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Assessment and treatment

Many people receive specialist mental health care and treatment in the community. Some people can experience severe mental health problems that require admission to hospital for assessment and treatment.

People can only be detained if the strict criteria laid down in the Act are met. The person must be suffering from a mental disorder as defined by the Act.

An application for assessment or treatment must be supported in writing by two registered medical practitioners. The recommendation must include a statement about why an assessment and/or treatment is necessary, and why other methods of dealing with the patient are not appropriate. 

Admissions to hospital

Most people who receive treatment in hospitals or psychiatric units for mental health conditions are there on a voluntary basis and have the same rights as people receiving treatment for physical illnesses.

However, a small number of patients may need to be compulsorily detained under a section of the Mental Health Act.

The Act explains who is involved in the decision about compulsory admission or detention, and the individual's or their nearest relative's right of appeal.

Approved social workers

Approved social workers are specially trained in both mental health and the law relating to it. They are appointed by local councils to interview and assess people. Approved social workers can make an application for admission if they consider that detention is the most appropriate way of providing care and treatment.

Nearest relative

The Act gives certain rights to the nearest relative which can be used to protect the patient's interests. Usually, the nearest relative is the person who occurs highest in the following list:

• husband, wife or civil partner
• partner (of either sex) who has lived with the patient for at least six months
• daughter or son
• father or mother
• brother or sister
• grandfather or grandmother
• aunt or uncle
• nephew or niece

If a person from the list above lives with or cares for the patient, that person is likely to be regarded as the nearest relative. A person who is not a relative but who has lived with the patient for at least five years can also be regarded as the nearest relative.

The appointment of the nearest relative can only be changed by a County Court.

What the nearest relative can do

The nearest relative has the right to:

• apply for compulsory assessment or treatment of the patient, or ask social services to ask an approved social worker to consider the patient's case
• be told if an approved social worker applies for the patient to be detained for compulsory assessment
• be consulted about, and object to, a social worker applying for the patient to be detained for compulsory treatment
• apply to a Mental Health Tribunal on behalf of the patient in certain situations
• receive written information about the patient's detention, rights and discharge unless the patient objects
• discharge the patient

The nearest relative's power of discharge can be overruled by the doctor who is responsible for the patient's treatment. The doctor can only do this if they think the patient is likely to act dangerously if discharged.

Finding out more about the Mental Health Act 1983

The most common sections of the Act under which patients are compulsorily admitted to a hospital are:

• section 2 : admission to hospital for up to 28 days for assessment
• section 3 : admission to hospital for up to six months for treatment
• section 4 : admission on an emergency basis for up to 72 hours

The mental health charity 'Mind' have an outline guide to the Mental Health Act on their website.

Further information and guidance about the Mental Health Act can also be found on the Department of Health website.

• Mental Health Act 1983: an outline guide - Mind website Opens new window

• Information on the Mental Health Acts - Department of Health website Opens new window