Legal Position of a Formal and Informal Patient Admitted to a Mental Health Facility
Compare and contrast the legal position of a formal and informal hospital patient suffering from mental disorder.
About 90% of those admitted to psychiatric facilities in England and Wales are admitted ‘informally’[1]. The grounds for this are found in section 131 (1) of the Mental health Act 1983 – nothing in the act shall be construed as ‘preventing a patient who requires treatment for mental disorder from being admitted to any hospital’ – regardless of whether the ‘correct’ procedure has been followed (i.e. recommendations from ASW). The definition of ‘mental disorder is laid out in section 1 of the act.
The legal position of a formally confined patient is much easier to define – as their confinement is by definition – formal – all the formalities of the governing statutes must be followed. Greater confusion can therefore be found in the category of informal patients, where every situation may not be legislated for, and case law may not as yet have filled in the gaps.
It is important to note that people admitted under s131 are not legally confined – and are legally permitted to leave. Those admitted informally also have the same rights as anyone else in society to consent to, or refuse treatment. It was held in R v Kirklees MBC[2] that section 131 applies only to the treatment of patients, and not to their assessment. Assessment is lawful for any patient who consents ‘just as he or she may be admitted to hospital for an operation’[3].
If an informal patient wants to leave, they must complete a report in writing to the managers of the hospital to that effect. If the doctor believes an application for detention ought to be made, they have a holding power under section 5 (2) MHA – allowing the patient to be detained for 72 hours while a full assessment is made.
Allowing a patient to admit themselves enables a more conventional doctor patient relationship. The balance of power stays on a more even footing, allowing patients to feel
About 90% of those admitted to psychiatric facilities in England and Wales are admitted ‘informally’[1]. The grounds for this are found in section 131 (1) of the Mental health Act 1983 – nothing in the act shall be construed as ‘preventing a patient who requires treatment for mental disorder from being admitted to any hospital’ – regardless of whether the ‘correct’ procedure has been followed (i.e. recommendations from ASW). The definition of ‘mental disorder is laid out in section 1 of the act.
The legal position of a formally confined patient is much easier to define – as their confinement is by definition – formal – all the formalities of the governing statutes must be followed. Greater confusion can therefore be found in the category of informal patients, where every situation may not be legislated for, and case law may not as yet have filled in the gaps.
It is important to note that people admitted under s131 are not legally confined – and are legally permitted to leave. Those admitted informally also have the same rights as anyone else in society to consent to, or refuse treatment. It was held in R v Kirklees MBC[2] that section 131 applies only to the treatment of patients, and not to their assessment. Assessment is lawful for any patient who consents ‘just as he or she may be admitted to hospital for an operation’[3].
If an informal patient wants to leave, they must complete a report in writing to the managers of the hospital to that effect. If the doctor believes an application for detention ought to be made, they have a holding power under section 5 (2) MHA – allowing the patient to be detained for 72 hours while a full assessment is made.
Allowing a patient to admit themselves enables a more conventional doctor patient relationship. The balance of power stays on a more even footing, allowing patients to feel