# 23 - The Mental Health Act in England and Wales

# The Mental Health Act in England and Wales

Prescribing psychotropics
CHAPTER 14
The Mental Health Act in England and Wales
The 1983 Mental Health Act (MHA) as amended by the 2007 MHA is the legislation 
within England and Wales that provides the framework for detaining and treating people with mental disorder in hospital. It also allows for the supervision of people in the 
community. Mental health law as it pertains to other countries is not covered in this 
book. The guidance here provides a quick summary of the sections that prescribers are 
likely to come across in their day-­to-­day work (Box 14.2). It is not an exhaustive list. 
The Act has a statutory Code of Practice for practitioners and Chapter 25 of the Code 
provides detailed guidance on the treatment rules of the Act.1 The MHA can be accessed 
at www.legislation.gov.uk.
The power to treat under S58 is only for treatment of mental disorder. Physical treatment (generally) is governed by the normal rules of consent or, if the person lacks 
capacity, the authority of the Mental Capacity Act.
The Responsible Clinician (RC) is usually the patient’s consultant.
For the first 3 months of detention, the RC may give medication with or without 
consent to a person under one of the detention sections named for the treatment of their 
mental disorder. Thereafter, the patient’s consent or a second opinion must be sought. 
The 3 months’ countdown starts when medication for mental disorder is first administered while the patient is detained. This includes a patient detained under S2 who is 
then, without a break, detained under S3. For practical purposes the 3-­month rule is 
usually calculated from the date of first detention.
Box 14.2  Civil and forensic detention sections
Section 2
Admission for assessment which lasts for up to 28 days
Section 3
Admission for treatment which may last up to 6 months and is renewable
Section 36
Remand to hospital for treatment
Section 37
Hospital Order made by the courts (runs like an S3)
Notional 37
Treat as if subject to S37. This term is used informally under a number of different 
circumstances. One example is where a patient was previously detained under S47/49 and their 
restriction order expires.
Section 38
Interim Hospital Order
Section 41
Restriction order: an order made by the Crown Court restricting discharge. Accompanies S37 
and is written as S37/41.
Section 47
Transfer to hospital of prisoners
Section 49
A restriction order which usually accompanies S47 (written as S47/49)
Section 48
Applies to un­sentenced prisoners in need of urgent treatment and is accompanied by S49 
(written as S48/49)
Section 58
Treatment requiring consent or a second opinion
Please note in law it is the Responsible Clinician (RC) who is accountable for the 
operation of S58