History
By the turn of the 18th and 19th Centuries, there was increasing opinion that "moral treatment" was preferable to traditional confinement methods (often with the use of mechanical restraints) for those who were mentally ill. Modernists campaigned for increased licensing for mental health institutions (known as 'madhouses') resulting in the Madhouses regulation Act of 1774 (for private madhouses).
There continued to be public concern in England about the welfare of those in care, following reports of scandalously low standards in some private madhouses. This concern led to the County Asylum Act of 1808, which provided for the building of mental hospitals in each of the English counties. Unfortunately, little was done by the county authorities, and in 1845 it was necessary to enact the Lunatics Act, which required the building of an asylum in every county. This Act also introduced Lunacy Commissioners: an independent body with the power to supervise and protect patients in all hospitals, asylums and licensed houses in England. These commissioners continued in the form of the Board of Control in 1913 and continued their work until the 1959 Act.
Due to growing concerns over the lack of safeguarding for those with mental illnesses, the Lunacy Act of 1890 was introduced, which meant that there was requirement for formal certification by judicial order following an application by relatives or Poor Law officials, supported by medical evidence. Publicly financed institutions for mentally disabled people were established under the Mental Deficiency Act of 1913 and an early system of classification of mental disorder was introduced.
The Mental Treatment Act 1930 moved away from the procedural formality and institutional preference of the late nineteenth century, instead renaming "asylums" into "mental hospitals" and "lunatics" to "persons of unsound mind." Voluntary status was introduced as well as "temporary" status for those non volitional patients who required treatment for less than a year. Until the 1959 Act, patients in mental illness hospitals could be voluntary or temporary patients under the 1930 Act of certified patients under the 1890 Act.
For those with learning disabilities or other forms of mental impairment (known then as "mental defectives"), there were other procedures illustrated in the Mental Deficiency Acts of 1913 and 1927. Institutions were not prohibited from taking patients without formality. Also, looking after people who lacked capacity to look after themselves was permitted by the common law doctrine of necessity. Notably, using this doctrine was supported and encouraged by the 1957 Percy Commission.
The 1959 Mental Health Act abolished the judicial certification prior to admission and replaced this with 'sectioning' by mental health experts. This involved an application made by a social worker supported by two medical recommendations presented to, and formally accepted by an individual(s) acting on behalf of the managers of the receiving hospital. The patient had the right to seek review of the need for detention before a Mental Health Review Tribunal (MHRT).
The 1983 Mental Health Act provided an emphasis on safeguards for patients' rights to seek review of detention and the right to be treated in the least restrictive environment. The amendments also included consistency with the European Court of Human Rights (see X v UK 1981).
The above 1983 Act was amended in 1995 to introduce safeguards for supervised discharge of patients who had been detained under the Act. The 1995 Act was amended in response to high profile homicides committed by mentally disordered people in the community.
The Mental Capacity Act 2005 was introduced in 2007 and the Mental Health Act 2007 was introduced in 2008. The Mental Health Act 2007 emphasizes public protection and risk management, extending the powers of compulsion, introducing compulsory community treatment orders, broadens the definition of detainable mental disorder, increases the range of different professional groups who can exercise powers of compulsion, and introduces ideas of compliance with medications as a key goal.