Main Changes in the Mental Health Act 2007
- The definition of mental disorder is broadened with limited exclusions - now 'any disorder or disability of the mind' - promiscuity, immoral conduct and sexual deviancy are removed as exclusions. Dependence on alcohol or drugs is excluded and the use of compulsory measures for learning disability patients is limited unless they are abnormally aggressive or seriously irresponsible.
- The treatability test is replaced by the appropriate medical treatment test. The likelihood of benefit is gone in favour of an intended benefit to alleviate or prevent deterioration in the patient's condition (symptoms or manifestations).
- The role of the Approved Social Worker (ASW) is gone in favour of the Approved Mental Health Professional (AMHP) - allowing for nurses, occupational therapists, psychologists and social workers to take on the role.
- The nearest relative function remains unchanged - however with the amendments in the Act, the patient can now apply for displacement of the nearest relative (to Crown Court under s29).
- The Responsible Medical Officer (RMO) is replaced by the Responsible Clinician (RC) - allowing other professionals to take on the role.
- Hospital Managers' powers have extended to discharge a patient from a Community Treatment Order (CTO) and have a duty to give information to patients and their nearest relatives.
- Mental Health Review Tribunals (MHRTs) underwent major structural changes (see on). Additionally, automatic reference dates are amended.
- Consent to treatment rules have been amended for ECT. A patient with an advance decision to refuse ECT will be very difficult to override even if he/she is detained. There are additional safeguards for children and amendments to cover community patients (part 4A).
- Introduction of Independent Mental Health Advocates (IMHAs) to provide advocacy services to patients.
- The introduction of CTOs (s17A), with its predecessor supervised aftercare abolished.
- Section 17 leave - An RC should consider a CTO before placing a patient on leave for seven consecutive days.
- Guardianship orders (under s7 or s37) - these powers include that of conveyance to the accommodation.
- Place of Safety Orders (under s135 or s136) - includes the power to move between different places of safety (covered by s44).
- For offender patients (under part 3 of the Mental Health Act) - There are no more time limited restriction orders.The 2007 Act amends the Domestic Violence, Crime and Victims Act 2004 with the requirement to give notification of Tribunals to victims of all hospital order patients.
- Inclusion of specific principles within the Code of Practice (covered by s118), including : the purpose, least restriction, respect, the participation and the effectiveness, equity and efficiency principles.
- Admission of Children - s131 (relating to informal admission) is changed so that if a patient is aged 16-17 who has Gillick capacity and does not consent to admission to hospital, the admission cannot be carried out on the basis of consent by a person who has parental responsibility for the patient. Also, a requirement for suitable environments for children being admitted.