Q1: What is the purpose of the Mental Health Commission's Reference Guide on The Mental Health Act 2001?
The Mental Health Commission's Reference Guide is written to provide a clear and practical understanding of the major objectives and requirements of the Mental Health Act 2001, as at 26th August 2005.
As there may be future amendments to the legislation, in response to advances in treatment of mental disorders and to developments in service delivery systems, the Reference Guide may be subject to updates. Therefore, if you download the Reference Guide for use it is your responsibility to check the Mental Health Commission website on a regular basis for updates as the Mental Health Commission can not be responsible for any out of date information. If you wish to be notified via email of any future changes to the Reference Guide please send your contact details with a brief message to firstname.lastname@example.org.
This Reference Guide should not be relied on as a legal interpretation of the Mental Health Act 2001. It is not intended to be a complete or authoritative statement of the law and is not intended as legal advice or advice of any type. It is a Reference Guide only and must be read in conjunction with the provisions of the Mental Health Act 2001, any regulations made there under and any other relevant legislation.
The Minister for Health and Children signed the commencement order in relation to sections 1 to 5 and 7 (Part 1), and sections 31 to 55 (Part 3) of the Mental Health Act 2001 in April 2002. These sections refer primarily to the establishment of the Mental Health Commission and the appointment of the inspectorate of the mental health services by the Commission.
The Commission is committed to implementing the remaining parts of the Mental Health Act, 2001.
Q2: What does the GP Assessment for the FORM 5 Recommendation involve?
Answer: The registered medical practitioner must carry out an examination of the person who is the subject of the application. The examination should be carried out as soon as is practicable and, in any event, must be carried out within 24 hours of the application being made. The registered medical practitioner must, in particular, examine the process and content of thought, the mood and the behaviour of the person concerned. (Section 2, Mental Health Act, 2001).
Q3: Should the GP let the patient know about their involuntary admission?
Answer: The registered medical practitioner is obliged to inform the person of the purpose of the examination unless to do so would, in the opinion of the registered medical practitioner, be prejudicial to the person's mental health, well-being or emotional condition. That the person was so informed must be confirmed by the registered medical practitioner on FORM 5 (Recommendation (by a Registered Medical Practitioner) for involuntary admission of an adult to an approved centre). (Section 10, Mental Health Act, 2001).
Q4: Should the GP give a copy of Form 5 to the applicant?
Answer: A copy of the recommendation must be given to the applicant (Section 10 (4), Mental Health Act, 2001). The Mental Health Commission has designed FORM 5 (Recommendation (by a Registered Medical Practitioner) for involuntary admission of an adult to an approved centre) in duplicate form, which will facilitate the registered medical practitioner giving a copy of the recommendation to the applicant.
Q5: If a GP refuses an involuntary admission to an applicant, can the applicant get a second opinion and does the applicant need to let the second GP know regarding previous refusal?
Answer: An applicant may seek a second opinion where a registered medical practitioner refuses to make a recommendation to admit a patient involuntarily to an Approved Centre. It is vital to note that any applicant, whether making an initial application or applying for a second opinion, is obliged by law to inform the registered medical practitioner from whom he seeks the recommendation or second opinion of the facts relating to the previous application and its refusal in so far as they are aware of them, as well as the facts relating to any other application and its refusal made previously in relation to that person, as far as they are aware of them. Failure to do this is an offence. (Section 11, Mental Health Act 2001).
Q6: Who is responsible for removing the patient to the Approved Centre in case of involuntary admission?
The applicant is responsible for arranging the removal of the patient, the subject of the recommendation to the Approved Centre. Where the applicant is unable to make such arrangements, the registered medical practitioner who made the recommendation must request the clinical director of the Approved Centre specified in the recommendation (or a consultant psychiatrist acting on his or her behalf) to arrange for members of staff of the Approved Centre concerned to remove the person to that centre. The assistance of the Garda Síochána may be requested (Section 13.3) if the clinical director of the Centre (or a consultant psychiatrist acting on his or her behalf) and the relevant registered medical practitioner are of the opinion that there is a serious likelihood of the person concerned causing immediate and serious harm to self or others. The Gardaí are obliged to assist members of staff of the Approved Centre in the removal of the person to the centre concerned.
Under Section 12 of the Act
Members of the Gardaí are empowered to enter, by force if necessary, any premises where they think the person concerned may be and may, if necessary detain and take into custody the person. Where a member of the Gardai takes a person into custody under (section12.1) he or she or any other member of the Garda shall make an application forthwith in a form specified FORM 3 to a registered medical practitioner for a recommendation. If a recommendation is made for involuntary admission to an Approved Centre a member of the Gardaí shall remove the person to the Approved Centre specified in the recommendation. (Section 12.5)
Assisted Admission Service
Nationwide Health Solutions Ltd was contracted by the Health Service Executive to provide an Assisted Admissions Service for the involuntary admission of patients to approved centres under the Mental Health Act 2001. The Assisted Admissions Service commenced in November 2006 and is fully funded by the HSE.
The Assisted Admissions Service is based in Naas, Co Kildare and so has the ability to respond in a timely manner to requests for service. The Assisted Admissions team consists of three Mental Health nurses and one driver. The service is available 24 hours a day all year round. The service is nationwide.
Should you have any queries in relation to the service, please contact the numbers below. The 24 hour phone number for the Assisted Admissions Service is 086 8565848. The Fax number is 045 898653.
Q7: What is the role of the psychiatric nurse in the admission process?
Section 14(2) of the Mental Health Act 2001states that -"A consultant psychiatrist, a medical practitioner or a registered nurse on the staff of the Approved Centre shall be entitled to take charge of the person concerned and detain him or her for a period not exceeding 24 hours (or such shorter period as may be prescribed after consultation with the Commission) for the purpose of carrying out an examination under subsection (1) or, if an admission order is made or refused in relation to the person during that period, until it is granted or refused."
Q8: Do the Gardaí receive any training in the area of mental health?
The Mental Health Commission has been working closely over the past year with representatives from the Garda training college with regard to the provision of training on the Mental Health Act, 2001. A mental health awareness programme is in place for student Gardaí and also at in-service level.
Q9: Are patients entitled to a second opinion if the initial application is refused?
If an application for a recommendation has been refused, the applicant can apply for a recommendation in respect of the same person from another registered medical practitioner.
It is vital to note that any applicant, whether making an initial application or applying for a second opinion, is obliged by law to inform the registered medical practitioner from whom he seeks the recommendation or second opinion of the facts relating to the previous application and its refusal in so far as they are aware of them, as well as the facts relating to any other application and its refusal made previously in relation to that person, as far as they are aware of them. Failure to do this is an offence.
Q10: Is there a difference in the admission process of private vs. GMS patients?
The admission process is the same for all persons who require an involuntary admission to an approved centre regardless of where that service is being provided i.e. Independent Sector or by the Health Service Executive.
Q11: Who makes up the Mental Health Tribunal and how does it operate?
The Mental Health Commission appoints three members to sit on a Mental Health Tribunal. The members will consist of a practising barrister or solicitor, who has been in practice for not less than seven years immediately prior to appointment, who will act as Chairperson, a consultant psychiatrist (retired consultant psychiatrists are eligible for appointment within seven years of their retirement), and a person other than a barrister, solicitor, consultant psychiatrist, registered medical practitioner or registered nurse. Each member of the tribunal has a vote and decisions are determined by a majority of votes. This means that the decision of the tribunal operates on a majority basis rather than one person having a decisive vote.
The information above was provided by the Mental Health Commission.