Table Of ContentMental 
Health 
Law
This page intentionally left blank
Mental 
Health 
Law 
a practical 
guide
second edition
Basant K. Puri MA, PHD, MB BCHIR, BSC (HONS) MATHSCI, 
FRCPSYCH, DIPSTAT, PG DIP MATHS, MMATH.
Hammersmith Hospital
Imperial College London and University of Limerick
Robert A. Brown MA APPLIED SOCIAL STUDIES
Director of Edge Training and Consultancy Ltd. Social Worker. Visiting Fellow 
Bournemouth University, Bournemouth, UK
Heather J. McKee MB, CHB, BAO, MRCPSYCH, LLM
Consultant Neuropsychiatrist, Royal Hospital for Neurodisability, West Hill, 
Putney, London, UK
Ian H. Treasaden MB, BS, LRCP, MRCS, FRCPSYCH, LLM
Consultant Forensic Psychiatrist, Three Bridges Medium Secure Unit, West 
London Mental Health NHS Trust, London; and Honorary Clinical Senior Lecturer 
in Forensic Psychiatry, Imperial College, London, UK
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2012 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Version Date: 20121026
International Standard Book Number-13: 978-1-4441-4975-3 (eBook - PDF)
This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to pub-
lish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the 
consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in 
this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright 
material has not been acknowledged please write and let us know so we may rectify in any future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any 
form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and 
recording, or in any information storage or retrieval system, without written permission from the publishers.
For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copy-
right.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. 
CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been 
granted a photocopy license by the CCC, a separate system of payment has been arranged.
Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification 
and explanation without intent to infringe.
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
Contents  
    Contributors  vii
    Legal advisors  viii
    Preface  ix
   1.  History of mental health legislation  1
   2.  Definitions used in mental health legislation   13
   3.  Professional roles   25
   4.  Safeguards for patients under the Mental Health Act   37
   5.   Compulsory Admission to Hospital: (Sections 2, 3 and 4 of the Mental 
    Health Act)   43
   6.  Consent to Treatment Provisions under the Mental Health Act   53
   7.  Community Treatment Orders, Leave of Absence and After-care   57
   8.  Guardianship (Sections 7 or 37 of the Mental Health Act)   63
   9.  Patients concerned in criminal proceedings or under sentence   73
  10.  Mental Health Tribunals   97
  11.  Hospital Managers   103
  12.  Cross-border arrangements   109
  13.  The Mental Health Act Code of Practice and the Reference Guide   115
  14.  The Care Quality Commission   123
  15.  Consent and Capacity   129
  16.  The Mental Capacity Act 2005: Principles   139
  17.  Mental Capacity Act 2005: Provisions   143
  18.  Assessment of Capacity   155
  19.  Safeguards under the Mental Capacity Act 2005   161
  20.  The Mental Capacity Act Codes of Practice   167
  21.  Human Rights Act 1998 in mental health legislation in the UK   173
  22.  Mental health, medication and the law   177
  23.  Research ethics   187
  24.  Child mental health law   191
  25.  Race, culture and mental health   207
  26.  Suicidal patients   211
  27.  Assessment of risk of violence    217
  28.  International comparison of mental health legislation   237
  Appendix I  Legal cases    248
  Appendix II  Summary of civil treatment codes   263
  Appendix III  Summary of civil compulsion sections   265
v
Appendix IV  Flowchart of decisions involving consent to treatment   266
  Appendix V  Sample forms   267
  Index    275
S
T
N
E
T
N
O
C
  
vi
Contributors  
Paul Barber BA Oxon
Solicitor and Former Partner, Bevan Brittan Solicitors 
Freelance Lecturer and Trainer in Mental Health, Incapacity and Human Rights 
Law, UK
Sharon Davies BA MBBS MRCPsych
Consultant Adolescent Forensic Psychiatrist, West London Mental Health NHS 
Trust, London, UK
Claire Dimond BSc MBBS MRCPsych
Consultant Adolescent Forensic Psychiatrist, Adolescent Forensic Directorate, 
WLMHT
Christine Dixon MRPharmS
Principal Pharmacist 
S.W. London Elective Orthopaedic Centre, Epsom, Surrey, UK
vii
Legal advisors
Sections of the manuscript related to mental health law and to criminal law were 
reviewed by the following advisors, who made suggestions and recommendations 
to the authors on the basis of their specialised experience and knowledge on 
current law and legal practice.  Their help is much appreciated. The final version 
of the text is the work of the authors, incorporating those suggestions  and 
recommendations as the authors have judged best: 
Nick Hopkins and Rebecca Hill
Solicitors, Needham Poulier & Partners, London, UK 
Helen Kingston
Solicitor and Principal Lecturer in Law, Northumbria University, Newcastle upon 
Tyne, UK
viii
Preface  
The preparation of a second edition of this book has given us the opportunity to 
cover the major developments in mental health legislation since the publication 
of the previous edition. These have included the new Mental Health Act 2007, 
the Mental Capacity Act 2005 together with its two Codes (one general and one 
covering the Deprivation of Liberty Safeguards), the revised Mental Health Act 
Code of Practice published in 2008 and changes in legislation related to research 
involving the mentally disordered. 
Once again, we have sought to strike a balance between the need to provide 
the reader with a relatively short and portable handbook containing practical 
advice and the desire to be over-inclusive with detailed considerations of the 
ramifications of legal argument. While the usual cautionary legal principle is 
that the reader should always refer to the latest primary legislation, this is rarely 
realistic in day-to-day practice. However, it is hoped that the new edition of this 
mental health law handbook will continue to live up to its name and provide 
helpful practical medico-legal advice.
We wish to thank all those who reviewed the first edition and the draft second 
edition and we are grateful for the feedback we received. 
We are very sorry to relate that Dr Paul Laking, the author of the excellent 
chapter on child mental health law in the first edition, has died.  We valued his 
contribution greatly and extend our sympathies to his family. 
ix