Severe mental impairment has a similar definition but with the word "significant" replaced with "severe". Psychopathic disorder is defined as a "persistent disorder or disability of mind (whether or not including significant impairment of intelligence) resulting in abnormally aggressive or seriously irresponsible conduct".These categories do not necessarily correspond to medical categories of mental disorder such as those outlined in ICD-10 or DSM-IV; the type of mental disorder afflicting a particular person is very much left up to the clinical judgement of the individual doctor. However, the category "mental illness" is thought by most psychiatrists to cover schizophrenia, anorexia nervosa, major depression, bipolar disorder and other similar illnesses, "(severe) mental impairment" to cover mental retardation (learning disability) and "psychopathic disorder" to cover the personality disorders.There are very few exclusions to these definitions of mental disorder. The Act states that one cannot be suffering from a mental disorder "by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs".


Professionals and persons involvedPlease note this section will be significantly amended by Mental Health Act 2007 - see belowThe Act involves specific professional roles by social workers and doctors as well as a specific role by a relative of the mentally disordered person.An Approved Social Worker (ASW) is a social worker who has extensive knowledge and experience of working with people with mental disorders. They have received specific training relating to the Mental Health Act, usually lasting one year, and performs a pivotal role in the assessment and detention process.A Section 12 Approved Doctor is a medically qualified doctor who has been recognised under section 12(2) of the Act. They have specific expertise in mental disorder and have additionally received training in the application of the Act. They are usually psychiatrists, although some are general practitioners (GPs) who have a special interest in psychiatry.A Responsible Medical Officer (RMO) is a doctor who is responsible for the treatment of mentally disordered persons who are compulsorily detained under the Act.



Within the National Health Service (NHS), he or she is almost exclusively a consultant psychiatrist, other than in rare situations in which a person is detained in a general hospital setting, such as a surgical ward.A Nearest Relative is a relative of a mentally disordered person. There is a strict hierarchy of types of relationship that needs to be followed in order to determine a particular person's Nearest Relative: husband, wife, or civil partner; son or daughter; father or mother; brother or sister; grandparent; grandchild; uncle or aunt; nephew or niece; lastly, an unrelated person who resides with the mentally disordered person. Thus a person's Nearest Relative under the Act is not necessarily their "next of kin". A mentally disordered person is not usually able to choose their Nearest Relative but under some circumstances they can apply to a County Court to have a Nearest Relative replaced. In practice more applications are made by Social Services Departments. The Nearest Relative is important as he or she has the power to discharge the mentally disordered person from some sections of the Act.

Mental Health Act

The Mental Health Act 1983 (1983 c. 20) is an Act of the Parliament of the United Kingdom but applies only to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters. In particular, it provides the legislation by which people suffering from a mental disorder can be detained in hospital and have their disorder assessed or treated against their wishes, unofficially known as "sectioning". Its use is reviewed and regulated by a special health authority known as the Mental Health Act Commission (MHAC). HistoryThe Lunacy Act 1890 gave mental hospitals or "asylums" the power to detain "lunatics, idiots and persons of unsound mind". The Mental Deficiency Act 1913 increased these powers, establishing a Board of Control to monitor asylums. These laws were superseded after World War II by the Mental Health Act 1959.This Act aimed to provide informal treatment for the majority of persons suffering from mental disorders, but to provide a legal framework such that such persons could, if necessary, be detained in hospital against their wishes.

However, the 1959 Act did not provide clarity as to whether a legal order to detain a mentally disordered person in hospital also empowered the hospital to impose medical treatment against the person's wishes. It had become clear by the 1970s that a specific legal framework for medical treatments such as psychiatric medications, electroconvulsive therapy and psychosurgery was needed in order to balance the rights of detained persons with society as a whole.The Mental Health Act 1983 came into force in the September of that year. Layout of the actThe Act is divided into ten "parts":Application of the Act Compulsory admission to hospital and guardianship Patients concerned in criminal proceedings or under sentence Consent to treatment Mental Health Review Tribunal Removal and return of patients within the United Kingdom Management of property and affairs of patients Miscellaneous functions of Local Authorities and the Secretary of State Offences Miscellaneous and supplementary Each of these ten parts are divided into "sections", which are numbered continuously throughout the Act.

In total, there are 149 sections in the Act. Definition of mental disorderPlease note this section will be significantly amended by Mental Health Act 2007 - see belowThe term "mental disorder" is very loosely defined under the Act, in contrast to countries such as Australia and Canada. Under the Act, mental disorder is defined as "mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind". There are four distinct subcategories of mental disorder stipulated in Section 1 of the Act - mental illness, mental impairment, severe mental impairment and psychopathic disorder.These categories are not well defined in the Act, indeed, mental illness is not defined at all. Mental impairment is defined as "a state of arrested or incomplete development of mind ... which includes significant impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned".