When is a Mental Health Act assessment required?

When a person is thought to be suffering from a mental disorder and is considered to pose a risk to themselves or others, an assessment under the Mental Health Act (MHA) may be arranged.

The purpose of the assessment is to consider whether it is necessary to detain a person in hospital under a section of the MHA. A person will only be detained under the MHA if their care and treatment can no longer be provided safely in the community, and they are unwilling (or unable) to agree to go into hospital (or stay in hospital) voluntarily.

A person may need to have a MHA assessment if:

• There is a rapid and serious deterioration in their mental health; or
• There is a gradual decline over a longer period which has reached a critical point; and
• The person or those around them are at significant risk of harm because of their current mental health needs.

If you are not the clinical team leader, team manager or senior worker, you must discuss the referral with a senior team member to rule out alternative support or treatment options before making a referral. For example:

• Have you considered and discussed with the person an informal admission to hospital?
• Has an enhanced or extended care plan been implemented to avoid hospital admission?
• Have all physical health causes for presenting symptoms been ruled out (blood or urine tests, for example)?
• Have you considered a referral for a care needs assessment, carer’s assessment or additional support?
• Have you considered using Mental Capacity Act provisions, such as Lasting Power of Attorney or Court Appointed Deputy for Health and Welfare – any advanced decisions or issues around capacity and consent to admission or other treatment plans?
• Have all lesser restrictive alternatives to admission been considered in line with the guiding principles of the Mental Health Act?
• Have you considered the views of the person, their carers or family in making decisions around care and treatment?