Thursday, 19 March 2020

The Coronavirus Bill – Proposed Amendments to the Mental Health Act 1983

26.03.20. Update: The Coronavirus Act 2020 has now been passed, but the changes, including to the MHA, are not as yet in force. Schedule 8, which relates to the MHA, appears unchanged from the Bill.

The Coronavirus Bill was published today (19th March 2020). You can find the full text here

The full Bill obviously covers a multitude of proposed measures, including for example emergency registration of nurses and social workers. The proposed amendments to the MHA for England and Wales are contained in Schedule 7. Changes to the Scottish legislation are contained in Schedule 8.

This is my understanding of the main proposed changes relating to the MHA 1983.

The main substance of these changes appears to relate to an anticipated shortage of doctors who can make recommendations. It does not appear to anticipate any shortage of AMHPs, who will still be required to undertake an assessment and make the application.

As has been signaled, there will be changes to the requirements regarding applications under s.2 and s.3 MHA.

The Bill states:

An application by an approved mental health professional under section 2 or 3... may be founded on a recommendation by a single registered medical practitioner (a “single recommendation”), if the professional considers that compliance with the requirement under that section for the recommendations of two practitioners is impractical or would involve undesirable delay.

So it would appear that, while s.2 and s.3 can still involve two medical recommendations, an AMHP can decide to dispense with one if it is not practical to obtain 2 doctors to make recommendations.

The Bill then goes on to say:

An emergency application under section 4 may not be founded on a single recommendation (but this does not limit section 4(3)).

I’m taking this to mean that in effect s.4 (which only requires one recommendation) is suspended for the duration of these amendments.

The Bill makes it clear that the single recommendation has to be made by a s.12 approved doctor, but that doctor does not need to have had previous acquaintance.

S.5(2) is being amended so that instead of this hospital detention lasting 72 hours, it will now last for up to 120 hours, or 5 days. The time limit for s.5(4), the nurse’s holding order, is also extended, from 6 hours to 12 hours.

Along the same lines, Part III of the MHA, relating to criminal proceedings, will only require one medical recommendation. This relates to s.36, s.37, s.38, and s.45A.

Presumably anticipating delays in admissions to hospital, the time limits for conveyance of accused or convicted prisoners to hospital have been relaxed, the Bill stating:

The provisions listed in sub-paragraph (2) have effect as if references to conveying or admitting a person to hospital within a specified period were references to doing so within that period or as soon as practicable after the end of that period.

Finally, s.135 & s.136 are amended to extend the period of detention in a place of safety from 24 hours to 36 hours (not 72 hours, as had previously been the time limit until the recent amendments in 2018).

Any existing forms that conflict with these changes can be used with “appropriate amendments” (which can presumably be handwritten if necessary).

There is no indication of how long these changes might continue.

The Bill does, of course, still have to pass through, and be approved by, Parliament, and there may be further amendments.

However, it does seem likely that most, if not all, of these changes will go through.

1 comment:

  1. I would be interested to hear your voice on changes to schedule 11 - social care. I have been battling to get an assessment under section 9 of the care act for a month now. Now I'm terrified I'm not going to get one for many months if their duty to assess is removed. I'll probably be dead before they get round to doing it.