What Do All The Sections Mean? …

Here is a very quick run down of all the sections of the MHA that seem relevant at some stage to the police – necessarily a snap-shot, I’m not going to explain all the ins and outs of every section listed – mental health law books are thousands of pages long!

You could argue about detail on this if you really wanted to but instead, I’d encourage you to read Mental Health Law Online, a website and goldmine of resources, if you want something more specific:

  • Part I
  • Section 1 – the definition of mental disorder: “‘mental disorder’ means any disorder or disability of the mind; and ‘mentally disordered’ shall be construed accordingly”.
  • Part II – this is the terminology you will hear AMHPs and MH professionals using:
  • Section 2 – the power to detain someone believed to be suffering mental disorder for assessment (and treatment). The order lasts for up to 28 days and cannot be extended or renewed. It is imposed after application by an AMHP and two DRs one of whom must be “section 12 approved”. <<< You see? … paradoxically, you need this guide just to understand it!?>! The patient has a right of appeal against detention to a Mental Health Review Tribunal.
  • Section 3 – the power to detain someone for treatment of mental disorder. This order lasts for six months and can be renewed. It is imposed after application by an AMHP and two DRs one of whom must be “section 12 approved”. Right of appeal against detention to a Mental Health Review Tribunal.
  • Section 4 – the emergency power to detain someone for assessment for up to 72hrs. This is in effect a s2 detention, but is imposed where an AMHP and only one s12 Doctor believe it is needed and delay for a 2nd doctor is impracticable. No right of appeal.
  • Section 5(2) – a ‘holding power’ for DRs to detain an inpatient in hospital for up to 72hrs for assessment under the Act. Cannot be used in A&E because the patients there are not (yet) “inpatients”. Can be used by non-psychiatric doctors on inpatients with psychiatric problems who are on ‘general’ medical wards in a non-psychiatric hospital.
  • Section 5(4) – a ‘holding power’ for a nurse of the prescribed class – usually a more senior psychiatric nurse – to detain someone for up to 6hrs: either for consideration by a DR of whether to use their 5(2) holding power; or to arrange an MHA assessment. Again, this holding power can only be used on patients already admitted.
  • Section 6 – the AMHPs authority to detain and convey someone to hospital for admission under the Act.
  • Section 7 – an AMHP and two DRs can authorise that patients be received into Guardianship, which is less restrictive than admission to hospital. This then gives the Guardian three authorities, covered in:
  • Section 8 – this provides a Guardian with authority to: determine where a s7 patient will reside; require them to attend locations for treatment, occupation or education / training; to require access be given to the patient for any registered medical practionarier or AMHP.
  • Section 12(2) – Various things in the MHA can only be done by or must include a “section 12 approved doctor”. Such DRs are those “having special experience in the diagnosis or treatment of mental disorder.”
  • Section 13 – the AMHPs duty to undertake MHA assessments and make applications for admission.
  • Section 17 – the right of hospitals to grant leave as part of rehabilitation and recovery. Such leave might be very brief when first granted – an hour or so – and it may be supervised by a staff member. However, as patients near release it may be for a weekend, for several days or longer. It is a very necessary part of rehabilitation and recovery for patients.
  • Section 17A – the right of hospitals to release a patient from detention subject to Supervised Community Treatment (SCT), otherwise known as a Community Treatment Order (CTO). Excuse the comparison, (but this page is being mainly written for police officers!) – it is effectively like “bail conditions”. If the conditions are not complied with, a person can be recalled and failure to return makes them ‘AWOL’ under the Act.
  • Section 18 – the power to (re-)detain AWOL patients and return them to hospital. There is NO power of entry in order to do so. Can only be exercised in a public place or where legal permission to enter a private building or dwelling has been obtained.
  • Section 19 – the authority of hospitals to transfer patients between different MH facilities.
  • Part III – these are sections relevant to decisions by criminal courts and prisons
  • Sections 35 & 36 – powers to remand an ‘accused person’ to hospital for assessment / treatment.
  • Section 37 – the power of a Crown Court to impose a hospital order upon a person convicted or found responsible for an offence. This order can be imposed after a full conviction of following a successful defence of insanity; or following conviction for manslaughter on the grounds of diminished responsibility. The order lasts until such time as the Responsible Clinician believes it needs to be discharged but patients retain a right of appeal (under different rules) to a Mental Health Review Tribunal.
  • Section 38 – an interim hospital order: can be imposed on a convicted or responsible person to undertake assessment and treatment as to whether a full hospital order is the right outcome.
  • Section 41a restriction order, sometimes known as a ’37/41 order’. Courts can ‘restrict’ an order made under s37 which subsequently prevents the DR from taking decisions to released the patient, transfer the patient to a different (kind of) mental health hospital or to allowing them periods of s17 leave from hospital. It obliges the DR to have such decisions authorised by the Ministry of Justice Mental Health Unit. Such restriction orders can only be imposed if the original court was satisfied that the patient posed a “significant risk of harm to the public.”
  • Section 42 – anyone detained under a restricted hospital order is never just ‘released’. They are always released under this section, in what is known as conditional restricted release. Again, pleased excuse the comparison, but with my police audience in mind, it amounts to being released on licence, again with some potential restrictions or conditions. If those restrictions or conditions are breached, the Secretary of State for Justice, through the MoJ Mental Health Unit, can issue a warrant for the return of that patient to a named hospital. They then assume the status of a s37/41 restricted patient.
  • Section 47 – a “transfer direction” authorises the moving of a convicted prisoner to a hospital, if they develop a need for mental health treatment whilst serving their sentence. By virtue of s47(3) MHA, such a patient is then treated in hospital ‘as if’ they had been sentenced to a s37 hospital order by a court. This is sometimes referred to a ‘Notional s37′ and I have written a specific post about this.
  • Section 48 – same power as per s47, but for remand and other prisoners (such as immigration detainees) in contrast to s47 for convicted prisoners.
  • Section 49 – a “restricted transfer direction” imposes restrictions upon leave, discharge or transfer without Ministry of Justice permission, as per s41 MHA. Sometimes, this is known as a ’47/49 order’, but it for our purposes the same as ’37/41 order’.
  • Section 50 – is a “remission direction” to remove a s47 MHA patient back to prison if their detention in hospital for mental health treatment is no longer required but their sentence of imprisonment is not yet up.
  • Parts IX and X – offences and police powers
  • Section 127 – criminal offence of wilful neglect of an inpatient.
  • Section 128 – criminal offence of assisting a person to absent themselves without leave from hospital; or harbouring such patients after absenting themselves.
  • Section 129 – criminal offence of obstruction of an AMHP
  • Section 132 – the rights which must be explained to someone when detained in hospital, including where detained under s135(1) or s136 as a place of safety.
  • Section 135 – warrants under the Act for (1) assessments on private premises; and (2) recovering patients who are absent without leave.
  • Section 135(6) – legal definition of a place of safety.
  • Section 136 – police power to detain someone in immediate need of care or control and remove them to a place of safety. Power to detain lasts for 72hrs.
  • Section 137 – authority to regard someone subject to an application for admission under the Act as being ‘in legal custody’.
  • Section 138 – power to detain or recover someone who has absented themselves from lawful custody in one of two situations: a) recover someone who absconded from s135(1) or s136 and return them to a place of safety. Power lasts for 72hrs after they went missing or after arrival at the place of safety; whichever is sooner; and b) to detain someone who absconded after being “sectioned” but before being admitted to hospital. This is known as someone who is “liable to be detained”.

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– the Mind 2012 Digital Media Award, in memory and in honour of Mark Hanson.
The Awards celebrate the “best portrayals of and reporting on mental health in the media.”
– a World of Mentalists 2012 #TWIMAward for the best in mental health blogs.
It was described as “a unique mix of professional resource, help for people using services and polemic.”

4 thoughts on “What Do All The Sections Mean? …

  1. I have a friend who was in a mental hospital who was so desperate to get out that she set fire to a piece of paper and held it up to the fire alarm so that it would go off and the fire door would open so that she could go home. She has since been moved to a high security hospital and has been told that the police want to talk to her. Can anyone tell me if the police will talk to her and how long will it take for them to come and see her. Also if she gets charged what will be the likely sentence? It was only a small flame (about the size a lighter gives out) and as soon as the fire alarm went off she put the paper out in the toilet. Thanks

    1. I don’t think anyone could say for certain whether the police will speak to her, and / or whether this would be a formal interview or a friendly warning as to future consequences if she did it again. Everything turns on particular circumstances and that would include your friend’s background in terms of mental ill-health and / or any previous offending. The are examples either way as to what happenes next so I’m afraid it will be a question of waiting to see. Maybe your friend, or someone one her behalf, could ask the staff at the new hospital or contact the officer in charge of case to get an indication of what will happen?

      1. So are the police likely to be investigating it as you said to contact the officer in charge of the case? Or will the police maybe not talk to her? She did it 2 and a half weeks ago. Are they leaving it to long to talk to her about it?

      2. I’m afraid you’ll have to confirm that with the police concerned and ask – there are too many background factors that could influence one way or the other. It will probably need to be someone acting on her behalf for confidentiality reasons.

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