Chapter 9
Mental Health Nursing
A The Legal Perspective
Michael Gunn and M.E. Rodgers
Whilst there are many issues which face nurses working with people with mental
illness or a learning difficulty, this chapter will consider what are perhaps the more
commonly encountered problems, in addition to looking at some of the future
developments for this area of practice. The chapter will therefore deal with:
treatment under the Mental Health Act 1983 #MHA) [1]; treatment falling outside
that Act; the use of the nurse's holding powers under section 5#4) of the MHA; the
care and management of violent or aggressive patients; the debate on compulsory
detention of individuals with personality disorders; and treatment in the
community. Readers should be aware that a comprehensive review of the MHA is
in progress, however legislation is unlikely to be forthcoming until 2002 at the
earliest [2].
9.1 Treatment under the Mental Health Act Michael Gunn and M.E. Rodgers
Treatment for mental disorder may lawfully be given under the MHA provided the
patient is detained under the Act by means of a non-emergency section. It is
important to stress that treatment for physical problems is not under consideration
here.
If nurses are to be involved in the treatment of a patient, they must first be able to
satisfy themselves whether the patient is detained under a relevant section. The
Fifth Biennial Report of the Mental Health Act Commission [3] stressed the
importance of the nurses' role, and it is the nurses' legal and ethical input to this
area of law which will be covered in this chapter.
9.1.1 First stage: is the patient a detained patient?
Anurse must be able to make sure that the appropriate detention documentation
for a non-emergency section is present in the patient's ward file. The nurse is,
therefore, looking for documentation which indicates that the patient is detained
under any of the following:
. section 2 #for assessment including medical treatment);
. section 3 #for treatment);