mental disorder

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For the purposes of the Mental Health Act 1983 as amended by the Mental Health Act 2007, any disorder or disability of the mind (s 1(2). This is a wide term and would include persons suffering from organic brain disorders such as dementia, schizophrenia, and other delusional disorders, personality disorders, autistic spectrum disorders, and in some cases learning disabilities. A person suffering from a mental disorder can be detained and treated in a hospital without his consent. Detention for assessment (under s 2) normally takes place on an application to the managers of the relevant hospital by an approved mental health professional or a nearest relative. This must be supported in either case by the recommendation of two doctors (or one in the case of an emergency) on the grounds that it is necessary in the interests of the patient's own health and safety or to protect others. The application authorizes detention for up to 28 days (72 hours in the case of an emergency), after which time further detention would be unlawful unless authorized under an application for detention for treatment (s 3). The procedure and grounds for detention are similar to those under section 2, one important difference being that if the nearest relative objects to the application a court order must be made to displace the nearest relative and appoint another person (usually a social worker) who will agree to the detention. The application authorizes detention for six months, renewable for a further six months initially and thereafter for periods of one year on a report to the hospital managers by the doctor in charge. Discharge of a patient may be effected by the hospital managers or the doctor in charge and in certain cases by the nearest relative. A patient has a right to appeal to the Mental Health Review Tribunal (MHRT). In addition, the hospital managers are under a duty to automatically refer any detained patient to the MHRT after the first six months of detention. The provision of medical treatment for the mental disorder is regulated by Part 1(v) of the Act. Certain treatments, such as psychosurgery and surgical implantation of hormones to remove sexual drive, cannot be given without the patient's consent and a second opinion. Electroconvulsive therapy cannot be given to a competent patient who refuses to consent to it and may only be given to an incompetent patient where it does not conflict with an advance decision or a decision of a donee of a lasting power of attorney. Any other treatment may be given for up to three months, beyond which authorization is required from a Second Opinion Appointed Doctor (SOAD) if the patient either refuses or is incapable of consenting.

Subjects: Law.

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