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Mental Health Bill [HL]


Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

20

 

20B     

Effect of expiry of community treatment order

(1)   

A community patient shall be deemed to be discharged absolutely from

liability to recall under this Part of this Act, and the application for

admission for treatment cease to have effect, on expiry of the

community treatment order, if the order has not previously ceased to

5

be in force.

(2)   

For the purposes of subsection (1) above, a community treatment order

expires on expiry of the community treatment period as extended

under this Part of this Act, but this is subject to sections 21 and 22

below.”

10

(4)   

Schedules 3 and 4 (which contain further amendments) have effect.

26      

Relationship with leave of absence

(1)   

The 1983 Act is amended as follows.

(2)   

In section 17 (leave of absence from hospital), after subsection (2) insert—

“(2A)   

But longer-term leave may not be granted to a patient unless the

15

responsible clinician first considers whether the patient should be dealt

with under section 17A instead.

(2B)   

For these purposes, longer-term leave is granted to a patient if—

(a)   

leave of absence is granted to him under this section either

indefinitely or for a specified period of more than seven

20

consecutive days; or

(b)   

a specified period is extended under this section such that the

total period for which leave of absence will have been granted

to him under this section exceeds seven consecutive days.”

(3)   

In Part 2 of Schedule 1 (patients subject to special restrictions), in paragraph 3

25

after paragraph (a) insert—

“(aa)   

subsections (2A) and (2B) shall be omitted;”.

27      

Consent to treatment

(1)   

Part 4 of the 1983 Act (consent to treatment) is amended as follows.

(2)   

For section 56 substitute—

30

“56     

Patients to whom Part 4 applies

(1)   

Section 57 and, so far as relevant to that section, sections 59 to 62 below

apply to any patient.

(2)   

Subject to that, this Part of this Act applies to a patient only if he falls

within subsection (3) or (4) below.

35

(3)   

A patient falls within this subsection if he is liable to be detained under

this Act but not if—

(a)   

he is so liable by virtue of an emergency application and the

second medical recommendation referred to in section 4(4)(a)

above has not been given and received;

40

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

21

 

(b)   

he is so liable by virtue of section 5(2) or (4) or 35 above or

section 135 or 136 below or by virtue of a direction under section

37(4) above; or

(c)   

he has been conditionally discharged under section 42(2) above

or section 73 or 74 below and he is not recalled to hospital.

5

(4)   

A patient falls within this subsection if—

(a)   

he is a community patient; and

(b)   

he is recalled to hospital under section 17E above.”

(3)   

In section 61 (review of treatment), in subsection (1)—

(a)   

after “58(3)(b) above” insert “or section 62A below,”, and

10

(b)   

in paragraph (a) for “or 21B(2) above renewing the authority for the

detention” substitute “, 20A(4) or 21B(2) above in respect”.

(4)   

After section 62 insert—

“62A    

Treatment on recall of community patient or revocation of order

(1)   

This section applies where—

15

(a)   

a community patient is recalled to hospital under section 17E

above; or

(b)   

a patient is liable to be detained under this Act following the

revocation of a community treatment order under section 17F

above in respect of him.

20

(2)   

For the purposes of section 58(1)(b) above, the patient is to be treated as

if he had remained liable to be detained since the making of the

community treatment order.

(3)   

But section 58 above does not apply to treatment given to the patient

if—

25

(a)   

the certificate requirement is met (within the meaning of section

64C below); or

(b)   

as a result of section 64B(4) or 64E(4) below, the certificate

requirement would not apply (were the patient a community

patient not recalled to hospital under section 17E above).

30

(4)   

In a case where this section applies, the certificate requirement is met

only in so far as—

(a)   

the Part 4A certificate expressly provides that it is appropriate

for one or more specified forms of treatment to be given to the

patient in that case (subject to such conditions as may be

35

specified); or

(b)   

a notice having been given under subsection (4) of section 64H

below, treatment is authorised by virtue of subsection (7) of that

section.

(5)   

Subsection (4)(a) above shall not preclude the continuation of any

40

treatment, or of treatment under any plan, pending compliance with

section 58 above if the approved clinician in charge of the treatment

considers that the discontinuance of the treatment, or of the treatment

under the plan, would cause serious suffering to the patient.

(6)   

In a case where subsection (1)(b) above applies, subsection (3) above

45

only applies pending compliance with section 58 above.

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

22

 

(7)   

In subsection (4) above—

“Part 4A certificate” has the meaning given in section 64H below;

and

“specified”, in relation to a Part 4A certificate, means specified in

the certificate.”

5

28      

Authority to treat

(1)   

After Part 4 of the 1983 Act, insert the following Part—

“Part 4A

Treatment of community patients not recalled to hospital

64A     

Meaning of “relevant treatment”

10

In this Part of this Act “relevant treatment”, in relation to a patient,

means medical treatment which—

(a)   

is for the mental disorder from which the patient is suffering;

and

(b)   

is not treatment falling within section 57 above.

15

64B     

Adult community patients

(1)   

This section applies to the giving of relevant treatment to a community

patient who—

(a)   

is not recalled to hospital under section 17E above; and

(b)   

has attained the age of 16 years.

20

(2)   

The treatment may not be given to the patient unless—

(a)   

there is authority to give it to him; and

(b)   

if it is section 58 type treatment, the certificate requirement is

met.

(3)   

But the certificate requirement does not apply if—

25

(a)   

giving the treatment to the patient is authorised in accordance

with section 64G below; or

(b)   

the treatment is immediately necessary and—

(i)   

the patient has capacity to consent to it and does consent

to it; or

30

(ii)   

a donee or deputy or the Court of Protection consents to

the treatment on the patient’s behalf.

(4)   

Nor does the certificate requirement apply in so far as the

administration of medicine to the patient at any time during the period

of one month beginning with the day on which the community

35

treatment order is made is section 58 type treatment.

(5)   

The reference in subsection (4) above to the administration of medicine

does not include any form of treatment specified under section 58(1)(a)

above.

64C     

Section 64B: supplemental

40

(1)   

This section has effect for the purposes of section 64B above.

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

23

 

(2)   

There is authority to give treatment to a patient if—

(a)   

he has capacity to consent to it and does consent to it;

(b)   

a donee or deputy or the Court of Protection consents to it on his

behalf; or

(c)   

giving it to him is authorised in accordance with section 64D or

5

64G below.

(3)   

Relevant treatment is section 58 type treatment if, at the time when it is

given to the patient, section 58 above would have applied to it, had the

patient remained liable to be detained at that time (rather than being a

community patient).

10

(4)   

The certificate requirement is met in respect of treatment to be given to

a patient if—

(a)   

a registered medical practitioner appointed for the purposes of

Part 4 of this Act (not being the approved clinician in charge of

the treatment) has certified in writing that it is appropriate for

15

the treatment to be given or for the treatment to be given subject

to such conditions as may be specified in the certificate; and

(b)   

if conditions are so specified, the conditions are satisfied.

(5)   

Treatment is immediately necessary if—

(a)   

it is immediately necessary to save the patient’s life; or

20

(b)   

it is immediately necessary to prevent a serious deterioration of

the patient’s condition and is not irreversible; or

(c)   

it is immediately necessary to alleviate serious suffering by the

patient and is not irreversible or hazardous; or

(d)   

it is immediately necessary, represents the minimum

25

interference necessary to prevent the patient from behaving

violently or being a danger to himself or others and is not

irreversible or hazardous.

(6)   

Subsection (3) of section 62 above applies for the purposes of this

section as it applies for the purposes of that section.

30

64D     

Adult community patients lacking capacity

(1)   

A person is authorised to give relevant treatment to a patient as

mentioned in section 64C(2)(c) above if the conditions in subsections (2)

to (6) below are met.

(2)   

The first condition is that, before giving the treatment, the person takes

35

reasonable steps to establish whether the patient lacks capacity to

consent to the treatment.

(3)   

The second condition is that, when giving the treatment, he reasonably

believes that the patient lacks capacity to consent to it.

(4)   

The third condition is that—

40

(a)   

he has no reason to believe that the patient objects to being

given the treatment; or

(b)   

he does have reason to believe that the patient so objects, but it

is not necessary to use force against the patient in order to give

the treatment.

45

(5)   

The fourth condition is that—

 
 

Mental Health Bill [HL]
Part 1 — Amendments to Mental Health Act 1983
Chapter 4 — Supervised community treatment

24

 

(a)   

he is the approved clinician in charge of the treatment; or

(b)   

the treatment is given under the direction of that clinician.

(6)   

The fifth condition is that giving the treatment does not conflict with—

(a)   

an advance decision which he is satisfied is valid and

applicable; or

5

(b)   

a decision made by a donee or deputy or the Court of

Protection.

(7)   

In this section—

(a)   

reference to an advance decision is to an advance decision

(within the meaning of the Mental Capacity Act 2005) made by

10

the patient; and

(b)   

“valid and applicable”, in relation to such a decision, means

valid and applicable to the treatment in question in accordance

with section 25 of that Act.

64E     

Child community patients

15

(1)   

This section applies to the giving of relevant treatment to a community

patient who—

(a)   

is not recalled to hospital under section 17E above; and

(b)   

has not attained the age of 16 years.

(2)   

The treatment may not be given to the patient unless—

20

(a)   

there is authority to give it to him; and

(b)   

if it is section 58 type treatment, the certificate requirement is

met.

(3)   

But the certificate requirement does not apply if—

(a)   

giving the treatment to the patient is authorised in accordance

25

with section 64G below; or

(b)   

in a case where the patient is competent to consent to the

treatment and does consent to it, the treatment is immediately

necessary.

(4)   

Nor does the certificate requirement apply in so far as the

30

administration of medicine to the patient at any time during the period

of one month beginning with the day on which the community

treatment order is made is section 58 type treatment.

(5)   

The reference in subsection (4) above to the administration of medicine

does not include any form of treatment specified under section 58(1)(a)

35

above.

(6)   

For the purposes of subsection (2)(a) above, there is authority to give

treatment to a patient if—

(a)   

he is competent to consent to it and he does consent to it; or

(b)   

giving it to him is authorised in accordance with section 64F or

40

64G below.

(7)   

Subsections (3) to (6) of section 64C above have effect for the purposes

of this section as they have effect for the purposes of section 64B above.

(8)   

Regulations made by virtue of section 32(2)(d) above apply for the

purposes of this section as they apply for the purposes of Part 2 of this

45

Act.

 
 

 
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