Chronology of UK Mental Health Legislation

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 National Mental Health Act (1946) (US)?

Introduction

The National Mental Health Act (1946) became law on 03 July 1946. It established and provided funds for a National Institute of Mental Health (NIMH).

An Act to amend the Public Health Service Act to provide for research relating to psychiatric disorders and to aid in the development of more effective methods of prevention, diagnosis, and treatment of such disorders, and for other purposes.

Background

The act made the mental health of the people a federal priority. It was inspired by alarm at the poor mental health of some draftees and veterans, and was demanded by veterans and their families. When veterans who were under stress during the war were later studied they displayed a high incidence of earlier mental health illness, completely aside from the problems that might have arisen from combat and wartime situations of high pressure.

Through the National Mental Health Act and the NIMH, a new form of diagnosis and treatment was created to better help those facing mental health problems. It was discovered during this time that mental health patients benefited more from evaluation and treatment rather than being institutionalized. The act redirected financing from the state level to a national level, and placed the NIMH as a leader for further research and analysis on the brain and psychiatric disorders.

In other words, wartime pressures had stirred up repressed mental illness in the soldiers, who were a representative statistical sample of the general population, gender aside. The government realised it had a very serious problem on its hands – a population with a high incidence of mental health illness and therefore should take care of it immediately via government intervention, aiming to cut off future social pathologies.

The Menninger brothers set about training analysts, to fill the vacuum that existed at that time.

Brief History

The act was first introduced by Congress in March, 1945, as the National Neuropsychiatric Institute Act. The name ultimately made its way to “Mental Health” to capture the importance of World War II and the problems associated with veterans returning from war.

Robert Felix, a psychiatrist appointed as director of the Public Health Service’s (PHS) Division of Mental Hygiene in 1944, did much work to try to pass the bill. William Menninger, Lawrence Kubie, and others helped Felix by testifying about how the lack of trained professionals in the field of mental health sometimes thwarted military morale and how intervening earlier rather than later actually helped the military in the long run by conserving personnel. They believed that if veterans received federal help and support through preventive services, professional training, and research they would transition back into post-war life quicker and easier. In addition, organisations like Mental Health America that advocated for changes in the psychiatric field helped push legislation towards action.

Before the act was passed, during World War II, there was a severe shortage of professionals in the mental health field, and advanced treatment and understanding of psychiatric disorders lagged behind the increasing numbers of problems in veterans returning from the war. This provided the foundation for the act and the reasoning behind it.

After the act was passed, many discoveries and breakthroughs regarding mental health diagnosis and treatment were made. These new drugs and treatments improved the lives of those previously suffering from psychosis and delusion, and were a result of the new funding and federal support that came from the National Mental Health Act of 1946.

What is a Community Mental Health Service?

Introduction

Centre for Mental Health Services, also known as community mental health teams (CMHT) in the United Kingdom, support or treat people with mental disorders (mental illness or mental health difficulties) in a domiciliary setting, instead of a psychiatric hospital (asylum). The array of community mental health services vary depending on the country in which the services are provided. It refers to a system of care in which the patient’s community, not a specific facility such as a hospital, is the primary provider of care for people with a mental illness. The goal of community mental health services often includes much more than simply providing outpatient psychiatric treatment.

Community services include supported housing with full or partial supervision (including halfway houses), psychiatric wards of general hospitals (including partial hospitalisation), local primary care medical services, day centres or clubhouses, community mental health centres, and self-help groups for mental health.

The services may be provided by government organisations and mental health professionals, including specialised teams providing services across a geographical area, such as assertive community treatment and early psychosis teams. They may also be provided by private or charitable organisations. They may be based on peer support and the consumer/survivor/ex-patient movement.

The World Health Organisation (WHO) states that community mental health services are more accessible and effective, lessen social exclusion, and are likely to have fewer possibilities for the neglect and violations of human rights that were often encountered in mental hospitals. However, WHO notes that in many countries, the closing of mental hospitals has not been accompanied by the development of community services, leaving a service vacuum with far too many not receiving any care.

New legal powers have developed in some countries, such as the United States, to supervise and ensure compliance with treatment of individuals living in the community, known as outpatient commitment or assisted outpatient treatment or community treatment orders.

Brief History

Origins

Community mental health services began as an effort to contain those who were “mad” or considered “lunatics”. Understanding the history of mental disorders is crucial in understanding the development of community mental health services. As medical psychology developed as a science and shifted toward the treatment of the mentally ill, psychiatric institutions began to develop around the world, and laid the groundwork for modern day community mental health services.

Pre-Deinstitutionalisation

On 03 July 1946, US President Harry Truman signed the National Mental Health Act which, for the first time in the history of the United States, generated a large amount of federal funding for both psychiatric education and research. The passing of this Act eventually led to the founding of the National Institute of Mental Health (NIMH) in 1949. At the end of the 1940s and moving into the beginning of the 1950s, the governor of Minnesota Luther Youngdahl initiated the development of numerous community-based mental health services. He also advocated for the humane treatment of people in state institutions.

Deinstitutionalisation

Philippe Pinel played a large role in the ethical and humane treatment of patients and greatly influenced Dorothea Dix. Dix advocated the expansion of state psychiatric hospitals for patients who were at the time being housed in jails and poor houses. Despite her good intentions, rapid urbanisation and increased immigration led to a gross overwhelming of the state’s mental health systems and because of this, as the 19th century ended and the 20th century began, a shift in focus from treatment to custodial care was seen. As quality of care declined and psychotropic drugs were introduced, those with mental illnesses were reintroduced to the community, where community mental health services were designated as primary care providers.

Mental Health Movements

Reform MovementEraSettingFocus of Reform
Moral Treatment1800-1850AsylumHumane, restorative treatment
Mental Hygiene1890-1920Mental hospital or clinicPrevention, scientific orientation
Community Mental Health1955-1970Community mental health centreDeinstitutionalisation, social integration
Community Support1975-PresentCommunitiesMental illness as a social welfare problem (e.g. treatment housing, employment, etc.)

Post-Deinstitutionalisation

Following deinstitutionalisation, many of the mentally ill ended up in jails, nursing homes, and on the streets as homeless individuals. It was at this point in history that modern community mental health services started to grow and become influential. In 1955, following a major period of deinstitutionalisation, the Mental Health Study Act was passed. With the passing of this Act, the US Congress called for “an objective, thorough, nationwide analysis and re-evaluation of the human and economic problems of mental health.” Following Congress’ mandate, the Joint Commission on Mental Illness conducted numerous studies. For the next four years this Commission made recommendations to establish community mental health centres across the country. In 1963, the Community Mental Health Centres Act was passed, essentially kick-starting the community mental health revolution. This Act contributed further to deinstitutionalisation by moving mental patients into their “least restrictive” environments. The Community Mental Health Centres Act funded three main initiatives:

  • Professional training for those working in community mental health centres;
  • Improvement of research in the methodology utilised by community mental health centres; and
  • Improving the quality of care of existing programmes until newer community mental health centres could be developed.

That same year the Mental Retardation Facilities and Community Mental Health Centres Construction Act was passed. President John F. Kennedy ran part of his campaign on a platform strongly supporting community mental health in the United States. Kennedy’s ultimate goal was to reduce custodial care of mental health patients by 50% in ten to twenty years. In 1965, the Community Mental Health Act was amended to ensure a long list of provisions. First, construction and staffing grants were extended to include centres that served patients with substance abuse disorders. Secondly, grants were provided to bolster the initiation and progression of community mental health services in low-SES areas. Lastly, new grants were established to support mental health services aimed at helping children. As the 20th century progressed, even more political influence was exerted on community mental health. In 1965, with the passing of Medicare and Medicaid, there was an intense growth of skilled nursing homes and intermediate-care facilities that alleviated the burden felt by the large-scale public psychiatric hospitals.

20th Century

From 1965 to 1969, $260 million was authorised for community mental health centres. Compared to other government organisations and programmes, this number is strikingly low. The funding drops even further under Richard Nixon from 1970-1973 with a total of $50.3 million authorised. Even though the funding for community mental health centres was on a steady decline, deinstitutionalisation continued into the 1960s and 1970s. The number of state and county mental hospital resident patients in 1950 was 512,501 and by 1989 had decreased to 101,402. This continuing process of deinstitutionalisation without adequate alternative resources led the mentally ill into homelessness, jails, and self-medication through the use of drugs or alcohol. In 1975, Congress passed an Act requiring community mental health centres to provide aftercare services to all patients in the hopes of improving recovery rates. In 1980, just five years later, Congress passed the Mental Health Systems Act of 1980, which provided federal funding for ongoing support and development of community mental health programmes. This Act strengthened the connection between federal, state, and local governments with regards to funding for community mental health services. It was the final result of a long series of recommendations by Jimmy Carter’s Mental Health Commission. Despite this apparent progress, just a year after the Mental Health Systems Act was passed, the Omnibus Budget Reconciliation Act of 1981 was passed. The Omnibus Act was passed by the efforts of the Reagan administration as an effort to reduce domestic spending. The Act rescinded a large amount of the legislation just passed, and the legislation that was not rescinded was almost entirely revamped. It effectively ended federal funding of community treatment for the mentally ill, shifting the burden entirely to individual state governments. Federal funding was now replaced by granting smaller amounts of money to the individual states. In 1977, the National Institute of Mental Health (NIMH) initiated its Community Support Program (C.S.P.). The C.S.P.’s goal was to shift the focus from psychiatric institutions and the services they offer to networks of support for individual clients. The C.S.P. established the ten elements of a community support system listed below:

  • Responsible team.
  • Residential care.
  • Emergency care.
  • Medicare care.
  • Halfway house.
  • Supervised (supported) apartments.
  • Outpatient therapy.
  • Vocational training and opportunities.
  • Social and recreational opportunities.
  • Family and network attention.

This conceptualisation of what makes a good community programme has come to serve as a theoretical guideline for community mental health service development throughout the modern-day United States psychological community. In 1986, Congress passed the Mental Health Planning Act of 1986, which was a Federal law requiring that at the state government level, all states must have plans for establishing case management under Medicaid, improving mental health coverage of community mental health services, adding rehabilitative services, and expanding clinical services to the homeless population. More specifically, community mental health providers could now receive reimbursement for services from Medicare and Medicaid, which allowed for many of the centres to expand their range of treatment options and services. As the 1990s began, many positive changes occurred for people with mental illnesses through the development of larger networks of community-based providers and added innovations with regards to payment options from Medicare and Medicaid. Despite these advancements, there were many issues associated with the increasing cost of health care. Community mental health services moved toward a system more similar to managed care as the 1990s progressed. Managed care as a system focuses on limiting costs by one of two means: either keeping the total number of patients using services low or reducing the cost of the service itself. Despite the drive for community mental health, many physicians, mental health specialists, and even patients have come to question its effectiveness as a treatment. The underlying assumptions of community mental health require that patients who are treated within a community have a place to live, a caring family, or supportive social circle that does not inhibit their rehabilitation. These assumptions are in fact often wrong. Many people with mental illnesses, upon discharge, have no family to return to and end up homeless. While there is much to be said for the benefits that community mental health offers, many communities as a whole often harbour negative attitudes toward those with mental illnesses. Historically, people with mental illnesses have been portrayed as violent or criminal and because of this, “many American jails have become housing for persons with severe mental illnesses arrested for various crimes.” In 1999 the Supreme Court ruled on the case Olmstead v. L.C. The Court ruled that it was a violation of the Americans with Disabilities Act of 1990 to keep an individual in a more restrictive inpatient setting, such as a hospital, when a more appropriate and less restrictive community service was available to the individual.

21st Century and Modern Trends

In 2002, President George W. Bush increased funding for community health centres. The funding aided in the construction of additional centres and increased the number of services offered at these centres, which included healthcare benefits. In 2003, the New Freedom Commission on Mental Health, established by President Bush, issued a report. The report was in place to “conduct a comprehensive study of the United States mental health delivery system…” Its objectives included assessing the efficiency and quality of both public and private mental health providers and identifying possible new technologies that could aid in treatment. As the 20th century came to a close and the 21st century began, the number of patients diagnosed with a mental health or substance abuse disorder receiving services at community mental health centres grew from 210,000 to approximately 800,000. This nearly four-fold increase shows just how important community mental health centres are becoming to the general population’s wellbeing. Unfortunately, this drastic rise in the number of patients was not mirrored by a concomitant rise in the number of clinicians serving this population. The staggering new numbers of patients then are being forced to seek specialised treatment from their primary care providers or hospital emergency rooms. The unfortunate result of this trend is that when a patient is working with their primary care provider, they are more likely for a number of reasons to receive less care than with a specialised clinician. Politics and funding have always been and continue to be a topic of contention when it comes to funding of community health centres. Political views aside, it is clear that these community mental health centres exist largely to aid areas painfully under resourced with psychiatric care. In 2008, over 17 million people utilised community mental health centres with 35% being insured through Medicaid, and 38% being uninsured. As the 2000s continued, the rate of increase of patients receiving mental health treatment in community mental health centres stayed steady.

Purpose and Examples

Cultural knowledge and attitude is passed from generation to generation. For example, the stigma with therapy may be passed from mother to daughter. San Diego county has a diverse range of ethnicities. Thus, the population diversity in San Diego include many groups with historical trauma and trans-generational trauma within those populations. For example, witnesses of war can pass down certain actions and patterns of survival mechanism to generations. Refugee groups have trans-generational trauma around war and PTSD. Providing services and therapy to these communities is important because it affects their day-to-day lives, where their experiences lead to trauma or the experiences are traumatic themselves. Knowledge and access to mental health resources are limited in these multicultural communities. Government agencies fund community groups that provide services to these communities. Therefore, this creates a power hierarchy. If their missions do not align with each other, it will be hard to provide benefits for the community, even though the services are imperative to the wellbeing of its residents.

The combination of a mental illness as a clinical diagnosis, functional impairment with one or more major life activities, and distress is highest in ages 18-25 years old. Despite the research showing the necessity of therapy for this age group, only one fifth of emerging adults receive treatment. Psychosocial interventions that encourage self-exploration and self-awareness, such as acceptance and mindfulness-based therapies, is useful in preventing and treating mental health concerns. At the Centre for Community Counselling and Engagement, 39% of their clients are ages 1-25 years old and 40% are in ages 26-40 years old as well as historically underrepresented people of colour. The centre serves a wide range of ethnicities and socio-economic statuses in the City Heights community with counsellors who are graduate student therapists getting their Master’s in Marriage and Family Therapy or Community Counselling from San Diego State University, as well as post-graduate interns with their master’s degree, who are preparing to be licensed by the state of California. Counselling fees are based on household incomes, which 69% of the client’s annual income is $1-$25,000 essentially meeting the community’s needs. Taking into account of San Diego’s population, the clinic serves as an example of how resources can be helpful for multicultural communities that have a lot of trauma in their populations.

Future

On one hand, despite the field’s movement toward community mental health services, currently “insufficient empirical research exists regarding the effectiveness of community treatment programmes, and the evidence that does exist does not generalise to all types of community treatment.” In addition to the fact that community mental health’s overall success must be further evaluated, in the times when it has proved effective, very little research exists to help in understanding what exact aspects make it effective. Effective and insightful research will be crucial in not only evaluating, but also improving the techniques community mental health utilises. On the other hand, the demand for and necessity of community mental health is driving it into the future. With this seemingly unrelenting increase in the number of people experiencing mental health illnesses and the number of people reporting these problems, the question becomes what role community mental health services will play. In 2007, almost 5% of adults in the United States reported at least one unmet need for mental health care. Funding has historically been and continues to be an issue for both the organisations attempting to provide mental health services to a community and the citizens of the community who are so desperately in need of treatment. The community mental health system’s goal is an extremely difficult one and it continues to struggle against changing social priorities, funding deficits, and increasing need. Community mental health services would ideally provide quality care at a low cost to those who need it most. In the case of deinstitutionalisation, as the number of patients treated increased, the quality and availability of care went down. With the case of small, private treatment homes, as the quality of the care went up their ability to handle large numbers of patients decreased. This unending battle for the middle ground is a difficult one but there seems to be hope. For example, the 2009 Federal Stimulus Package and Health Reform Act have increased the funding for community health centres substantially. Undoubtedly as community mental health moves forward, there will continue to be a juggling act between clinical needs and standards, political agendas, and funding.