership National Health Service Trust (Dissolution) Order 2010UK Statutory Instruments
Mental Health (Wales) Measure 2010Measures of the National Assembly for Wales

2011

Legislation TitleLegislation TypeRemarks
The Barnet, Enfield and Haringey Mental Health National Health Service Trust (Establishment) Amendment Order 2011UK Statutory Instruments
The Worcestershire Health and Care National Health Service Trust (Establishment) and the Worcestershire Mental Health Partnership National Health Service Trust (Dissolution) Order 2011UK Statutory Instruments
The Mental Health (Assessment of Former Users of Secondary Mental Health Services) (Wales) Regulations 2011Wales Statutory Instruments
The Mental Health (Independent Mental Health Advocates) (Wales) Regulations 2011Wales Statutory Instruments
The Mental Capacity Act 2005 (Appropriate Body) (England) Amendment Regulations 2011UK Statutory Instruments
The Mental Health (Care Co-ordination and Care and Treatment Planning) (Wales) Regulations 2011Wales Statutory Instruments
The Suffolk Mental Health Partnership National Health Service Trust (Dissolution) Order 2011UK Statutory Instruments
The Mental Health (Wales) Measure 2010 (Commencement No.1 and Transitional Provision) Order 2011Wales Statutory Instruments

2012

Legislation TitleLegislation TypeRemarks
The Mental Health Tribunal for Scotland (Practice and Procedure) (No. 2) Amendment Rules 2012Scottish Statutory Instruments
The Mental Health (Safety and Security) (Scotland) Amendment Regulations 2012Scottish Statutory Instruments
The Mental Health (1986 Order) (Commencement No. 5) Order (Northern Ireland) 2012Northern Ireland Statutory Rules
Mental Health (Private Hospitals) (Fees) Regulations (Northern Ireland) 2012Northern Ireland Statutory Rules
Mental Health (Private Hospitals) Regulations (Northern Ireland) 2012Northern Ireland Statutory Rules1. Revoked.
The Mental Health (Hospital, Guardianship and Treatment) (England) (Amendment) Regulations 2012UK Statutory Instruments
The Mental Health (Regional Provision) (Wales) Regulations 2012Wales Statutory Instruments
The Mental Health (Hospital, Guardianship, Community Treatment and Consent to Treatment) (Wales) (Amendment) Regulations 2012Wales Statutory Instruments
The Mental Health (Primary Care Referrals and Eligibility to Conduct Primary Mental Health Assessments) (Wales) Regulations 2012Wales Statutory Instruments
The Mental Health (Wales) Measure 2010 (Commencement No.2) Order 2012Wales Statutory Instruments
The Mental Health (Secondary Mental Health Services) (Wales) Order 2012Wales Statutory Instruments
The Mental Health (Wales) Measure 2010 (Commencement No.3) Order 2012Wales Statutory Instruments
Mental Health (Approval Functions) Act 2012UK Public General Acts

2013

Legislation TitleLegislation TypeRemarks
Mental Health (Private Hospitals) Regulations (Northern Ireland) 2013Northern Ireland Statutory Rules
The Mental Health (Discrimination) Act 2013 (Commencement) Order 2013UK Statutory Instruments
Mental Health (Discrimination) Act 2013UK Public General Acts1. Relates to the Mental Health Act 1983 and the Juries Act 1974.

2014

Legislation TitleLegislation TypeRemarks
The Barnet, Enfield and Haringey Mental Health National Health Service Trust (Establishment) Amendment Order 2014UK Statutory Instruments

2015

Legislation TitleLegislation TypeRemarks
Assisted Decision-Making (Capacity) Act 2015UK Public General Acts
The Mental Health Tribunal for Scotland (Practice and Procedure) (No. 2) Amendment Rules 2015Scottish Statutory Instruments
The Mental Health (Scotland) Act 2015 (Commencement No. 1, Transitional and Saving Provisions) Order 2015Scottish Statutory Instruments
The Mental Health (Detention in Conditions of Excessive Security) (Scotland) Regulations 2015Scottish Statutory Instruments
The Mental Health (Scotland) Act 2015 (Commencement No. 2) Order 2015Scottish Statutory Instruments
Mental Health (Scotland) Act 2015Acts of the Scottish Parliament

2016

Legislation TitleLegislation TypeRemarks
The Mental Health Review Tribunal (Amendment) Rules (Northern Ireland) 2016Northern Ireland Statutory Rules
Mental Capacity Act (Northern Ireland) 2016Acts of the Northern Ireland Assembly1. When fully commenced, will fuse together mental capacity and mental health law for those aged 16 years old and over within a single piece of legislation, as recommended by the Bamford Review of Mental Health and Learning Disability.
2. The Act provides a statutory framework for people who lack capacity to make a decision for themselves and for those who now have capacity but wish to make preparations for a time in the future when they lack capacity.
3. When the Act is fully commenced the Mental Health (Northern Ireland) Order 1986 will be repealed for anyone over the age of 16.

2017

Legislation TitleLegislation TypeRemarks
The Mental Health (Scotland) Act 2015 (Commencement No. 3) Order 2017Scottish Statutory Instruments
The Mental Health Tribunal for Scotland (Practice and Procedure) (No. 2) Amendment Rules 2017Scottish Statutory Instruments
The Mental Health (Conflict of Interest) (Scotland) Regulations 2017Scottish Statutory Instruments
The Mental Health (Patient Representation) (Prescribed Persons) (Scotland) Regulations 2017Scottish Statutory Instruments
The Mental Health (Certificates for Medical Treatment) (Scotland) Regulations 2017Scottish Statutory Instruments
The Mental Health (Scotland) Act 2015 (Commencement No. 4 and Transitional and Savings Provisions) Order 2017Scottish Statutory Instruments
The Mental Health (Cross-border transfer: patients subject to detention requirement or otherwise in hospital) (Scotland) Amendment Regulations 2017Scottish Statutory Instruments
The Mental Health (Cross-border Visits) (Scotland) Amendment Regulations 2017Scottish Statutory Instruments
The Mental Health (Cross-border transfer: patients subject to requirements other than detention) (Scotland) Regulations 2017Scottish Statutory Instruments
The Mental Health (Scotland) Act 2015 (Commencement No. 5 and Transitional Provisions) Order 2017Scottish Statutory Instruments
The Mental Health Act 1983 (Places of Safety) Regulations 2017UK Statutory Instruments
The Mental Health Act 2007 (Commencement No. 12 and Transitional Provisions) Order 2017UK Statutory Instruments
The Mental Health Review Tribunal for Wales (Amendment and constitution of tribunals) Rules 2017UK Statutory Instruments

2018

Legislation TitleLegislation TypeRemarks
The West London Mental Health National Health Service Trust (Establishment) (Amendment) Order 2018UK Statutory Instruments
The Mental Health (Northern Ireland) (Amendment) Order 2018UK Statutory Instruments
Mental Health Units (Use of Force) Act 2018UK Public General Acts1. Also known as Seni’s Law.
2. Amended the 1983 Act.

2019

Legislation TitleLegislation TypeRemarks
The Mental Capacity (2016 Act) (Commencement No. 1) Order (Northern Ireland) 2019Northern Ireland Statutory Rules
The Mental Capacity (Deprivation of Liberty) Regulations (Northern Ireland) 2019Northern Ireland Statutory Rules1. Revoked.
The Mental Capacity (Deprivation of Liberty) (Amendment) Regulations (Northern Ireland) 2019Northern Ireland Statutory Rules1. Revoked.
The Mental Capacity (2016 Act) (Commencement No. 1) (Amendment) Order (Northern Ireland) 2019Northern Ireland Statutory Rules
The Mental Capacity (Deprivation of Liberty) (Revocation) Regulations (Northern Ireland) 2019Northern Ireland Statutory Rules
The Mental Capacity (Research) Regulations (Northern Ireland) 2019Northern Ireland Statutory Rules
The Mental Capacity (Deprivation of Liberty) (No. 2) Regulations (Northern Ireland) 2019Northern Ireland Statutory Rules
The Mental Capacity (Money and Valuables) Regulations (Northern Ireland) 2019Northern Ireland Statutory Rules
The Mental Capacity (Deprivation of Liberty) (No. 2) (Amendment) Regulations (Northern Ireland) 2019Northern Ireland Statutory Rules
The Mental Health Units (Use of Force) Act 2018 Commencement (No. 1) Regulations 2019UK Statutory Instruments
Mental Capacity (Amendment) Act 2019UK Public General Acts

2020

Legislation TitleLegislation TypeRemarks
The Mental Capacity (Research) (Amendment) Regulations (Northern Ireland) 2020Northern Ireland Statutory Rules
The Mental Health (Northern Ireland) (Amendment) Order 2020Northern Ireland Statutory Rules
The Mental Capacity (Deprivation of Liberty) (Amendment) Regulations (Northern Ireland) 2020Northern Ireland Statutory Rules1. Revoked.
The Mental Capacity (Deprivation of Liberty) (Amendment) (Revocation) Regulations (Northern Ireland) 2020Northern Ireland Statutory Rules
The Mental Health (1986 Order) (Amendment No. 2) Order (Northern Ireland) 2020Northern Ireland Statutory Rules
The Mental Health (Nurses, Guardianship, Consent to Treatment and Prescribed Forms) (Amendment) Regulations (Northern Ireland) 2020Northern Ireland Statutory Rules
The Mental Health Tribunal for Scotland (Practice and Procedure) (No. 2) Amendment Rules 2020Scottish Statutory Instruments
The Mental Capacity (2016 Act) (Commencement No.1) (Amendment) Order (Northern Ireland) 2020Northern Ireland Statutory Rules
The Dudley and Walsall Mental Health Partnership National Health Service Trust (Establishment) (Amendment) Order 2020UK Statutory Instruments
The Mental Health (Hospital, Guardianship and Treatment) (England) (Amendment) Regulations 2020UK Statutory Instruments
The Worcestershire Health and Care National Health Service Trust (Establishment) and the Worcestershire Mental Health Partnership National Health Service Trust (Dissolution) (Amendment) Order 2020UK Statutory Instruments
The Debt Respite Scheme (Breathing Space Moratorium and Mental Health Crisis Moratorium) (England and Wales) Regulations 2020UK Statutory Instruments
The Coronavirus Act 2020 (Expiry of Mental Health Provisions) (England and Wales) Regulations 2020UK Statutory Instruments

2021

Legislation TitleLegislation TypeRemarks
The Mental Health (1986 Order) (Amendment) Order (Northern Ireland) 2021Northern Ireland Statutory Rules
The Mental Health (1986 Order) (Amendment No. 2) Order (Northern Ireland) 2021Northern Ireland Statutory Rules

What is the Mental Capacity Act 2005 (UK)?

Published on by Andrew Marshall5 Comments

Introduction

The Mental Capacity Act 2005 (c 9) is an Act of the Parliament of the United Kingdom applying to England and Wales, receiving Royal Assent on 07 April 2005.

Its primary purpose is to provide a legal framework for acting and making decisions on behalf of adults who lack the capacity to make particular decisions for themselves.

An Act to make new provision relating to persons who lack capacity; to establish a superior court of record called the Court of Protection in place of the office of the Supreme Court called by that name; to make provision in connection with the Convention on the International Protection of Adults signed at the Hague on 13 January 2000; and for connected purposes.

Refer to Mental Health Act 1983 and Mental Health Act 2007.

You can find a full chronology of mental health legislation in the UK here.

Key Features of the Act

The Five Statutory Principles

The five principles are outlined in the Section 1 of the Act. These are designed to protect people who lack capacity to make particular decisions, but also to maximise their ability to make decisions, or to participate in decision-making, as far as they are able to do so.

  1. A person must be assumed to have capacity unless it is established that he/she lacks capacity.
  2. A person is not to be treated as unable to make a decision unless all practicable steps to help him/her to do so have been taken without success.
  3. A person is not to be treated as unable to make a decision merely because he/she makes an unwise decision.
  4. An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in his/ her best interests.
  5. Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action.

Summary of Other Key Elements of the Act

  • The Act makes provision for people to plan ahead for a time when they may need support. This introduces advance decisions to refuse treatment.
  • The decision (or question) under consideration must be time and decision specific.
  • The Act upholds the principle of Best Interest for the individual concerned.
  • A Court of Protection will help with difficult decisions.
    • The Office of the Public Guardian (formerly Public Guardianship Office), the administrative arm of the Court of Protection, will help the Act work.
  • An Independent Mental Capacity Advocate (IMCA) service will provide help for people who have no intimate support network.
  • S(44) of The Act makes it a criminal offence to wilfully neglect someone without capacity.
  • The Act generally applies only to those over the age of 16 years, although may apply to some younger people if it is supposed that their capacity will continue to be impaired into adulthood.

Section 68: Commencement and Extent

The following orders have been made under this section:

  • The Mental Capacity Act 2005 (Commencement No.1) Order 2006 (S.I. 2006/2814 (C. 95)).
  • The Mental Capacity Act 2005 (Commencement No.1) (Amendment) Order 2006 (S.I. 2006/3473 (C. 133)).
  • The Mental Capacity Act 2005 (Commencement No.2) Order 2007 (S.I. 2007/1897 (C. 72)).
  • The Mental Capacity Act 2005 (Commencement No.1) (England and Wales) Order 2007 (S.I. 2007/563 (C. 24)).
  • Mental Capacity Act 2005 (Commencement) (Wales) Order 2007 (S.I. 2007/856 (W. 79) (C. 34)).

Timetable of New Features

The new measures that the Act introduced included:

  • April 2007:
    • A new criminal offence of wilful neglect of a person without capacity.
    • A new Independent Mental Capacity Advocacy Service in England.
    • A Code of Practice that tells people how to ensure they are following the Act.
  • October 2007:
    • Extension of the Independent Mental Capacity Advocacy Service to Wales.
    • Lasting Powers of Attorney and deputies.
    • A new Court of Protection.
    • A new Office of the Public Guardian.

Amendments

In response to the ruling by the European Court of Human Rights in HL v UK (2004) (the ‘Bournewood’ judgment) the Act was amended by the Mental Health Act 2007 in July that year. These additions are known as the Deprivation of Liberty Safeguards (DoLS), and were implemented in April 2009. These amendments created administrative procedures to ensure the Act’s processes are observed in cases of adults who are, or may be, deprived of their liberty in care homes or hospitals, thus protecting health and social care providers from prosecution under human rights legislation.

Key elements of the DoLS are that the person must be provided with a representative and given the right to challenge the deprivation of liberty through the Court of Protection, and that there must be a mechanism for the deprivation of liberty to be reviewed and monitored regularly.

The DoLS were introduced in response to the Bournewood case, on which the European Court of Human Rights ruled in October 2004 (HL v United Kingdom) that a detention of an incapacitated patient which did not comply with Article 5 of the European Convention on Human Rights had taken place; in particular, a person who is detained must be told the reasons for the detention and must also, under Article 5(4), have the right of speedy access to a court to appeal against the detention.

Mental Capacity (Amendment) Bill 2019

The Mental Capacity Act was amended in May 2019. This act will replace DoLS with a new legal framework called Liberty Protection Safeguards (LPS). These will be used for anyone 16 or above who lacks capacity rather than 18 as previously used in DoLS. The “acid test’ from the Cheshire West case remains, there is still no statuary definition of deprivation of liberty. Target date for implementation was October 2020. It was announced by Helen Whately, Minister for Care in July 2020 that the implementation would be delayed, with full implementation expected by April 2022. Some of this delay was due to the Coronavirus disease 2019 pandemic. During this period a draft Code of practice will be produced which will go out to Public consultation.