The Mental Health Act 1983  is an Act of the Parliament of the United Kingdom which applies to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters. In particular, it provides the legislation by which people diagnosed with a mental disorder can be detained in hospital or police custody and have their disorder assessed or treated against their wishes, unofficially known as “sectioning”. Its use is reviewed and regulated by the Care Quality Commission

The 1983 Act is largely concerned with the circumstances in which a person with a mental disorder can be detained for treatment for that disorder without his or her consent. It also sets out the processes that must be followed and the safeguards for patients, to ensure that they are not inappropriately detained or treated without their consent. The main purpose of the legislation is to ensure that people with serious mental disorders which threaten their health or safety or the safety of the public can be treated irrespective of their consent where it is necessary to prevent them from harming themselves or others.

It was ammended in 2007.

The commonest sections of the Mental Health Act are:

Civil (all unrestricted): sections 2 and 3

Criminal, unrestricted: section 37

Criminal, restricted: section 37/41, section 47/49

Section 2

Main article: Admission for assessment

This is a civil admission for assessment (or assessment followed by treatment) and lasts for a maximum of 28 days. It cannot be renewed, so will lapse at the end of the period; however, the patient can at any time be placed under section 3 instead. The patient can be discharged by the following routes:

1. The RC can discharge the patient at any time.
2. The patient can apply to the MHRT during the first 14 days of detention (and can do this by fax). The hearing must be held within 7 days. The Tribunal will discharge if the “section 2” criteria in s72 are not met.
3. The patient can also apply for a HMH, at any time. It depends on the efficiency/policy of the hospital whether this takes place before the section ends.
4. The patient’s NR can request the patient’s discharge (see below) which leads to considerations of dangerousness rather than the standard criteria.

Section 3

Main article: Admission for treatment

This is a civil admission for treatment. The initial duration is for a maximum of 6 months. It can be renewed for a further period of 6 months; after that, for further periods of 12 months. At any time the patient can be discharged by the following routes:

1. RC, as for s2
2. The patient can apply to the MHRT at any time. The MHRT’s target is to hold the hearing within 5 weeks. It usually takes 5-8 weeks. The Tribunal will discharge if the criteria in s72 are not met.
3. HMH, as for s2
4. NR, as for s2, with one exception (see below).

Section 37

Main article: Hospital order

This is a court order imposed instead of a prison sentence, if the offender is sufficiently mentally unwell at the time of sentencing to require hospitalisation. It has the same duration as a section 3, and in many ways operates exactly the same way. One difference is the routes to discharge:

1. RC, as for s2 and s3.
2. MHRT, as for s3.
3. HMH, as for s3
4. NR. Note that this is entirely different. The nearest relative discharge procedure does not operate for criminal sections; however, for s37 the nearest relative can apply to the MHRT.

Section 37/41

Main article: Restriction order

This is a court order, which can only be made by the Crown Court, which imposes a s37 hospital order together with a s41 restriction order. The restriction order is imposed to protect the public from serious harm. The restrictions affect leave of absence, transfer between hospitals, and discharge, all of which require Ministry of Justice permission. The NR has no part to play. The following are the routes to discharge:

1. MHRT, as for s3, except that no application can be made within the first 6-month period. The MHRT aim to hold the hearing within 14 weeks; it usually takes 4-5 months. The criteria in s73 apply.
2. The Ministry of Justice can discharge at any time. This is relatively rare, but would usually happen at the request of the RC.

Section 47

Main article: Transfer direction

This is called a transfer direction, and is used by the Ministry of Justice to transfer a serving prisoner to hospital. It operates just like s37 so is often called a “notional section 37”. The patient cannot be returned to prison unless he breaches his licence conditions. The following are the routes to discharge:

1. RC, at any time.
2. MHRT. Note that an application can be made during the first six months, unlike with s37 (as there was no judicial process in the decision to transfer).
3. HMH, as above.
4. NR, as for s37 (application to MHRT only).

Section 47/49

Main article: Restriction direction

This is a transfer direction under s47 together with a restriction direction under s49. The restrictions are the same as those in s41. The prisoner can be transferred back to prison at any time, on medical advice or the advice of the MHRT. In theory these patients can be discharged directly into the community, but in practice (except for a minority called “technical lifers”) they are returned to prison when the MHA is not necessary. These are the routes to discharge:

1. MHRT. Eligibility is as for s47. The MHRT make a notification is invariably followed by the Ministry of Justice.
2. Ministry of Justice.