Mental Health Tribunals

Under the current Act, Mental Health Review Tribunals (MHRT), comprising of three members, deal with applications and references in respect of patients subject to the provisions of the Mental Health Act, including those subject to compulsory admission to hospital and guardianship. Each Tribunal must consist of a legal member; a medical member (i.e. a registered medical practitioner), and a member with relevant experience (e.g. a knowledge of social services).

Tribunals have the power to discharge unrestricted people from hospital if they are satisfied that the patient is not suffering from a mental disorder of a nature or degree which warrants his/her detention, or their detention cannot be justified under Section 72 of the 1983 Act.

Hospital Managers also have the power to discharge unrestricted people,.Tribunals have limited powers to discharge restricted people under Section 73 of the 1983 Act.

Article 6 of the European Convention on Human Rights, which was introduced into English Law by the Human Rights Act 1998, provides for a right to a fair trial, which includes the right to:

Patients have free legal representation at Mental Health Review Tribunals.

The Draft Bill proposes to abolish the Mental Health Review Tribunal system and replace it with the Mental Health Tribunal (MHT) for England and Wales. There will be a President of the Tribunal appointed by the Lord Chancellor and the function of hospital managers in respect of reviewing detention will be abolished.

MHT members must fall within the following categories:

  1. Legal members - who must always be included and will chair the MHT
  2. Clinical members - i.e. a person with knowledge or experience of the treatment of mentally disordered people (which will include psychiatry, nursing, psychology and other clinical specialisms)
  3. General members - i.e. a person with knowledge or experience of providing mental health services.

The main functions of the MHT will be to provide legal authority for compulsory treatment beyond 28 days following applications by the clinical supervisor; and to review patientsí cases following applications by the patient, their nominated person and, if the patient is under 16, any person with parental responsibility. The main powers of the MHT will be to discharge the patient from compulsory powers if the relevant conditions are not or no longer met, make orders for assessment or treatment and approve the care plan, and determine whether patient should be detained in hospital as a resident patient or dealt with in the community as a non-resident patient.

An application by the patient or nominated person for discharge or change of status to a non resident patient can be made at any time after the patient becomes liable to assessment. The clinical supervisor may bring forward an application for a treatment order so that both applications are dealt with at the same time. Applications to discharge the treatment order can be made once after 3 months but further applications may be made with leave of the Tribunal. Applications to change the status of the patient from resident to non-resident can be made at any time and once before the end of the order. Further applications may be made with leave of the Tribunal.

an application should be made to the MHT for an order authorising medical treatment or further assessment within 28 days. The order for medical treatment may not exceed 6 months. This may be followed by two further orders for up to 6 months and, after 12 months or 3 consecutive orders, a further order can be made for up to 12 months. The clinical supervisor is required to consult the nominated person and any informal carer before an application is made to the MHT.

The Tribunal will be advised by an independent medical expert drawn from the Expert Panel and it may appoint other members to provide advice. The panel will include doctors drawn from a variety of backgrounds, including from black and ethnic minorities. It will also include people with experience of ethnic minority issues, social care, learning disability nursing, mental health nursing and the probation service.

The Tribunal also has powers to:

A Mental Health Appeal Tribunal (MHAT) will provide a second tier of appeal from the MHT on points of law.