Assessing the mental health needs of older people

Further information

Books and reports

Audit Commission (2000) Forget-me-not: mental health services for older people, London: Audit Commission.

Easterbrook, L (2003) Moving on from community care: The treatment, care and support of older people in England, London: Age Concern

Jones, R. M. (2004) Mental Health Act Manual, 9th edition, London: Sweet & Maxwell.

Lingard, J and Milne, A (2004) Integrating older people's mental health services: Community mental health teams for older people , London: Department of Health.

Mental Health Act Commission (2003) Tenth Biennial Report 2001-2003: Placed among strangers - twenty years of the Mental Health Act 1983 and future prospects for psychiatric compulsion, London: The Stationery Office.

J. Moriarty and S. Webb (2000) Part of their lives: Community care for older people with dementia, Bristol: The Policy Press.


Alzheimer's Society: information about dementia, treatments and services:

Institute of Mental Health Act Practitioners: specialist website on the law run by a lawyer for information on law and policy issues

MIND: information on law and policy issues and campaigns (not specialists in older people)

The Mental Health Foundation: excellent, accessible information on services, policy and the law

Department of Health: for general information on policy, government reports and reviews of the impact of policy

For general information on a wide range of policies and services of relevance to older people, see the websites of Help the Aged and Age Concern

Mental Health Act (1983) England and Wales: Key Sections and Grounds for Detention

Major sections of the Mental Health Act (1983)

Major sections of the Mental Health Act (1983)

Section 1

Section 1 of the Act outlines its remit thus: 'the reception, care and treatment of mentally disordered patients, the management of their property and other related matters'. It also defines 'mental disorder' as: 'mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind'. Most Sections are applied for by an approved social worker or the patient's nearest relative and are recommended by two doctors; only one doctor is needed for Section 4.

Section 2

Allows compulsory admission and detention for up to 28 days for assessment and necessary treatment. Grounds are: the patient must be suffering from mental disorder of 'a nature or degree, which warrants the detention of the patient in a hospital for assessment'. In addition the patient may need to be detained to protect him/herself or others.

Section 3

Allows compulsory detention for up to six months for treatment. Grounds are: to ensure that a severely mentally disordered person receives treatment in a hospital setting; such treatment is likely to alleviate or prevent a deterioration of the condition; it is necessary for the health and safety of the patient or for the protection of other persons.

Section 4

Allows emergency admission for up to 72 hours for assessment. It has similar grounds to those pertaining to Section 2 although it only requires one medical recommendation. It is not a short-cut to Section 2 and is only for use in urgent situations where any delay in seeking a second medical recommendation could be harmful to the patient or others.

Section 5

Gives a doctor (under Section 5,2) or a nurse (under Section 5.4) 'holding power' to prevent a client from discharging themselves from hospital if either think it is not in the client's best interests to leave

Section 7-10

Guardianship: A local authority or private individual can become the guardian to a person who needs protection from themselves or others due to mental incapacity. The guardian has the power to require the patient to live in a specified place or to attend for medical treatment, occupation or training.

Section 117

This section requires health and local authorities to arrange a package of 'aftercare' for patients on a Section 3. The purpose of aftercare is to enable patients to return home and to minimise the chances of their needing any future in-patient care.

Section 135

Enables an approved social worker to obtain a magistrate's warrant granting permission to enter a person's home if it is felt that the person is a risk or danger to themselves or others due to a mental disorder. Once entry is made, the order allows compulsory detention for a period no longer than 72 hours at a place of safety (hospital or police station) for psychiatric assessment.

Section 136

Allows a police officer to remove someone who appears to have a mental disorder and is a risk to themselves or others from a public place to a place of safety for a psychiatric assessment. Detention must not exceed 72 hours.


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