There are numerous legislations in relation to mental illness, with the mental health act which was introduced in 1983 and later updated in 2007 acting as the main piece of legislation. This act covers the assessment, treatment, and rights of people with a mental illness. It is used most frequently when performing a mental health act assessment to determine whether someone has the capacity to make their own decisions regarding their care, or whether they need to be sectioned. To do the latter means that urgent treatment is deemed necessary to protect either the individual or other people (i.e., they are a risk to themselves or others.) Whilst everyone detained under the mental health act is in the same position regarding being unable to make decisions for themselves, everyone’s length of detention will differ depending on the section under which they have been detained. The two outcomes of a section result in either a section 2 (allowing one to be detained for up to 28 days), or a section 3 (up to 6 months.) A section 2 is commonly used to assess someone, to determine whether they need more intensive treatment imposed on them, or whether they can make the decision for themselves. A section 3 on the other hand is used when a treatment order is deemed necessary.
To detain someone under the mental health act, whether that be under a section 2 or a section 3, an independent assessment must first be carried out to ensure that detention is necessary. This is governed by the mental capacity act (2005) which allows somebody to decide the necessary treatment course required on behalf of a person aged 16 or over in their best interests, if the person lacks capacity to make the decision for themselves.
As part of this formal assessment process involved in the mental health act, a patient is assessed by doctors as well as an approved mental health professional (AMHP) and a second opinion appointed doctor (SOAD.) The SOAD is someone who has no previous involvement in the patients care, therefore they approach the assessment from a completely objective, non-biased view. This second opinion ensures that everyone is on the same page regarding the patient requiring treatment by law. It is necessary to have a SOAD present if the patient refuses to give consent for treatment due to being too ill to do so. Not only does the SOAD confirm the appropriateness of the recommended treatment for the patient from a clinical perspective, but they also act as an advocate for the patient, ensuring that their views and rights have been considered.
Whilst section two and section three are the most widely used pieces of the mental health act, there is in fact a third outcome that can come from a mental health act assessment, that being a CTO (Community treatment order.) A CTO is used if a person has already been treated in hospital, either voluntarily or under the mental health act, and is being discharged back into the community or is allowed out of hospital temporarily on short-term leave. The conditions of a CTO follow section 17 of the mental health act, meaning a person can leave hospital but will be recalled back should their condition worsen for any reason. This gives them a greater sense of independence whilst still serving to protect them by being a legal requirement to engage with treatment.
Although being sectioned means that one does not have a say in whether they receive treatment or not because they are considered incapable of making that decision for themselves, they still have rights that must be upheld, one of them being the right to appeal the section. Access to formal appeal processes such as tribunals and hospital managers meetings are carefully monitored by the CQC (Care quality commission.)
The mental health act is indisputably the biggest piece of legislation used in the context of mental health, however other pieces of legislation that relate to mental illness include the equality act (2010)- a law that gives everyone the right to challenge discrimination, the care act (2014)- a law that sets out the duties of the local authorities in relation to assessing peoples needs and their eligibility for care and support, and the human rights act (1998)- a law that details the basic rights and freedoms that everyone in the UK should have. Examples of human rights that we commonly hear about are the right to life, and the right to a fair trial, the latter being why people detained under the mental health act are entitled to a tribunal whereby they can appeal their detention if they feel as though their assessment has reached a wrongful conclusion.
To evaluate, it is incredibly important that all legislation is abided to, and that everyone is aware of their own rights- the rights of which are governed by law.