The 1983 Act is largely concerned with the circumstances in which a person with a mental illness can be provided with treatment without his or her consent. This is to ensure that people with serious mental illnesses can be treated where it is necessary to prevent them from harming themselves or others.

Most people who receive psychiatric treatment in hospital are there on a voluntary basis and have the same rights as people receiving treatment for physical illnesses. However, a small number of people 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, the processes to be followed and the appeals and safeguards that are available to the patient and to their nearest relative.

An application for compulsory admission must be supported in writing by two authorised practitioners. The recommendations must include a statement about why assessment or treatment is necessary and why other options are not appropriate.
People detained under the Act may have a right to apply to a Mental Health Review Tribunal to challenge their detention. Legal advocates are available to represent people at MHRTs and can be contacted at Sheffield Mental Health CAB or at www.communitylegaladvice.org.uk

From November 2008 new amendments to the 1983 Act were introduced. The following are the main changes to the Act:

• introduces of the new role of Approved Mental Health Professional (AMHP) which replaces the Approved Social Worker (ASW). As well as social workers other professionals such as nurses, psychologists and occupational therapists can now be involved in compulsory admissions.
• Introduces of the Approved Clinician (AC) replacing the Responsible Medical Officer (RMO). The RMO had to be a doctor, but the AC can now include other professions.
• Introduces a new ‘appropriate medical treatment’ test meaning that for a patient to be compulsorily detained there has to be appropriate medical treatment available to the patient.
• Gives patients the right to make an application to displace their nearest relative and appoint an alternative.
• Introduces Supervised Community Treatment (also known as Community Treatment Orders) for some patients following a period of detention in hospital. It will allow some patients to live in the community whilst they continue with compulsory medical treatment.
• Introduces additional safeguards for patients by way of ‘Independent Mental Health Advocates’ who must be available for all patients who are detained. These are in addition to having a legal representative at a Mental Health Review Tribunal. It also reduces the time before a case can come before a Mental Health Review Tribunal.
• Introduces new safeguards for patients with regards to electro convulsive therapy (ECT).

Further information and publications about the Mental Health Act and amendments can be found on the Mind and Department of Health websites.