Nigel Turner's HyperGUIDE to the Mental Health Act

Section 20: Renewals

Renewal of Periods of Detention in Hospital

Summary

Section 20 provides the authority for someone who is already detained in hospital for treatment under Section 3 or Section 37, to be detained for a further period. The renewal takes effect when the Managers officially receive a report by the Responsible Medical Officer.

Duration

Up to 6 months after the initial period of 6 months. Subsequent renewals are for up to 12 months.

Conditions

The grounds which the RMO must certify are stated in the Act are:

• the patient is suffering from mental illness, severe mental impairment, psychopathic disorder or mental impairment, and his mental disorder is of a nature or degree which makes it appropriate for him to receive medical treatment in a hospital; and
• such treatment is likely to alleviate or prevent a deterioration of his condition [ in the case of mental illness or severe mental impairment only, an alternative condition is that the patient, if discharged, in unlikely to be able to care for himself, to obtain the care which he needs or to guard himself against serious exploitation]; and
• it is necessary for the health or safety of the patient or for the protection of other persons that he should receive such treatment and that it cannot be provided unless he continues to be detained.

The Process of Renewal

The doctor who is the Responsible Medical Officer provides a report (in practice, fills in a form) to the Managers, certifying the above conditions are met. The doctor must examine the patient and provide the report no earlier than 2 months before the end of the current period of detention, but it could be at the last minute, just before the current period is due to expire.
The Managers would normally delegate the receipt of such reports to administrative staff. However, Section 20 states that the Managers will inform the patient of the renewal of the Section 3 or Section 37, "unless they discharge the patient". This last phrase has been taken to mean that the Managers must review the person's continued detention (preferably) before the expiry of the current period and consider whether to use their Section 23 powers of discharge as an alterntive to officially receiving/accepting the doctor's report. Sometimes this Managers' Hearing will take place after the end of the period of detention which is being renewed; the patient's detention in the interim period is valid so long as the Section 20 form provided by the doctor has been offically received by an authorirsed person on the Managers' behalf.

Renewal of Guardianship

Periods of Guardianship can be renewed in a similar way. In this case the appropriate medical officer makes the report to the social services authority (and to the Guardian if this is not the social services authority). The conditions for the renewal of Guardianship are:

• the patient is suffering from mental illness, severe mental impairment, psychopathic disorder or mental impairment, and his mental disorder is of a nature or degree which warrants his reception into Guardianship; and
• it is necessary in the interests of the welfare of the patient or for the protection of other persons that the patient should remain under Guardianship.