Mental Health Act

The Mental Health Act 1983 is the law which applies in England and Wales, under which an individual can be admitted, detained and treated in hospital for a mental disorder against their wishes. This is carried out in the interest of the health and safety of the individual or with a view to protect others. A mental disorder has been defined by the Mental Health Act as ‘any disorder or disability of mind', in which this  definition includes schizophrenia.



The Mental Health Act 1983 is divided into various different parts in which a person can be sectioned under for an assessment or to receive treatment.

Section 2
• A person can be admitted to hospital for a mental health assessment and to receive any required treatment.
• This is for a period of up to 28 days.
• Without consent, electroconvulsive therapy (ECT) cannot be given to the patient unless specific criteria are fulfilled.
• Section 2 cannot be renewed, however the person can be transferred onto a section 3 (see below).

Section 3
• A person can be admitted to hospital for the treatment of schizophrenia.
• This is for a period of 6 months.
• Following an initial admission under Section 2, the individual can be detained under Section 3.
• Detention under Section 3 can be renewed for a further period of 6 months, and then for further periods of one year at a time.
• Without consent, electroconvulsive therapy (ECT) cannot be given to the patient unless specific criteria are fulfilled.

Both Sections 2 and 3 require an application for admission to hospital by a close relative or an Approved Mental Health Professional (AMHP), which have seen the patient within the past 14 days. It is also based on the recommendations by two separate doctors, one of which must be approved under the Mental Health Act. Both doctors must have seen the patient within 5 days of each other and hospital admission has to be arranged within 14 days of the last medical examination.

Section 4
• A person can be detained under Section 4 when an emergency assessment is required (i.e., a high risk of harm to others or suicide), where if it were not for an emergency, detention under section 2 would be carried out.
• This is for a period of 72 hours.
• It is based on the recommendation of only one doctor that has seen the patient within the last 24 hours.
 

Section 5
• A person can be detained under Section 5 by a doctor or nurse to prevent someone leaving hospital who is an inpatient receiving hospital treatment.
• It should be used only in circumstances where it is not possible or safe to use sections 2, 3, or 4.
• Section 5(2) is the doctors holding power and the person can be held for up to 72 hours.
• Section 5(4) is the nurse's holding power and the person can be held for up to 6 hours.



Patients either under Sections 4 and 5 have the right to refuse treatment and before any treatment is given consent must be provided. However, only under some circumstances can treatment be given without consent:
1. Where the patient does not have the capacity to make an informed decision about treatment and the treatment is in their best interest.
2. When the treatment needs to be given in an emergency to prevent serious harm to themselves or others

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