'Critically evaluate the role and the relationship between professionals and lay persons in the process of civil admissions under the Mental Health Act 1983.'

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'Critically evaluate the role and the relationship between professionals and lay persons in the process of civil admissions under the Mental Health Act 1983.'

The process of civil admissions under the Mental Health Act (MHA) 1983 may be viewed by civil libertarians as a violation of the individual's freedom. The state's justification for such a 'violation' is for the need to protect the individual concerned or to protect others in society. The Mental Health Act 1983 does not explicitly require that an individual would have to be 'dangerous' in order for that individual to be admitted to hospital. However, there has developed a 'dangerousness' criterion, (whether the individual would be considered to be 'dangerous' to himself or others) which is often mentioned as being the requirement for confinement; and it forms part of a public interest to preserve public peace and safety. However, as Bartlett and Sandland state; 'the desire to protect individuals from harming themselves is less evidently a public interest.'1 The paternalistic notion of the 'dangerousness' criterion is clearly evident. However, there is uncertainty over the application of the criterion and also confusion over how the person would be considered to be 'dangerous.' Furthermore, Price states that; ' a clear dichotomy should be created between parens patriae (detentions in the best interests of the individual him or herself) and police power (detentions for the protection of others) commitments.'2

The main provisions of the MHA 1983 regarding civil confinement are contained in sections 2 and 3.3 Section 2 of the MHA 1983 allows for 'assessment' of a patient with any mental disorder who ought to be detained in the interests of his own health and safety or for the protection of others for 28 days, which are non-renewable. Section 3 allows for 'treatment' of a patient who is suffering from one of the specific categories of disorder,4 which is deemed 'necessary' for the patient's health or safety or for the protection of others.

The process of civil confinement requires an application for admission to the hospital from either an 'approved social worker' (ASW) or the 'nearest relative' (NR) of the individual who is to be confined. The applications must also be certified by two medical recommendations (one medical recommendation will suffice in an emergency under s.4). Section 26 (1) of the MHA 1983 provides the legal definition of the NR. The relatives of whole blood are usually preferred over relatives of half-blood. In the event that there are two relatives of the relevant class, the elder of the two will usually be chosen as the 'nearest relative'.

Section 114 (2) of the MHA 1983 requires that ASWs should have 'appropriate competence in dealing with persons who are suffering from mental disorder.' An ASW must also undergo twelve weeks of training and must also attend regular refresher courses. This is in contrast with the NR, who does not require any specialist training or knowledge. It is also a divergence from the duties of the Mental Welfare Officer under the Mental Health Act 1959, who also did not require any specialist training to undertake their duties.
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Their expertise in the area of compulsory admission process places the ASW in a better position than the NR in making an application for admission of the patient. However, the NR is placed on an 'equal footing' as the ASW in making an application.5 An ASW is also under a duty to inform and consult the NR prior to making an application; an NR would also have to consult an ASW, if they were making an application. An ASW must also interview the patient and provide a report to the hospital.6

The Mental Health Act 1983 Code ...

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