What happens at a Mental Health Act managers’ review

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A Mental Health Act managers’ review is normally held at a hospital.

The following people will usually be there:

  • You
  • The managers
  • Your responsible clinician
  • A nurse from the ward or your community nurse
  • A social worker
  • A hospital administrator

Your nearest relative may be invited if you want them to be there. If you do not want your nearest relative there, they can share their views in the reports of the hospital team. You also have the option of asking an Advocate to attend in order to give you support. In certain circumstances you can seek the attendance of a legal representative.

The managers will have read through the reports. Make sure you have had an opportunity to read the reports prior to the meeting. Remember that you can ask for the meeting to be delayed/adjourned if you have not had time to fully read the reports. After this the chairperson  will give you a chance to speak. At the end of the hearing the hospital managers will decide if you should stay under your section or be discharged from it. Being discharged from the Section does not mean you are discharged from hospital – if the doctor suggests you can remain in hospital informally (that means voluntarily) then you are able to decide this for yourself. All three of the managers have to agree for you to be discharged unanimously. Even if only one of the managers disagrees then the Section will remain in place.

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Shortage of medicationsfollowing Brexit?

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The government has put in place a number of precautions to prevent medication shortages regardless of what happens during Brexit. However, make sure to voice your concerns to your local Pharmacist. They’re a fantastic resource and can give you more up to date information on any medication that might be an issue and in case of any delays in obtaining them will know exactly what to do. The government has also introduced a “serious shortage protocol” for the antidepressant Fluoxetine, which allows pharmacists to give patients an alternative strength or form of the drug because of temporary shortages of some doses.

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Queens Speech Oct 2019

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My Government will bring forward proposals to reform adult social care in England to ensure dignity in old age. My Ministers will continue work to reform the Mental Health Act to improve respect for, and care of, those receiving treatment“.

Even if the Government is able to get this through Parliament approval – what does it mean.We keep waiting!!

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World Mental Health Day

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Listening is one of our most important senses…

….the World Health Organisation recognises World Mental Health Day on 10 October every year. This year’s theme set by the World Federation for Mental Health is suicide prevention.



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What is CRITERIA FOR DETENTION when considering a Community Treatment Order?

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The responsible clinician (RC) may not make a community treatment order unless—

(a) in the RC’s opinion, the relevant criteria are met; and
(b) an approved mental health professional states in writing—
(i) that he agrees with that opinion; and
(ii) that it is appropriate to make the order.

 The relevant criteria are

(a) the patient is suffering from mental disorder of a nature or degree which makes it appropriate for that person to receive medical treatment;
(b) it is necessary for that person’s health or safety or for the protection of other persons that he should receive such treatment;
(c) subject to that person being liable to be recalled as mentioned in paragraph (d) below, such treatment can be provided without them continuing to be detained in a hospital;
(d) it is necessary that the responsible clinician should be able to exercise the power under section 17 E(1)  to recall the patient to hospital; and
(e) appropriate medical treatment is available for that patient.


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Section 17 Leave

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Section 17 leave is the power of a patient’s responsible clinician to grant, detained patients, leave from the hospital. A detained patient is only allowed to leave the hospital with this leave in place.A patient granted leave under Section 17 remains “liable to be detained” under the Act and is, therefore, subject to the same consent to treatment provision as if they were still in hospital.It is immaterial if the patient is escorted by hospital staff, whether the excursion is part of a specified treatment plan or even as a result of an emergency, without the consent of the RC, or with the authority of the Secretary of State for Justice if the patient is subject to restrictions, the leave is invalid and a breach of the law.Section 17 concerns leave of absence from hospital. This is the hospital which is named in the application or order which provides authority for the patient’s detention.

Leave of absence can be granted to any patient detained under sections 2, 3, and 37 of the Mental Health Act 1983. It is not legally possible to do so where a patient is subject to sections 4, 5(2), 5(4), 135 and 136.Patients detained under Sections 35, 36 and 38 cannot be granted leave of absence.Patients who are subject to a restriction order under Sections 41 or 49 cannot be granted leave of absence without the permission of the Secretary of State for Justice.

The authority for granting Section 17 leave cannot be delegated, so RC cannot delegate the task to a junior. Where the RC is on annual leave or otherwise unavailable, permission can only be granted by the approved clinician who is for the time being in charge of the patient’s treatment and who is, therefore, temporarily acting as the patient’s RC.

Section 17 leave should not be confused with discharging a patient subject to a Community Treatment Order (CTO) which is granted under section 17A of the Mental Health Act.  Section 17 leave may be used to grant shorter periods of leave from hospital in the build up to discharging patients on to a CTO, but they are distinct legal concepts.

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St Nicholas Gosforth

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The City of Newcastle upon Tyne and its’ neighbours at Durham, Northumberland, Cumberland and Westmorland were all authorities which were slow to respond to the 1845 Lunacy and County Asylums Acts which had obliged them to provide lunatic asylums. Until the new asylum was opened, Newcastle had utilised a number of private asylums in the Gateshead, Co. Durham area.The new asylum site was chosen in 1865.The asylum was designated as the County of Northumberland War Hospital by the military in 1914 and in addition to the medical and surgical cases accepted, 100 beds were also set aside for mental health patients. With the return of the civilian population the opportunity was taken to rename the asylum, which became the Newcastle upon Tyne City Mental Hospital.In line with surrounding authorities and the Mental Deficiency Act of 1913 the Newcastle Corporation purchased a site at Shotley Bridge in order to provide facilities for so called mentally defective persons. Shotley Bridge was evacuated at the start of the 1939 War to serve as an Emergency Medical Services Hospital. After the War, the creation of the National Health Service 1948 meant the transfer of the Newcastle upon Tyne City Mental Hospital to the newly formed Newcastle Regional Hospital Board. The new management resulted in a change of name to the St. Nicholas Hospital.

As the Government’s policy of winding down large mental hospitals continued into the 1980’s the former female wing, previously the original asylum was gradually vacated and patients were concentrated into the 1890’s extensions. The chapel was destroyed by fire in 1986 and subsequently demolished, part of its’ site being developed in 1994 as the Ashgrove Nursing Home. The hospital continues to operate from the refurbished former male wing and a number of newer detached units in the grounds. The majority of the hospital grounds south of the main buildings are occupied by housing development.


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