Under Section 114 a local social services authority must appoint a sufficient number of social workers who have "appropriate competence in dealing with persons who are suffering from mental disorder". Guidance is issued by the Central Council for Education and Training in Social Work as to the training which should be provided in order for social workers to fulfil this role. Most local authorities will ensure that an ASW is available 24 hours a day in order to make assessments in the community and thus to consider whether an Application should be made for admission under the Act.
The Responsible Medical Officer is defined in Section 34 as the doctor in charge of treatment for the patient. This will normally be the consultant psychiatrist, but does not legally have to be a consultant. In the absence of the consultant, it must be clear who has been delegated this responsibility in the interim. A patient detained under the Act can only have one doctor acting as RMO at any one time. In the case of someone subject to Guardianship, the RMO is authorised as such by the social services authority.
The Appropriate Medical Officer has a slightly wider meaning than Responsible Medical Officer. A person who is under the Guardianship of someone other than a local authority social services department, will have a nominated medical attendant. The term Appropriate Medical Officer includes RMOs and nominated medical attendants.
This is an independent doctor appointed by the Secretary of State [in practice by the Mental Health Act Commission], who gives a second opinion with regard to treatment which can be given without the patient's consent under Section 57 or Section 58.
As the Nearest Relative has a number of specific rights and powers under the Act, it is vital to be able to determine which of a person's relatives is the Nearest Relative. This is set out at Section 26. The Nearest Relative is the person who is nearest the top of the list given below, and where more that one person is in the same category, the Nearest Relative will be the elder or eldest of the relatives in that category:
Relatives who are "of the full blood" take precedence over half-relatives of the same category. Also, if the person concerned has been residing with a relative who has been caring for him/her, then that relative will take precedence. People with whom someone has been living "as husband and wife" count as Husband or Wife in the above list, if they have been living together for at least 6 months at the relevant time (which, for detained patients, is the time of admission under the Act). The law does not normally regard a same-sex couple as living together "as husband and wife", so a gay or lesbian partner would only be regarded as the Nearest Relative if they fell into the last of the numbered categories in the list above and if there were no relatives in the other categories.
The following relatives do not count in working out
who is the Nearest Relative:
The following people can ask a Court, using
Section 29, to appoint an acting
Nearest Relative:
The Mental Health Act makes many references to the "hospital managers". This does not mean the management staff who work at the hospital, but refers to the body which is ultimately responsible for running the establishment. When the Act was written, this meant the local health authority, but most hospitals are now run by an NHS Trust, and "hospital managers" refers to the board of the Trust. In most cases, the board sets up a special Committee to undertake the Trust's duties and responsibilities under the Act. This Committee will probably include a majority of co-opted members who are not on the Trust board. The Managers have powers, given in Section 23, to discharge people detained under Section 2, Section 3 and Section 37 and therefore appeals to the Managers can be made.
The Mental Health Review Tribunal is constituted by law and exists to hear appeals against detention under the Act. Its proceedings are generally formal and often the parties involved will be represented by lawyers. In fact, there is a number of Tribunals, geographically based, with members appointed by the Lord Chancellor. The Tribunals consist of medical members, legal members and lay members, the latter including people with experience in social services. Appeals to the MHRT are dealt with in accordance with rules set down by the Lord Chancellor.
The Mental Health Act Commission is officially a "special health
authority". Its powers and duties include: