21st May 2004: Department of Health response to The Bad Ischl Declaration

We have received a response from the Department of Health to the ESMHD Bad Ischl Declaration:

Thank you for your letter of 22nd April 2004 regarding the Bad Ischl Declaration of the ESMHD 2003 Congress. The Secretary of State has asked me to reply on his behalf.

S13(2) of the Mental Health Act 1983 places a duty on approved social workers, when making an application for a patient's admission for assessment and/or treatment or guardianship, to interview the patient in a suitable manner to satisfy himself that detention is the most appropriate way to ensure that the patient obtains the care that he needs. Those patients involved in the management of deaf psychiatric patients should either have the use of an interpreter or a fluency in British Sign Language.

Chapter 14 of the Code of Practice to the Mental Health Act 1983 states that, under s132, the Hospital Managers must ensure that all detained patients are given and understand:

1. specific information as soon as is practicable after their admission;
2. particular information in so far as it is relevant to the patient.

Hospital Managers should ensure that:

1. the correct information is given to the patient;
2. the information is given in a suitable manner and at a suitable time and in accordance with the requirements of the law;
3. the member of staff who is to give information has received sufficient training and guidance and is identified in relation to each detained patient;
4. a record is kept of the information given, including how, when, where and by whom it was given;
5. a regular check is made that information has properly given to each detained patient, and understood by them.

Specifically, with regard to consent to treatment, Hospital Managers should inform the patient;

• of the nature, purpose and likely effects of the treatment which is planned;
• of their rights to withdraw their consent to treatment at any time and of the need for consent to be given to any further treatment;
• how and when treatment can be given without their consent, including by the second opinion process and when treatment has begun if stopping it would cause serious suffering to the patient.

Also, with regard to information on detention, renewal and discharge;

• of the provisions of the Act under which they are detained, and the reasons for their detention;
• that they will not automatically be discharged when the current period of detention ends;
• that their detention will not automatically be renewed when the current period of detention ends;
• of their right to have their views about their continued detention or discharge considered before any decision is made.

In addition, patients and their nearest relative must be informed about the Mental Health Review Tribunal and the Mental Health Act Commission (MHAC).

In our updating of the mental health legislation, we have been at pains to ensure that this kind of safeguard is strengthened and feel confident that current and future legislation in this country reflects the spirit of the declaration.

I hope this is helpful.

Yours sincerely,

Bob McDonald
Senior Policy Advisor
Mental Health

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