Legal Matters
This section explains some of the laws (Acts of Parliament) which deal with mental health and carers. These laws can be complicated to understand and you may never have any dealings with them. But they are important, and there are carers support workers and rights workers who will help you to understand how these laws affect you, if you do need to find out more.
The Mental Health Act 1983
Sometimes people may believe they are not ill, despite what their doctor says. So they may refuse to go into hospital when actually quite poorly. If they do not receive treatment, their condition will get worse. They may become a danger to themselves (perhaps because they are not looking after themselves) or a danger to other people (perhaps they mistakenly believe someone is trying to persecute them). In the opinion of medical experts, hospital is the best place for them to get better.
Under the Mental Health Act a person can be admitted to hospital against their will (involuntarily). This is called 'sectioning' because different sections of the Act can be used in different circumstances. This happens only in the most severe cases, and it means the person is not free to leave the hospital until the doctors believe they are well enough. The different sections are described next.
Section 4:
Lasts 72 hours (3 days). This is an emergency assessment which usually the family doctor puts into place. It allows the hospital to assess the person to see what treatment they might need and if they might need to spend longer in hospital.
Section 2:
Lasts 28 days. This allows the hospital a longer period of time to assess someone. Two doctors need to put this into place, one of whom must have special psychiatric knowledge.
Section 3:
Last for up to six months. This allows the hospital to treat a person, usually with drugs, to make them better.
Section 136:
This section allows a police officer to take a person suspected of being a danger to themselves or other people from a public place to a 'place of safety' which is usually a hospital. At the hospital, the person can be assessed by a doctor and approved social worker. This must be done within 72 hours.
Patients and relatives have the right to appeal against these sections, either to the Hospital Managers or in some cases before a Mental Health Review Tribunal. The hospital will be able to tell you about the appeal procedures.
Rights under law
One of the problems involved in caring for someone with a mental health problem is knowing where to get help. You and your parent are entitled to help under law. We shall look at how to access this help next.
Background to the NHS and Community Care Act 1990
You may have seen films about asylums or mental institutions which could have influenced the way you feel about mental illness. People could spend a long time there without really improving their health. As attitudes changed about how to treat mental illness and more effective medication became available, it was felt people would benefit by recovering from illness back in the community, amongst familiar faces, supported by a team of professionals. The NHS and Community Care Act covers the ways this should be handled.
What is Community Care?
It means that given the right level of support, people recovering from illness can live independently for as long as possible in their own homes. Social Services now have legal duty to assess people's need for community care (this means seeing what support people need) and provide this support. So what are you and your parent entitled to?
Coming out of hospital
People leaving hospital should have an aftercare plan. This plan should help them find their feet after their stay in hospital by looking at their health (e.g. medication), social (e.g. work training or attending day centres) or housing needs. The person leaving hospital should be consulted about the plan, and a keyworker (either a social worker or doctor or nurse) will be responsible for co-ordinating the care.
Contact with a psychiatrist
It could be that your parent has never been to hospital, but perhaps has seen as psychiatrist. Under the Care Programme Approach everyone who has been in contact with the specialist psychiatric services, whether they have been admitted to hospital or not, is entitled to a care plan. Again a keyworker will be appointed to manage the delivery of care.
Difficulty Coping?
It could be that you are helping to look after a parent who has never been in hospital or in touch with the psychiatric services, and you are finding it hard to cope. Perhaps the family doctor is not being helpful. Under section 47 of the NHS and Community Care Act anyone who needs health or social care is entitled to be assessed by social services. This is called Care Management and will involve a care plan and will be looked after by a care manager or a keyworker .
Carers (Recognition and Services) Act 1995
This is the first time carers have been recognised in law. It is now widely recognised that carers play an important role in looking after relatives. This act hopes to ensure that carers (including young carers) are supported as much as possible and not left on their own to cope. Under the Act, if a carer who is providing 'regular and substantial' help asks for an assessment of their needs from social services, then social services have a duty to carry out an assessment. The word 'assessment' sounds a bit scary, like a test, but it is actually a way to gather information. So a social worker will visit you and ask you about what things you do as a carer, and how you feel about the situation at home. As a result, extra services may be introduced to help your family which should take the load off you a bit. You can choose to see the social worker on your own or with someone else present. This is another way to access help. Telephoning social services, or indeed anyone outside of the family, can be a hard thing to do. You may want to keep problems to yourself. It may be difficult for you to talk about your parent to someone else. But it is worth knowing that there are people who can help you and there are laws to protect you. You don't
have to go through this on your own.
Introduction
What is mental health?
Living with mental health problems
What about me?
Treatment
Who can help
Legal matters
And finally....
Useful addresses and telephone numbers
