This is one of the first questions that many people detained under the Mental Health Act (MHA) 1983 ask. If you are given medication or offered other treatment in hospital, can you refuse the treatment? What happens if you do?
What is the general position?
The general position is set out in section 63 of the MHA 1983. It states that when Part 4 of the MHA applies, the approved clinician can administer medical treatment for a patient’s mental disorder without the consent of the patient. This means that you can be given treatment for your mental disorder against your will if it is approved by the doctor.
When does Part 4 apply?
Simply put, under Part 4 of the MHA, treatment without consent can be given to patients detained under section 2, section 3 and the criminal detaining sections (usually section 37, section 37/41 and section 47/49). Treatment without consent cannot be given to patients detained under section 4, the holding powers under section 5 and to patients on a Community Treatment Order (CTO).
Are there any exceptions?
It all sounds pretty worrying. Does this mean that ‘anything goes’ if it is approved by the Doctor?
Thankfully, this is not the case. There are several safeguards built into the MHA 1983, setting out types of treatment which are not covered by the general position in section 63.
Section 57 details that neurosurgery, psychosurgery and implanting hormones to reduce male sex drive require both the consent of the patient and the second opinion of another doctor. Section 58 sets out that the ‘administration of medication after three months’ requires either the consent of the patient or a second opinion that the treatment is appropriate. Section 58A deals with Electro-convulsive therapy, which can only be administered with the consent of the patient.
Is that it?
Confusingly, no. Section 62 sets out the ‘urgent treatment’ provisions, which allow the doctors to override the safeguards in sections 57, 58 and 58A and administer these treatments without the consent of the patient. These include only the most extreme of situations, including where treatment is immediately necessary to save the patients life.
What does this mean for me?
If you are detained in hospital under the MHA 1983 the doctor does not require your consent for most common types of treatment, like medication.