Mental Health Review Tribunal
Encyclopedia
The Mental Health Review Tribunal consists of two distinct bodies, within a single non-departmental public body
, which exist to protect the rights of persons subject to the Mental Health Act 1983
in England
and Wales
in the United Kingdom
. Essentially, it provides for consideration of appeals against detention in hospital made by people thus detained
.
. The Tribunal members are appointed by the Ministry of Justice
. There is a Liaison Judge appointed to the Tribunal to lead its development.
The second body is the Mental Health Review Tribunal Secretariat. This is staffed by members of the Department of Health
, and has responsibility for the administration of the Tribunals.
and the Mental Health Review Tribunal Rules 1983. A Tribunal's main purpose is to review the case of a patient detained under the Mental Health Act
and to direct the discharge of any patient for whom the statutory criteria for discharge have been satisfied. In some cases, the Tribunal also has the discretion to discharge a patient who does not meet the statutory criteria. Such cases usually involve making a balanced judgement on a number of serious issues such as the freedom of the individual, the protection of the public and the best interests of the patient.
makes appointments to the panels of members for each region. In the case of medical and lay members, the Secretary of State for Health
(for cases in England) or the Secretary of State for Wales
is also consulted. The Regional Chairmen appoint the members who are to sit at a particular hearing and there must be a legal member, a medical member and a lay member appointed for each Tribunal hearing.
are properly observed and advising on any questions of law which may arise. He or she is also responsible, in consultation with other members of the Tribunal, for drafting the reasons for the decision, and for signing the record of the decision. The legal members are required to have "such legal experience, as the Lord Chancellor
considers suitable". They are normally senior practitioners, but in 'restricted patient' cases, must be Circuit Judges, or one of a small number of Recorders, who are also Queen's Counsel
.
The Tribunal will consider the case and the patient as presented on the day. The Tribunal cannot question the circumstances that gave rise to the detention. The Tribunal decides whether or not to end the patient's detention in hospital. The Tribunal has the power to order a deferred discharge which may be conditional (for example that an aftercare package is put in place).
Decisions of the Tribunal can be appealed in the High Court, usually by way of Judicial Review.
and Manchester
. Regional Chairmen's responsibilities include appointing members to particular hearings, ensuring that all the statutory requirements are complied with, making judicial decisions and giving such directions as are necessary to ensure the speedy and just determination of every case. Regional Chairmen are also responsible for organising training for members, for overseeing the members' appraisal and mentoring scheme and for handling complaints about a member's conduct.
is responsible for meeting the expenses of Tribunals in England
and for providing accommodation and staff. Administration is carried out at the Secretariat offices in Leicester
. The Welsh Assembly has similar responsibilities for Tribunals in Wales
and administration is carried out at the Secretariat office in Cardiff
. All the Secretariat staff are civil servants and are completely independent of the hospital authorities. The Regional Chairmen and the Secretariat work closely together to make sure that the whole Tribunal process is closely managed. The role of the Home Office
is confined to cases involving 'restricted patients'.
Tribunals operate independently of all Government Departments.
Non-departmental public body
In the United Kingdom, a non-departmental public body —often referred to as a quango—is a classification applied by the Cabinet Office, Treasury, Scottish Government and Northern Ireland Executive to certain types of public bodies...
, which exist to protect the rights of persons subject to the Mental Health Act 1983
Mental Health Act 1983
The Mental Health Act 1983 is an Act of the Parliament of the United Kingdom which applies to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters...
in England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
and Wales
Wales
Wales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...
in the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
. Essentially, it provides for consideration of appeals against detention in hospital made by people thus detained
Involuntary commitment
Involuntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a hospital or in the community ....
.
The bodies
The first body is a Judicial Tribunal with the responsibility for hearing applications or references concerning people detained under the Mental Health Act 1983Mental Health Act 1983
The Mental Health Act 1983 is an Act of the Parliament of the United Kingdom which applies to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters...
. The Tribunal members are appointed by the Ministry of Justice
Ministry of Justice (United Kingdom)
The Ministry of Justice is a ministerial department of the UK Government headed by the Secretary of State for Justice and Lord Chancellor, who is responsible for improvements to the justice system so that it better serves the public...
. There is a Liaison Judge appointed to the Tribunal to lead its development.
The second body is the Mental Health Review Tribunal Secretariat. This is staffed by members of the Department of Health
Department of Health (United Kingdom)
The Department of Health is a department of the United Kingdom government with responsibility for government policy for health and social care matters and for the National Health Service in England along with a few elements of the same matters which are not otherwise devolved to the Scottish,...
, and has responsibility for the administration of the Tribunals.
The judicial tribunals
Mental Health Review Tribunals are independent judicial bodies that operate under the provisions of the Mental Health Act 1983Mental Health Act 1983
The Mental Health Act 1983 is an Act of the Parliament of the United Kingdom which applies to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters...
and the Mental Health Review Tribunal Rules 1983. A Tribunal's main purpose is to review the case of a patient detained under the Mental Health Act
Mental Health Act 1983
The Mental Health Act 1983 is an Act of the Parliament of the United Kingdom which applies to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters...
and to direct the discharge of any patient for whom the statutory criteria for discharge have been satisfied. In some cases, the Tribunal also has the discretion to discharge a patient who does not meet the statutory criteria. Such cases usually involve making a balanced judgement on a number of serious issues such as the freedom of the individual, the protection of the public and the best interests of the patient.
Tribunal members
The Lord ChancellorLord Chancellor
The Lord High Chancellor of Great Britain, or Lord Chancellor, is a senior and important functionary in the government of the United Kingdom. He is the second highest ranking of the Great Officers of State, ranking only after the Lord High Steward. The Lord Chancellor is appointed by the Sovereign...
makes appointments to the panels of members for each region. In the case of medical and lay members, the Secretary of State for Health
Secretary of State for Health
Secretary of State for Health is a UK cabinet position responsible for the Department of Health.The first Boards of Health were created by Orders in Council dated 21 June, 14 November, and 21 November 1831. In 1848 a General Board of Health was created with the First Commissioner of Woods and...
(for cases in England) or the Secretary of State for Wales
Secretary of State for Wales
The Secretary of State for Wales is the head of the Wales Office within the British cabinet. He or she is responsible for ensuring Welsh interests are taken into account by the government, representing the government within Wales and overseeing the passing of legislation which is only for Wales...
is also consulted. The Regional Chairmen appoint the members who are to sit at a particular hearing and there must be a legal member, a medical member and a lay member appointed for each Tribunal hearing.
Role of the legal member
The legal member's role is to preside (i.e. take the chair) at Tribunal hearings. His or her responsibilities also include making sure that the proceedings are conducted fairly, that the legal requirements of the Mental Health Act 1983Mental Health Act 1983
The Mental Health Act 1983 is an Act of the Parliament of the United Kingdom which applies to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters...
are properly observed and advising on any questions of law which may arise. He or she is also responsible, in consultation with other members of the Tribunal, for drafting the reasons for the decision, and for signing the record of the decision. The legal members are required to have "such legal experience, as the Lord Chancellor
Lord Chancellor
The Lord High Chancellor of Great Britain, or Lord Chancellor, is a senior and important functionary in the government of the United Kingdom. He is the second highest ranking of the Great Officers of State, ranking only after the Lord High Steward. The Lord Chancellor is appointed by the Sovereign...
considers suitable". They are normally senior practitioners, but in 'restricted patient' cases, must be Circuit Judges, or one of a small number of Recorders, who are also Queen's Counsel
Queen's Counsel
Queen's Counsel , known as King's Counsel during the reign of a male sovereign, are lawyers appointed by letters patent to be one of Her [or His] Majesty's Counsel learned in the law...
.
Role of the medical member
The medical member has a dual role to perform. They are required by the Tribunal Rules to carry out an examination of the patient before the hearing and to take any steps that they consider necessary to form an opinion of the patient's mental condition. At the hearing they, together with the other members, have the judicial responsibility of deciding whether or not the patient should continue to be detained. If the medical member's opinion of the patient differs significantly from other medical witnesses then this should be made known at the beginning of the hearing. This is because it would be unfair and contrary to a basic principle of natural justice if the Tribunal members were to take notice of information that had not been shared with all the other parties at the hearing. The medical member is invariably a consultant psychiatrist of several years' standing. He or she will be able to advise the other members of the Tribunal on any medical matters.Role of the lay member
The lay member provides balance to the Tribunal as a representative of the community outside the legal and medical professions. Most of them will have a background of practical experience of working in the health and welfare fields in the NHS, voluntary organisations or private health sector.Course of the tribunal
Tribunals normally sit in private and take place in the hospital or community unit where the patient is detained. Physical location aside, the tribunals resemble court hearings, during which appropriate witnesses are invited to speak in turn. These include the detained person, his or her solicitor, the member of the multi-disciplinary team responsible for the detained person's care in hospital, known as the Responsible Clinician or RC (usually a consultant psychiatrist), a representative of the nursing staff at the hospital and the Approved Mental Health Professional (AMHP). Additionally, the RC and AMHP (or more frequently the patient's care coordinator) are required to submit written reports on the person's state of health to the Tribunal in advance of the hearing. Sometimes the primary inpatient nurse for the patient may also submit a written report.How the decision is made
Each member of the Tribunal is entitled to an equal voice on questions of law, procedure and substance. All the members participate in the making of decisions and, although the legal member is expected to draft and sign the written record, this is done only after taking into account the contributions of the other members. If the members do not all agree then a decision of the majority of members of the Tribunal is taken as the decision of the Tribunal.The Tribunal will consider the case and the patient as presented on the day. The Tribunal cannot question the circumstances that gave rise to the detention. The Tribunal decides whether or not to end the patient's detention in hospital. The Tribunal has the power to order a deferred discharge which may be conditional (for example that an aftercare package is put in place).
Decisions of the Tribunal can be appealed in the High Court, usually by way of Judicial Review.
Regional chairmen
There is a Regional Chairman appointed for each of the two Tribunal regions (the North Region and the South Region), based in LondonLondon
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
and Manchester
Manchester
Manchester is a city and metropolitan borough in Greater Manchester, England. According to the Office for National Statistics, the 2010 mid-year population estimate for Manchester was 498,800. Manchester lies within one of the UK's largest metropolitan areas, the metropolitan county of Greater...
. Regional Chairmen's responsibilities include appointing members to particular hearings, ensuring that all the statutory requirements are complied with, making judicial decisions and giving such directions as are necessary to ensure the speedy and just determination of every case. Regional Chairmen are also responsible for organising training for members, for overseeing the members' appraisal and mentoring scheme and for handling complaints about a member's conduct.
Organisation of the Tribunal
The Secretary of State for HealthSecretary of State for Health
Secretary of State for Health is a UK cabinet position responsible for the Department of Health.The first Boards of Health were created by Orders in Council dated 21 June, 14 November, and 21 November 1831. In 1848 a General Board of Health was created with the First Commissioner of Woods and...
is responsible for meeting the expenses of Tribunals in England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
and for providing accommodation and staff. Administration is carried out at the Secretariat offices in Leicester
Leicester
Leicester is a city and unitary authority in the East Midlands of England, and the county town of Leicestershire. The city lies on the River Soar and at the edge of the National Forest...
. The Welsh Assembly has similar responsibilities for Tribunals in Wales
Wales
Wales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...
and administration is carried out at the Secretariat office in Cardiff
Cardiff
Cardiff is the capital, largest city and most populous county of Wales and the 10th largest city in the United Kingdom. The city is Wales' chief commercial centre, the base for most national cultural and sporting institutions, the Welsh national media, and the seat of the National Assembly for...
. All the Secretariat staff are civil servants and are completely independent of the hospital authorities. The Regional Chairmen and the Secretariat work closely together to make sure that the whole Tribunal process is closely managed. The role of the Home Office
Home Office
The Home Office is the United Kingdom government department responsible for immigration control, security, and order. As such it is responsible for the police, UK Border Agency, and the Security Service . It is also in charge of government policy on security-related issues such as drugs,...
is confined to cases involving 'restricted patients'.
Tribunals operate independently of all Government Departments.