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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

15

 

(2)   

In subsection (1)(a), after “wife” insert “or civil partner”.

(3)   

In subsection (5)—

(a)   

in paragraph (b) after “wife” insert “or civil partner”, and

(b)   

in paragraph (c) after “wife,” insert “civil partner,”.

(4)   

In subsection (6)—

5

(a)   

for “and “wife” include a person who is living with the patient as the

patient’s husband or wife” substitute “, “wife” and “civil partner”

include a person who is living with the patient as the patient’s husband

or wife or as if they were civil partners”, and

(b)   

for “unless the husband or wife” substitute “or a patient in a civil

10

partnership unless the husband, wife or civil partner”.

(5)   

In subsection (7)(b), for “unless the husband or wife” substitute “or a patient in

a civil partnership unless the husband, wife or civil partner”.

(6)   

In section 27 of the 1983 Act (children and young persons in care), after “wife”

insert “or civil partner”.

15

Chapter 4

Supervised community treatment

26      

Community treatment orders, etc

(1)   

The 1983 Act is amended as follows.

(2)   

After section 17 insert—

20

“17A    

Community treatment orders

(1)   

The responsible clinician may by order in writing discharge a detained

patient from hospital subject to his being liable to recall in accordance

with section 17E below.

(2)   

A detained patient is a patient who is liable to be detained in a hospital

25

in pursuance of an application for admission for treatment.

(3)   

An order under subsection (1) above is referred to in this Act as a

“community treatment order”.

(4)   

The responsible clinician may not make a community treatment order

unless—

30

(a)   

in his opinion, the relevant criteria are met; and

(b)   

an approved mental health professional states in writing—

(i)   

that he agrees with that opinion; and

(ii)   

that it is appropriate to make the order.

(5)   

The relevant criteria are—

35

(a)   

the patient is suffering from mental disorder of a nature or

degree which makes it appropriate for him to receive medical

treatment;

(b)   

it is necessary for his health or safety or for the protection of

other persons that he should receive such treatment;

40

 
 

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

16

 

(c)   

subject to his being liable to be recalled as mentioned in

paragraph (d) below, such treatment can be provided without

his continuing to be detained in a hospital;

(d)   

it is necessary for his health or safety or for the protection of

other persons that he should be liable to be recalled to hospital

5

for medical treatment; and

(e)   

appropriate medical treatment is available for him.

(6)   

In this Act—

“community patient” means a patient in respect of whom a

community treatment order is in force;

10

“the community treatment order”, in relation to such a patient,

means the community treatment order in force in respect of

him; and

“the responsible hospital”, in relation to such a patient, means the

hospital in which he was liable to be detained immediately

15

before the community treatment order was made, subject to

section 19A below.

17B     

Conditions

(1)   

A community treatment order shall specify conditions to which the

patient is to be subject while the order remains in force.

20

(2)   

But the order may only specify conditions which the approved mental

health professional mentioned in section 17A(4)(b) above agrees should

be specified.

(3)   

The conditions which may be specified include—

(a)   

a condition that the patient reside at a particular place;

25

(b)   

a condition that the patient make himself available at particular

times and places for the purposes of medical treatment;

(c)   

a condition that the patient receive medical treatment in

accordance with the responsible clinician’s directions;

(d)   

a condition that the patient make himself available for

30

examination (for the purposes, in particular, of section 20A(4)

below or of enabling a Part 4A certificate (within the meaning of

section 64H below) to be given in his case);

(e)   

a condition that the patient abstain from particular conduct.

(4)   

The responsible clinician may from time to time by order in writing

35

vary the conditions specified in a community treatment order.

(5)   

He may also suspend any conditions specified in a community

treatment order.

(6)   

If a community patient fails to comply with a condition specified in the

community treatment order, that fact may be taken into account for the

40

purposes of exercising the power of recall under section 17E(1) below.

(7)   

But nothing in this section restricts the exercise of that power to cases

where there is such a failure.

17C     

Duration of community treatment order

A community treatment order shall remain in force until—

45

 
 

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

17

 

(a)   

the period mentioned in section 20A(1) below (as extended

under any provision of this Act) expires, but this is subject to

sections 21 and 22 below;

(b)   

the patient is discharged in pursuance of an order under section

23 below or a direction under section 72 below;

5

(c)   

the application for admission for treatment in respect of the

patient otherwise ceases to have effect; or

(d)   

the order is revoked under section 17F below,

whichever occurs first.

17D     

Effect of community treatment order

10

(1)   

The application for admission for treatment in respect of a patient shall

not cease to have effect by virtue of his becoming a community patient.

(2)   

But while he remains a community patient—

(a)   

the authority of the managers to detain him under section 6(2)

above in pursuance of that application shall be suspended; and

15

(b)   

reference (however expressed) in this or any other Act, or in any

subordinate legislation (within the meaning of the

Interpretation Act 1978), to patients liable to be detained, or

detained, under this Act shall not include him.

(3)   

And section 20 below shall not apply to him while he remains a

20

community patient.

(4)   

Accordingly, authority for his detention shall not expire during any

period in which that authority is suspended by virtue of subsection

(2)(a) above.

17E     

Power to recall to hospital

25

(1)   

The responsible clinician may recall a community patient to hospital if

in his opinion—

(a)   

the patient requires medical treatment in hospital for his mental

disorder; and

(b)   

there would be a risk of harm to the health or safety of the

30

patient or to other persons if the patient were not recalled to

hospital for that purpose.

(2)   

The responsible clinician may also recall a community patient to

hospital if the patient fails to comply with a condition imposed under

section 17B(3)(d) above.

35

(3)   

The hospital to which a patient is recalled need not be the responsible

hospital.

(4)   

Nothing in this section prevents a patient from being recalled to a

hospital even though he is already in the hospital at the time when the

power of recall is exercised; references to recalling him shall be

40

construed accordingly.

(5)   

The power of recall under subsections (1) and (2) above shall be

exercisable by notice in writing to the patient.

(6)   

A notice under this section recalling a patient to hospital shall be

sufficient authority for the managers of that hospital to detain the

45

patient there in accordance with the provisions of this Act.

 
 

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

18

 

17F     

Powers in respect of recalled patients

(1)   

This section applies to a community patient who is detained in a

hospital by virtue of a notice recalling him there under section 17E

above.

(2)   

The patient may be transferred to another hospital in such

5

circumstances and subject to such conditions as may be prescribed in

regulations made by the Secretary of State (if the hospital in which the

patient is detained is in England) or the Welsh Ministers (if that hospital

is in Wales).

(3)   

If he is so transferred to another hospital, he shall be treated for the

10

purposes of this section (and section 17E above) as if the notice under

that section were a notice recalling him to that other hospital and as if

he had been detained there from the time when his detention in

hospital by virtue of the notice first began.

(4)   

The responsible clinician may by order in writing revoke the

15

community treatment order if—

(a)   

in his opinion, the conditions mentioned in section 3(2) above

are satisfied in respect of the patient; and

(b)   

an approved mental health professional states in writing—

(i)   

that he agrees with that opinion; and

20

(ii)   

that it is appropriate to revoke the order.

(5)   

The responsible clinician may at any time release the patient under this

section, but not after the community treatment order has been revoked.

(6)   

If the patient has not been released, nor the community treatment order

revoked, by the end of the period of 72 hours, he shall then be released.

25

(7)   

But a patient who is released under this section remains subject to the

community treatment order.

(8)   

In this section—

(a)   

“the period of 72 hours” means the period of 72 hours beginning

with the time when the patient’s detention in hospital by virtue

30

of the notice under section 17E above begins; and

(b)   

references to being released shall be construed as references to

being released from that detention (and accordingly from being

recalled to hospital).

17G     

Effect of revoking community treatment order

35

(1)   

This section applies if a community treatment order is revoked under

section 17F above in respect of a patient.

(2)   

Section 6(2) above shall have effect as if the patient had never been

discharged from hospital by virtue of the community treatment order.

(3)   

The provisions of this or any other Act relating to patients liable to be

40

detained (or detained) in pursuance of an application for admission for

treatment shall apply to the patient as they did before the community

treatment order was made, unless otherwise provided.

 
 

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

19

 

(4)   

If, when the order is revoked, the patient is being detained in a hospital

other than the responsible hospital, the provisions of this Part of this

Act shall have effect as if—

(a)   

the application for admission for treatment in respect of him

were an application for admission to that other hospital; and

5

(b)   

he had been admitted to that other hospital at the time when he

was originally admitted in pursuance of the application.

(5)   

But, in any case, section 20 below shall have effect as if the patient had

been admitted to hospital in pursuance of the application for admission

for treatment on the day on which the order is revoked.”

10

(3)   

After section 20 (the cross-heading immediately above which becomes

“Duration of authority and discharge”) insert—

“20A    

Community treatment period

(1)   

Subject to the provisions of this Part of this Act, a community treatment

order shall cease to be in force on expiry of the period of six months

15

beginning with the day on which it was made.

(2)   

That period is referred to in this Act as “the community treatment

period”.

(3)   

The community treatment period may, unless the order has previously

ceased to be in force, be extended—

20

(a)   

from its expiration for a period of six months;

(b)   

from the expiration of any period of extension under paragraph

(a) above for a further period of one year,

   

and so on for periods of one year at a time.

(4)   

Within the period of two months ending on the day on which the order

25

would cease to be in force in default of an extension under this section,

it shall be the duty of the responsible clinician—

(a)   

to examine the patient; and

(b)   

if it appears to him that the conditions set out in subsection (6)

below are satisfied, to furnish to the managers of the

30

responsible hospital a report to that effect in the prescribed

form.

(5)   

Where such a report is furnished in respect of the patient, the managers

shall, unless they discharge him under section 23 below, cause him to

be informed.

35

(6)   

The conditions referred to in subsection (4) above are that—

(a)   

the patient is suffering from mental disorder of a nature or

degree which makes it appropriate for him to receive medical

treatment;

(b)   

it is necessary for his health or safety or for the protection of

40

other persons that he should receive such treatment;

(c)   

subject to his continuing to be liable to be recalled as mentioned

in paragraph (d) below, such treatment can be provided

without his being detained in a hospital;

(d)   

it is necessary for his health or safety or for the protection of

45

other persons that he should continue to be liable to be recalled

to hospital for medical treatment; and

 
 

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

20

 

(e)   

appropriate medical treatment is available for him.

(7)   

Before furnishing a report under subsection (4) above the responsible

clinician shall consult one or more other persons who have been

professionally concerned with the patient’s medical treatment.

(8)   

Where a report is duly furnished under subsection (4) above, the

5

community treatment period shall be thereby extended for the period

prescribed in that case by subsection (3) above.

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

10

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

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

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

15

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

below.”

(4)   

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

27      

Relationship with leave of absence

(1)   

The 1983 Act is amended as follows.

20

(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

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—

25

(a)   

leave of absence is granted to him under this section either

indefinitely or for a specified period of more than seven

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

30

to him under this section exceeds seven consecutive days.”

(3)   

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

after paragraph (a) insert—

“(aa)   

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

28      

Consent to treatment

35

(1)   

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

(2)   

For section 56 substitute—

“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.

40

 
 

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

21

 

(2)   

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

within subsection (3) or (4) below.

(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

5

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

above has not been given and received;

(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

10

(c)   

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

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

(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.”

15

(3)   

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

(a)   

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

(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—

20

“62A    

Treatment on recall of community patient or revocation of order

(1)   

This section applies where—

(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

25

revocation of a community treatment order under section 17F

above in respect of him.

(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.

30

(3)   

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

if—

(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

35

requirement would not apply (were the patient a community

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

(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

40

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

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

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

45

section.

 
 

 
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