Mental Health Act 2007
Part 1 — Amendments to Mental Health Act 1983
Chapter 1 — Changes to key provisions
Mental disorder
Removal of categories of mental disorder
1
- (1) Section 1(2) of the 1983 Act (key definitions) is amended as set out in subsections (2) and (3).
- (2) For the definitions of “mental disorder” and “mentally disordered” substitute—
“mental disorder” means any disorder or disability of the mind; and “mentally disordered” shall be construed accordingly;
.
- (3) The following definitions are omitted—
- (a) those of “severe mental impairment” and “severely mentally impaired”,
- (b) those of “mental impairment” and “mentally impaired”, and
- (c) that of “psychopathic disorder”.
- (4) Schedule 1 (which contains further amendments to the 1983 Act and amendments to other Acts) has effect.
Learning disability
2
- (1) Section 1 of the 1983 Act (application of Act) is amended as follows.
- (2) After subsection (2) insert—
(2A) But a person with learning disability shall not be considered by reason of that disability to be— (a) suffering from mental disorder for the purposes of the provisions mentioned in subsection (2B) below; or (b) requiring treatment in hospital for mental disorder for the purposes of sections 17E and 50 to 53 below, unless that disability is associated with abnormally aggressive or seriously irresponsible conduct on his part. (2B) The provisions are— (a) sections 3, 7, 17A, 20 and 20A below; (b) sections 35 to 38, 45A, 47, 48 and 51 below; and (c) section 72(1)(b) and (c) and (4) below.
- (3) After subsection (3) insert—
(4) In subsection (2A) above, “learning disability” means a state of arrested or incomplete development of the mind which includes significant impairment of intelligence and social functioning.
Changes to exclusions from operation of 1983 Act
3
In section 1 of the 1983 Act (application of Act), for subsection (3) substitute—
(3) Dependence on alcohol or drugs is not considered to be a disorder or disability of the mind for the purposes of subsection (2) above.
Tests for detention etc
Replacement of “treatability” and “care” tests with appropriate treatment test
4
- (1) The 1983 Act is amended as follows.
- (2) In section 3 (admission for treatment)—
- (a) in subsection (2), omit paragraph (b) (and the word “and” at the end of that paragraph),
- (b) in that subsection, after paragraph (c) insert
; and (d) appropriate medical treatment is available for him.
, and
- (c) in subsection (3)(a), for “(b)” substitute “ (d) ”.
- (3) In that section, after subsection (3) insert—
(4) In this Act, references to appropriate medical treatment, in relation to a person suffering from mental disorder, are references to medical treatment which is appropriate in his case, taking into account the nature and degree of the mental disorder and all other circumstances of his case.
- (4) In section 20 (renewal of authority to detain), in subsection (4)—
- (a) omit paragraph (b) (and the word “and” at the end of that paragraph),
- (b) after paragraph (c) insert
and (d) appropriate medical treatment is available for him.
, and
- (c) omit the words from “but, in the case of mental illness” to the end.
- (5) In section 37(2) (conditions for exercise of powers of court to order hospital admission or guardianship), in paragraph (a)(i), for the words from “, in the case of psychopathic disorder” to the end substitute “ appropriate medical treatment is available for him; or ”.
- (6) In section 45A(2) (conditions for exercise of powers of court to direct hospital admission), for paragraph (c) substitute—
(c) that appropriate medical treatment is available for him.
- (7) In section 47(1) (conditions for exercise of Secretary of State's powers to direct removal to hospital), in paragraph (b), for the words from “and, in the case of psychopathic disorder” to the end substitute
; and (c) that appropriate medical treatment is available for him;
.
- (8) In section 72—
- (a) in subsection (1)(b) (powers of tribunal to direct discharge of patient not liable to be detained under section 2), after sub-paragraph (ii) insert—
(iia) that appropriate medical treatment is available for him; or
, and
- (b) omit subsection (2).
- (9) In section 73(1) (powers of tribunal to direct discharge of restricted patients), in paragraph (a), for “or (ii)” substitute “ , (ii) or (iia) ”.
- (10) In section 145 (interpretation), after subsection (1AA) insert—
(1AB) References in this Act to appropriate medical treatment shall be construed in accordance with section 3(4) above.
Further cases in which appropriate treatment test is to apply
5
- (1) The 1983 Act is amended as follows.
- (2) In section 36(1) (remand to hospital for treatment) after paragraph (a) (inserted by Schedule 1 to this Act) insert
and (b) appropriate medical treatment is available for him.
- (3) In section 48(1) (removal to hospital of immigration detainees etc) after paragraph (b) (inserted by Schedule 1 to this Act) insert
and (c) appropriate medical treatment is available for him;
.
- (4) In section 51(6)(a) (further power to make hospital order) after sub-paragraph (i) (inserted by Schedule 1 to this Act) insert
and (ii) appropriate medical treatment is available for him; and
.
Medical treatment
Appropriate treatment test in Part 4 of 1983 Act
6
- (1) Part 4 of the 1983 Act (consent to treatment) is amended as follows.
- (2) In the following provisions, for the words from “, having regard to” to the end substitute “ it is appropriate for the treatment to be given. ”
- (a) section 57(2)(b) (certification of second opinion where treatment requires consent and a second opinion), and
- (b) section 58(3)(b) (certification of second opinion where treatment requires consent or a second opinion).
- (3) In section 64 (supplementary provisions for Part 4), after subsection (2) insert—
(3) For the purposes of this Part of this Act, it is appropriate for treatment to be given to a patient if the treatment is appropriate in his case, taking into account the nature and degree of the mental disorder from which he is suffering and all other circumstances of his case.
Change in definition of “medical treatment”
7
- (1) Section 145 of the 1983 Act is amended as follows.
- (2) In subsection (1), in the definition of “medical treatment”, for the words from “and also” to the end substitute “ psychological intervention and specialist mental health habilitation, rehabilitation and care (but see also subsection (4) below); ”.
- (3) After subsection (3) insert—
(4) Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations.
Fundamental principles
The fundamental principles
8
After section 118(2) of the 1983 Act (code of practice) insert—
(2A) The code shall include a statement of the principles which the Secretary of State thinks should inform decisions under this Act. (2B) In preparing the statement of principles the Secretary of State shall, in particular, ensure that each of the following matters is addressed— (a) respect for patients' past and present wishes and feelings, (b) respect for diversity generally including, in particular, diversity of religion, culture and sexual orientation (within the meaning of section 35 of the Equality Act 2006), (c) minimising restrictions on liberty, (d) involvement of patients in planning, developing and delivering care and treatment appropriate to them, (e) avoidance of unlawful discrimination, (f) effectiveness of treatment, (g) views of carers and other interested parties, (h) patient wellbeing and safety, and (i) public safety. (2C) The Secretary of State shall also have regard to the desirability of ensuring— (a) the efficient use of resources, and (b) the equitable distribution of services. (2D) In performing functions under this Act persons mentioned in subsection (1)(a) or (b) shall have regard to the code.
Chapter 2 — Professional roles
Approved clinicians and responsible clinicians
Amendments to Part 2 of 1983 Act
9
- (1) Part 2 of the 1983 Act (compulsory admission to hospital and guardianship) is amended as follows.
- (2) In section 5 (application in respect of patient already in hospital)—
- (a) in subsection (2), after “registered medical practitioner” insert “ or approved clinician ”,
- (b) for subsection (3) substitute—
(3) The registered medical practitioner or approved clinician in charge of the treatment of a patient in a hospital may nominate one (but not more than one) person to act for him under subsection (2) above in his absence. (3A) For the purposes of subsection (3) above— (a) the registered medical practitioner may nominate another registered medical practitioner, or an approved clinician, on the staff of the hospital; and (b) the approved clinician may nominate another approved clinician, or a registered medical practitioner, on the staff of the hospital.
, and
- (c) in subsection (4), after “a practitioner”, in each place, insert “ or clinician ”.
- (3) In section 17 (leave of absence)—
- (a) in subsection (1)—
- (i) for “responsible medical officer” substitute “ responsible clinician ”, and
- (ii) for “that officer” substitute “ that clinician ”,
- (b) in subsection (3), for “responsible medical officer” substitute “ responsible clinician ”, and
- (c) in subsection (4)—
- (i) for “responsible medical officer” substitute “ responsible clinician ”, and
- (ii) for “that officer” substitute “ that clinician ”.
- (4) In section 20 (duration of authority)—
- (a) in subsections (3) and (5), for “responsible medical officer” substitute “ responsible clinician ”,
- (b) after subsection (5) insert—
(5A) But the responsible clinician may not furnish a report under subsection (3) above unless a person— (a) who has been professionally concerned with the patient's medical treatment; but (b) who belongs to a profession other than that to which the responsible clinician belongs, states in writing that he agrees that the conditions set out in subsection (4) above are satisfied.
,
- (c) in subsection (6), for “appropriate medical officer” substitute “ appropriate practitioner ”, and
- (d) omit subsection (10).
- (5) In section 21B (patients who are taken into custody or return after more than 28 days)—
- (a) in subsections (2) and (3), for “appropriate medical officer” substitute “ appropriate practitioner ”, and
- (b) in subsection (10), omit the definition of “appropriate medical officer”.
- (6) In section 23(2) (persons who may apply for discharge of patient), in paragraphs (a) and (b), for “responsible medical officer” substitute “ responsible clinician ”.
- (7) In section 24 (visiting and examination of patients), in each place, after “registered medical practitioner” insert “ or approved clinician ”.
- (8) In section 25(1) (restrictions on discharge by nearest relative)—
- (a) for “responsible medical officer” substitute “ responsible clinician ”, and
- (b) for “that officer” substitute “ that clinician ”.
- (9) In section 34 (interpretation of Part 2 of the 1983 Act), in subsection (1), insert the following definition at the appropriate place—
- “the appropriate practitioner” means—
- in the case of a patient who is subject to the guardianship of a person other than a local social services authority, the nominated medical attendant of the patient; and
- in any other case, the responsible clinician;
.
- (10) In that subsection, for the definition of “the responsible medical officer” substitute—
“the responsible clinician” means— (a) in relation to a patient liable to be detained by virtue of an application for admission for assessment or an application for admission for treatment, or a community patient, the approved clinician with overall responsibility for the patient's case; (b) in relation to a patient subject to guardianship, the approved clinician authorised by the responsible local social services authority to act (either generally or in any particular case or for any particular purpose) as the responsible clinician;
.
Amendments to Part 3 of 1983 Act
10
- (1) Part 3 of the 1983 Act (patients concerned in criminal proceedings) is amended as follows.
- (2) In section 35 (remand to hospital for report)—
- (a) in subsections (4) and (5), for “registered medical practitioner” substitute “ approved clinician ”, and
- (b) in subsection (8), after “registered medical practitioner” insert “ or approved clinician ”.
- (3) In section 36 (remand to hospital for treatment)—
- (a) in subsection (3), for “registered medical practitioner who would be in charge of his treatment” substitute “ approved clinician who would have overall responsibility for his case ”,
- (b) in subsection (4), for “responsible medical officer” substitute “ responsible clinician ”, and
- (c) in subsection (7), after “registered medical practitioner” insert “ or approved clinician ”.
- (4) In section 37 (hospital and guardianship orders), in subsection (4), for “registered medical practitioner who would be in charge of his treatment” substitute “ approved clinician who would have overall responsibility for his case ”.
- (5) In section 38 (interim hospital orders)—
- (a) in subsection (4), for “registered medical practitioner who would be in charge of his treatment” substitute “ approved clinician who would have overall responsibility for his case ”, and
- (b) in subsection (5), for “responsible medical officer”, in each place, substitute “ responsible clinician ”.
- (6) In section 41 (power of courts to restrict discharge from hospital), in subsections (3)(c) and (6), for “responsible medical officer” substitute “ responsible clinician ”.
- (7) In section 44(2) (person who is to give evidence in connection with committal to hospital), for “registered medical practitioner who would be in charge of the offender's treatment” substitute “ approved clinician who would have overall responsibility for the offender's case ”.
- (8) In section 45A(5) (person who is to give evidence in connection with hospital or limitation direction), for “registered medical practitioner who would be in charge of his treatment” substitute “ approved clinician who would have overall responsibility for his case ”.
- (9) In the following provisions, for “responsible medical officer” substitute “ responsible clinician ”
- (a) section 45B(3) (requirement to produce report on person subject to hospital and limitation directions), and
- (b) section 49(3) (requirement to produce report on person subject to restriction direction).
Further amendments to Part 3 of 1983 Act
11
- (1) Part 3 of the 1983 Act (patients concerned in criminal proceedings) is further amended as follows.
- (2) In section 50(1) (powers of Secretary of State in respect of prisoners under sentence)—
- (a) for “responsible medical officer” substitute “ responsible clinician ”, and
- (b) for “registered medical practitioner” substitute “ approved clinician ”.
- (3) In section 51 (further provisions as to detained persons)—
- (a) in subsection (3)—
- (i) for “responsible medical officer” substitute “ responsible clinician ”, and
- (ii) for “registered medical practitioner” substitute “ approved clinician ”, and
- (b) in subsection (4), for “responsible medical officer” substitute “ responsible clinician ”.
- (4) In section 52 (further provisions as to persons remanded by magistrates' courts), in subsections (5) and (7), for “responsible medical officer” substitute “ responsible clinician ”.
- (5) In section 53(2) (powers of Secretary of State in respect of civil prisoners and persons detained under the Immigration Acts)—
- (a) for “responsible medical officer” substitute “ responsible clinician ”, and
- (b) for “registered medical practitioner” substitute “ approved clinician ”.
- (6) In section 54 (requirements as to medical evidence), for subsection (2) substitute—
(2) For the purposes of any provision of this Part of this Act under which a court may act on the written evidence of any person, a report in writing purporting to be signed by that person may, subject to the provisions of this section, be received in evidence without proof of the following— (a) the signature of the person; or (b) his having the requisite qualifications or approval or authority or being of the requisite description to give the report. (2A) But the court may require the signatory of any such report to be called to give oral evidence.
- (7) In section 55 (interpretation of Part 3), for the definition of “responsible medical officer” in subsection (1) substitute—
“responsible clinician”, in relation to a person liable to be detained in a hospital within the meaning of Part 2 of this Act, means the approved clinician with overall responsibility for the patient's case.
- (8) In Part 2 of Schedule 1 (modifications in relation to patients subject to special restrictions), in paragraph 3—
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