Mental health
Most people with (serious) mental health problems live independently in the community in the same way as people with other long-term heath problems. They will normally:
-
seek help from their doctor if they are feeling unwell
-
be in touch with a specialist mental health service such as a community psychiatric nurse (CPN), a psychiatrist, psychologist or other health service specialist
-
be supported in the community by a package of care organised by a social services care manager
If you are concerned about your mental health or that of a close relative or friend, your doctor is the primary source of help. They will have knowledge of the person's history and be able to advise them about treatment or help. The doctor can refer them to specialist services if it is appropriate and the person agrees.
When a situation appears to
require urgent action
Assessment under the Mental
Health Act 1983
What is a 'section'?
How to appeal against the
order
The nearest relative
Community mental health resource
centres
Mental Capacity Act 2005
Useful links
When
a situation appears to require
urgent action
If the doctor feels the person needs urgent assessment or
treatment from mental health services, they can telephone the duty
worker at the local
mental health resource centre
and arrange an immediate assessment.
For out-of-hours emergencies contact your local mental health resource centre direct.
If the person with a mental health problem is not willing to accept mental health services and is presenting or behaving in such a way as to give serious concern for their mental health, their safety or the safety of others, then the doctor or the nearest relative can ask the duty worker to arrange a Mental Health Act assessment. The referrer will be asked to provide as much information as possible over the telephone so that doctors and an approved social worker are properly prepared for the assessment.
Assessment
under the Mental Health
Act 1983
The approved social worker (ASW) is a qualified social worker
who has undertaken a further course of full time specialist
training in mental health and been "approved" by a panel of
assessors. They will collate all the information they can
gather on the person's previous mental history, their family, their
social and domestic situation, their present behaviour, and the
name and address of the person thought to be the
nearest relative,
before making the assessment. They will then try to arrange
for the person to be seen by their doctor (if this has not already
occurred) and another doctor with specialist knowledge of mental
health.
If the person's doctor cannot attend then another doctor, independent of the second doctor, will be asked to go in their place. In some situations, where the person is believed to be potentially violent, the ASW may ask for the police to attend during the assessment.
In nearly all circumstances, it is important that the person is seen by two doctors, who are independent of each other, as well as the ASW. The doctors and the ASW will interview the person, sometimes separately and sometimes together. They will agree about the state of a person's mental health, and if it is serious enough as to consider admission to hospital against their will. In coming to this view they will take account of social and cultural factors including ethnicity, gender, age, sexuality, disability and whether the person is a danger to themselves or others.
They will consider whether the person can stay in their present situation, perhaps with extra support or treatment at home; or whether the person needs to be in hospital. In reaching either conclusion the ASW will have tried to take account of the views of relatives or others closely involved with the person.
The Data Protection Act 1998 defines the rules for processing personal information and applies to most paper records and to computer records.
What
is a 'section'?
If the decision is to admit the person to hospital and they
will not go voluntarily, then the ASW will apply for admission to
the hospital under a section of the Mental Health Act 1983.
This is sometimes referred to as being 'sectioned'.
This means the person will be compulsorily admitted to hospital for treatment and care. In due course, if the hospital is satisfied that the person no longer needs to be compulsorily detained, the order will be removed and the person can become a voluntary or informal patient.
How
to appeal against the
order
The patient can appeal against their detention to the
hospital managers or the Mental Health Review Tribunal.
Hospital staff have a duty to provide information to the patient in
writing of their rights when they are admitted. The Mental
Health Review Tribunal has the power to discharge the order or
agree to continued detention. The
nearest relative, as
defined by the act, will also be informed in writing of their right
to request discharge of the patient.
The
nearest
relative
The Mental Health Act 1983 defines who this is and what the
specific rights of a nearest relative are.
The nearest relative is set out as follows in order of priority:
- husband or wife (including living as husband or wife for six months or more and also same sex partners)
- son or daughter
- father or mother
- grandparent
- grandchild
- uncle or aunt
- nephew or niece
Where there is an alternative, the oldest relative has priority. Sometimes the nearest relative cannot be contacted, or does not wish to have that role, or is not able to carry out that role, or does not appear to meet any of the above relationships. The ASW will advise on these matters.
The nearest relative has a number of rights and powers:
- they can request that an ASW investigate the person's situation if they believe the person needs to be in hospital
- they have the right to be informed of any detention
- in some circumstances they have the right to object to a 'section'
- they have the right to request discharge from a 'section'
Community mental health resource centres
Avenue House (for residents of Acton W3, W4 and NW10)
43-47 Avenue Road,Acton W3 8NJ
Tel: (020) 8993 7781
Manor Gate Centre (for residents of Northolt, Greenford and
Perivale)
1A Manor Gate, Northolt,Middlesex UB5 5TG
Tel: (020) 8841 5271
Southall Norwood (for residents of Southall and Norwood
Green)
The Green,Southall,Middlesex UB2 4BH
Tel: (020) 8571 6110
Lamas Centre (formerly Walpole House - for residents of Ealing
W5)
13 Mattock Lane, Ealing W5 5BG
Tel: (020) 8483 2600
Specialist services:
The following borough-wide teams work specifically with
people with severe mental illness who need specialist services. A
referral is required from your local mental health resource
centre.
RISE (Reach and Include Support and Empowerment)
This is a specialist service which aims to work with people
with severe and enduring mental health problems on enhanced CPA who
have difficulties engaging with traditional mental health services.
In addition, they will have a range of complex needs.
Cherington House, Cherington Road, London W7 3HL
Tel: (020) 8566 2777
Home Treatment
This service aims to provide an alternative to in-patient
care for people living in the borough who are experiencing a mental
health crisis of such a degree that would otherwise warrant
admission to hospital. The service offers safe and effective home
based assessment and treatment for people aged 16-65. Access to
this service is through your local community mental health resource
centre