Code of Practice:Mental Health Act 1983

Easy Read version

About this booklet

About the Mental Health Act

About the Code of Practice

Why the Code of Practice needs to change

How we worked on the changes

1. Using the Mental Health Act

Guiding Principles

2. Patient’s Rights

Information

Nearest relative

IMHAs

Attorneys and deputies

Privacy, safety and dignity

Saying what you want before you are ill

Keeping your personal information confidential

Visiting patients in hospital

The Tribunal

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3. Getting the right care in the right place

The Mental Capacity Act 2005

Detaining (holding) a person in a hospital

4. Specific groups of patients

People with learning disabilities or autism

People who are involved with the police or courts

5. Safe care and treatment in hospital

Medical treatment

Safe ways to respond to behaviour that isdifficult or dangerous

6. Leaving hospital

Community treatment orders (CTOs)

Guardianship

7. Professional responsibilities

Hospital managers’ discharge power

Information for victims

What do the words mean?

What is in this booklet page

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About this booklet

The Department of Health wrote thisbooklet.

It is about the new Code of Practice thattells people about the Mental Health Act.

Some difficult words are in bold text.

There is a list at the end of the booklet toexplain these words.

We have put the information about theCode into 7 different parts.

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Each part is a different colour to help youfind things more easily.

This booklet covers those parts we thinkyou will be most interested in.

There is more information in the longversion of the Code of Practice.

You can read this at:www.gov.uk/government/publications/code-of-practice-mental-health-act-1983

The longer version has the same 7 parts asthis booklet.

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About the Mental Health Act

The Mental Health Act is a law aboutdetaining (holding) and treating peoplewith a mental disorder in England andWales.

Under the Mental Health Act people canbe made to stay in hospital.

This means they are detained there andare not free to leave even if they want to.

They can also stay at home with certainrules about what they must do.

This booklet is about the revised Code ofPractice that says how to use the Act inEngland.

Wales has its own Code.

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About the Code of Practice

The Code of Practice explains the law andtells people and services what they mustdo.

It helps patients get the right treatment,care and support when they are treatedunder the Mental Health Act.

The Code of Practice is for:

· people who work with patients withmental health problems

· people who are being treated underthe Mental Health Act in hospital or inthe community

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· the families and friends of people withmental health problems

· hospital managers

· other people like the police orambulance staff.

It will also help the Care QualityCommission (CQC) and otherorganisations that check mental healthservices are being provided properly.

The Code of Practice tells people about therights of patients and their carers. Itmakes sure patients are treated equallyand fairly.

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It helps people:

· understand the Mental Health Act anduse it properly

· make decisions about how to care forpeople with mental health problems

· give the best care to people withmental health problems.

Why the Code of Practice needed tochange

The Code of Practice needed to bestronger and clearer because:

· it was last written in 2008 and lawsand health services have changedsince then

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· it will only work if it is up to date andpeople understand how to use itproperly

· patients get poor or unsafe care whenservices do not understand or do notuse the Code properly.

How we worked on the changes

In 2014 we asked lots of different peopleand organisations about a new Code.

A group of Experts by Experience workedwith us from the very beginning.

They are people who know what it is likewhen someone is treated under theMental Health Act.

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They told us the new Code should:

· make sure patients can speak up

· stop poor or dangerous care

· make sure all staff get the same, goodtraining

· be clear and easy for everyone tounderstand.

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1. Using the Mental Health Act

The Mental Health Act says:

· when you can be given treatment,even if you do not want it

· when you can be held in hospital forassessment or for treatment for yourmental disorder

· what your rights are.

The Code helps services treat patientsfairly and equally when they use theMental Health Act.

The Code explains the 5 guidingprinciples. These are things everyonemust think about when they use theMental Health Act.

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1.2.3.4.5.

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1.2.3.4.5.

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ü 1. Give treatment in the leastrestrictive way and help people tobe as independent as possible

This means:

· only use the Act and keep people inhospital if they really need to

· keep people in hospital for the shortesttime possible

· avoid any rules that apply to allpatients. This means treat patients asindividuals and do not just have thesame rules for everyone

· help patients get well and be asindependent as possible.

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1.2.3.4.5.

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2. Involve patients

· involve patients as much as possible inplanning their treatment and care

· think about what patients have saidbefore about what was important tothem

· write down the patient’s views

· give patients information and supportto be involved in decisions

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· tell patients how an advocate couldsupport them to be involved

· involve family or carers if the patientwants them to be.

3. Respect patients, families, carersand friends

· respect, understand and listen to them

· understand that every patient isdifferent. Think about what this meansfor their treatment and care.

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1.2.3.4.5.

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ü 1 4. Help people get well

· use the Act to give people thetreatment they need

· treat people in places that are safe andhelp them get well

· plan the right services and support forpatients in hospital and when theyleave

· think about patient’s physical health aswell as their mental health.

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5. Making fair and efficientdecisions

· mental health is as important asphysical health

· work together to keep patients inhospital for as short a time as possible

· make sure staff understand how to usethe mental health act to support alltheir patients safely

· work together to give you good safemental health services and the rightsupport when you leave hospital.

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Services must stick to laws about treatingpeople equally and fairly.

They must make sure that everyone hasthe same chance to get good treatmentand care.

Services must make reasonableadjustments or changes so people with adisability are treated equally.

For example, having information inEasyRead or staff who can communicatein sign language.

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2. Patients’ Rights

The Code says patients should have a sayin their care and be treated with dignityand respect.

Families and carers must know about theCode and understand their rights

The Code says what people should do tokeep patients safe.

Information

Give patients clear information about howthe Mental Health Act applies to them andtheir rights.

Tell them this information, give it in writingand communicate it in a way that theyunderstand it.

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Tell patients when they can refusetreatment and when it can be given evenif they do not want it.

Tell the patient what information will beshared with their nearest relative underthe Act and talk about what the patient ishappy to share.

Give patients the support they need if theyspeak another language or have adisability that affects theircommunication.

Tell patients how Independent mentalhealth advocates (IMHAs) can help themunderstand their treatment and rights.

Tell patients and carers how to complain ifthey are not happy with their treatment orcare.

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Nearest relative

Your nearest relative is given certaininformation and involved in certaindecisions about your treatment and care.

The Mental Health Act says who yournearest relative is. This might not be thesame as your ‘next of kin’ or the personyou feel closest to.

The nearest relative can ask someone elseto take on their role.

If you have no close family, a court canchoose a nearest relative for you. Thismight be the local authority.

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IMHAs

Independent mental health advocates(IMHAs) help patients understand theirrights and be involved in decisions.

They are only there to support you.

Anyone who is held in hospital or under acommunity treatment order under theMental Health Act can have support froman IMHA.

The person treating you must tell youabout IMHAs and how to get support.

The advocates are specially trained tounderstand the Mental Health Act.

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They are independent which means theyare nothing to do with any person orservice that is giving you treatment orcare.

The local authority must plan advocacyservices to meet different people’s needs.

Attorneys and deputies

If you do not have capacity to make adecision for yourself, an attorney ordeputy can make it for you if you haveone.

A Lasting Power of attorney is someonewho you have said can make certaindecisions for you in the future if you do nothave capacity to make that decisionyourself.

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You need to follow the things the law saysyou must do to create a lasting power ofattorney. The person you choose is calledan attorney.

A deputy is someone who the court ofprotection has said can make decision foryou because you do not have capacity tomake that decision.

If you are treated under the Mental HealthAct and do not have capacity, yourattorney or deputy can make somedecisions for you.

In some cases consent (agreement) is notneeded, for example, for some medicaltreatment under the Act.

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Privacy, safety and dignity

People who treat you must make sure theyrespect your privacy and dignity whenthey try to keep you safe.

They should think about your privacywhen you:

· undress or wash

· read or send letters or emails

· use the telephone

· meet your advocate, family or friends.

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Staff should treat patients as individualsand decide what is safe for them, not justhave the same rules for everyone.

There should be separate places for menand women to sleep, wash and go to thetoilet and a room for just women to go toduring the day.

Sometimes patients need to besomewhere that is more secure. Yourresponsible clinician will make thisdecision.

This should only take away your freedom ifit keeps you or other people safe.

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Saying what you want beforeyou are ill

Patients who are treated under the MentalHealth Act cannot decide what treatmentthey want.

Doctors have to think about what thepatient said in the past and what theyknow is important to them.

When you are well you can write astatement about what you want tohappen if you don’t have capacity at sometime in the future, for example, becauseyour mental illness gets worse.

An advance statement of wishes andfeelings says how you want to be treated.

Doctors have to think about this whenthey decide what is in your best interests,but they do not have to do what you say inthe statement.

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An advance decision: The Mental CapacityAct says that people who have capacityand are at least 18 years old can make adecision that they do not want a particulartreatment.

Doctors should not give that treatment tothem unless they are using powers in theMental Health Act where they do not needyour consent to give you that treatment.

Your confidential information

The law about confidential information isthe same for patients who are treatedunder the Mental Health Act as for otherpeople, except where the Act saysotherwise.

Sometimes, your confidential informationcan be shared without your agreement.

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Sometimes they need to shareinformation with other services likehousing. They should usually ask if youagree to this.

But the Act says there are some timeswhen services can share information, evenif you do not agree.

This is usually where the law says it can beshared.

People must write down who they sharethe confidential information with and whythey did this.

An IMHA can help a patient understandhow their confidential information is beingused.

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Visiting patients in hospital

All patients have the right to see theirfamily and friends while they are held inhospital.

You also have the right to see people likeyour advocate in private.

The hospital has to make sure the patientand visitors are safe.

There are some times where hospitalmanagers may restrict visitors, refuse tolet them in or ask them to leave. Managersshould have a policy (plan) for the timeswhen they can limit visits to patients.

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This should be clearly displayed on theward so staff and patients can read it.

They have to write down why theystopped the visitor coming and show thereis a good reason for this.

Hospitals cannot have rules for everyonethat say things like no visitors for the first4 weeks.

Hospital managers must check when staffare stopping visitors. They should have apolicy on when visits are not allowed.

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The Tribunal

The Mental Health Tribunal is anindependent group.

They review (look again at) cases where apatient is held in hospital or subject to acommunity treatment order or toguardianship.

For example, The Tribunal can decide thata person should not be held in hospital.

If this happens, doctors have to tell theTribunal why the patient should be held inhospital and why they they are doing whatthe Act says they must do.

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Hospital managers must tell patientsabout the Tribunal and how to ask them tolook at their case.

You can get free help and advice from asolicitor to help you with this.

The Tribunal usually meets in the hospitaland the patient usually goes to themeeting with someone who can speak forthem.

The hospital manager must make surethe patient and their family can beinvolved and understand what ishappening.

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3. Getting the right care in theright place

People must use the Mental Health Act togive patients the treatment they need.

The Code says:

· how doctors must ask for a person tobe held in hospital under the MentalHealth Act

· how patients should be taken tohospital.

Sometimes the police need to takesomeone away from a public place to keepthem or other people safe.

They should only use a police station as asafe place if there is nowhere else to takethe person.

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The Mental Capacity Act

People who make decisions, includingdoctors, must understand the MentalCapacity Act and how to support peoplewho do not understand how to makedecisions about their treatment or care.This is called lacking capacity.

There are 5 important things people mustdo and think about when they use theMental Capacity Act:

1. Start off by thinking that everyone hascapacity to make their own decisions

2. Give the person all the support theycan to help them make decisions

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3. No-one should be stopped frommaking a decision just becausesomeone else thinks it is wrong or bad

4. If everyone agrees that a person lackscapacity, another person can make adecision for them, but it must be theright thing for the person.

This is called a best interests decision.The Mental Capacity Act says howpeople must do this.

5. When they do something or decidesomething for another person, theymust involve the person.

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For example, a decision can be madeunder the Mental Capacity Act about:

· whether to take certain medicines ornot

· whether to stay in a hospital or carehome or not.

The Deprivation of Liberty Safeguards arepart of the Mental Capacity Act.

Services have to think about thesesafeguards if they give you any care ortreatment that deprives (takes away) aperson’s liberty.

This means where you are not free toleave and where you may be watched orcontrolled all the time.

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They must tell the local authority(council) and the Care QualityCommission (CQC) if they use theDeprivation of Liberty Safeguards so theycan check what they are doing.

Sometimes people have to decide whetherto keep a person in hospital under theMental Health Act or the Deprivation ofLiberty Safeguards. Both cannot be usedat the same time.

Asking for a person to be detained inhospital

A person can be held in hospital forassessment to find out what treatmentand care they need if:

· they have a mental disorder whichneeds them to be held in hospital forassessment

· they need to be held in hospital fortheir own health or safety or to keepother people safe.

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A person can be detained in hospital fortreatment if:

· they have a mental disorder whichmeans it is right for them to be treatedin hospital

· it is needed for their own health orsafety or to protect other people andthe treatment can only be given if theperson is held in hospital for treatmentand

· the right medical treatment isavailable.

The patient’s nearest relative or anapproved mental health professional(AMHP) can ask for a person to bedetained in hospital under the MentalHealth Act.

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Approved mental health professionalscan be social workers, psychologists andsome specific other persons who havebeen approved by a local authority.

2 doctors must give a medicalrecommendation saying that the criteriafor detention are met.

Before making an application, theApproved Mental Health Professional mustthink about:

· how to support the patient tocommunicate and understand theassessment

· what the patient wants now or saidthey wanted in the past

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· whether keeping them in hospital isthe only way to treat the patient

· how it will affect the patient and theirfamily if they are taken into hospital.

The NHS must make sure that localauthorities (councils) know where thereare hospital beds for patients who needthem urgently.

The NHS should try to place patients asclose as is reasonably possible to theirhome.

If it is difficult for the patient’s carer orfamily to visit a patient because of thedistance they need to travel, then the NHSshould think about what support they canprovide.

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4. Specific groups of patients

The Mental Health Act protects patientsbut says there are special things to thinkabout for some people.

The Code has extra information abouttreatment and care for:

· children and young people under 18years old

· people with learning disabilities orautism

· people with a type of mental illnesscalled a personality disorder

· people who have been involved withthe police or courts.

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People with learning disabilities orautism

A person cannot be detained and treatedunder the Mental Health Act just becausethey have a learning disability or autism.

The Act defines a learning disability (sayswhat it is). If a person’s mental disorder isa learning disability, then the Act can onlybe used if the rules for detention are metand the learning disability is linked with:

· very (unusually) aggressive or

· seriously irresponsible conduct (forexample, behaving in a way that isdangerous to them or other people.)

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This is not the same as bizarre or unusualbehaviour.

The person might be angry or frustratedbecause they cannot say or do what theywant.

It is important to think about why theperson is behaving like this to make surethat their behaviour is not caused bysomething they need that they are notgetting that could be solved.

The definition of mental disorder in theAct includes autistic spectrum disorders.

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People with autism can find changesdifficult or upsetting. Being kept in hospitalcan be difficult for them so they needsupport from staff who understandautism.

The staff should listen to carers and otherpeople who know the person well and cansay if they understand the decision.

People who are involved with thepolice or courts

People should not usually be sent toprison, held at a police station orimmigration removal centre if they needtreatment for their mental health.

The police or courts must ask for anassessment if they think someone needstreatment for their mental health.

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Liaison and Diversion services supportpeople at risk to get the services theyneed.

People at risk include:

· children and young people

· people with mental health problems

· people with learning disabilities

· people with autism.

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A doctor will assess the person and say ifthey should go to hospital instead ofprison.

Doctors write reports to tell the court whatis best for the patient.

This might be:

· treatment they must have in hospital

· going to prison

· treatment they must have in thecommunity.

A hospital order is not for a set time like aprison sentence. You have to stay inhospital until you do not need to betreated there any more.

A hospital direction has a time limit like aprison sentence. The patient can bemoved to a prison when the hospitalcannot treat them any more.

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5. Safe care and treatment inhospital

The Code says all patients must get theright treatment in a place that is safe forthem.

Doctors should think about the patient’swishes when they plan their treatmentand care.

Medical treatment

Treatments with special rules

There are special rules for sometreatments that the patient has toconsent or agree to or a second doctorhas to say they need.

Doctors must think carefully aboutwhether the patient needs this treatment.

They should tell the CQC how they willkeep to the rules about consent andsecond doctors.

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Community treatment orders

If you have been in hospital under theMental Health Act the doctor in charge ofyour care can put you on a communitytreatment order (CTO) if it meets certainrules.

If you are under a Community TreatmentOrder you must go for medicalexaminations for some things if you areasked to.

You can also have other rules which will:

· make sure you get medical treatmentfor your mental disorder

· stop you being a danger to your ownhealth and safety and protect otherpeople.

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Except in an emergency, physical forcecannot be used to make you have medicaltreatment for your mental healthproblems when you are under aCommunity Treatment Order.

A patient on a community treatment ordercan be recalled (called back to) tohospital.

Patients who cannot agree to treatment

If you are held under the Mental HealthAct, you can be treated without yourconsent, but people must follow the rulesin the Act.

An IMHA can help you understand whatthis means for your treatment.

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For example, the Mental Health Act saysyou can be given treatment during the 3months when you are first detained(although there are special rules for sometreatments).

Even if they can treat you against yourwishes, doctors should still ask if youagree to the treatment and write down ifyou refuse.

Your IMHA can help you to understand ifany special rules apply to the treatmentyou are getting.

The Mental Health Act sometimes saysdoctors must decide:

· whether you have capacity to agree toor refuse the treatment

· whether you do agree to it.

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If you need to agree to some treatment,the Mental Capacity Act will apply if youare 16 or over.

There are different rules for children.

Treatment plans

A treatment plan is an important part oftreatment under the Mental Health Act. Itshould say:

· what treatment you need

· how you will be treated

· why you are having that treatmentand how it will help your mentalillness.ü

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You should have the chance to be involvedin talking about your treatment plan. Anadvocate can help you with this.

If your family will be caring for you whileyou have the treatment, it is important toinvolve them in the treatment plan.

The Mental Health Act and MentalCapacity Act

If you have to consent to treatment underthe Mental Health Act and doctors findthat a patient aged 16 or over does nothave the capacity to agree to it, then theymust use the Mental Capacity Act.

In certain cases the Court of Protectionmay have a power to order that doctorsmust not give the treatment.

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Safe ways of dealing with behaviourthat can be difficult or dangerous

The Code says services should give good,safe care to people who have difficultbehaviour and might hurt themselves orothers.

Hospitals and community services should:

· assess patients to see if theirbehaviour might be dangerous ordifficult when they first go into hospital

· have rules and training about how tostop people doing dangerous things

· understand and think about humanrights

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· care for patients in safe places that arenot noisy or upsetting

· know what can upset the patient. Haveplans about how to stop things beforetheir behaviour gets dangerous

· only use restrictive interventions(things like physical restraint orholding people physically) for as longas necessary to stop the patientharming themself or others.

This must be a proportionate responseto the possible harm the patient coulddo.

It should take away as little freedomas possible. Your IMHA can help youunderstand if this happens to you.

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· have clear information about keepingpatients away from other people tokeep them or others safe. Do this for asshort a time as possible

· write down if how and why theyrestrain a patient or keep them awayfrom other people

· talk to the patient afterwards aboutwhat happened, why they wererestrained and what they thoughtabout

· tell patients and their families how tocomplain if they are not happy aboutthe restraint

· think about physical healthcare andnot just mental health.

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6. Leaving hospital

When patients leave hospital it might be:

· for a short break called leave ofabsence

· to have their treatment in thecommunity.

· because they are discharged or senthome.

Local authorities and clinicalcommissioning groups must make surepatients get the right care in thecommunity after they have been kept inhospital for treatment.

This is called after-care and the MentalHealth Act says what this means.

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Community treatment orders

A Community treatment order means aperson can stop being held in hospital fortreatment and can be treated in thecommunity.

It is a way to be more independent andget back to normal life at home or withyour family.

A CTO is not right for everyone.

There are rules to make sure you carry onwith the treatment and your doctor canbring you back to hospital if they need to.

Your doctor has to make sure they keep tothe rules in the Act.

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You do not have to agree to a CTO but youshould be involved in planning yourtreatment.

You should get clear information aboutyour treatment and have the right tosupport from an IMHA.

Your doctor will check how things aregoing and can decide to change yourtreatment or bring you back into hospitalfor treatment if you do not keep to certainrules.

Your doctor must end your CTO if it doesnot meet the rules any more or if you havebeen held in hospital for more than 72hours.

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Guardianship

Guardianship is a way for patients to getcare outside a hospital.

You can be put under guardianship if youare 16 or over, have a mental disorder anddoctors need to protect you or otherpeople.

The guardian is the local authority orsomeone that the local authority hasapproved.

Guardians can:

· say where you have to live

· say that you have to go for treatment,work or training at a set time andplace. But they cannot use force totake you there

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· say that a doctor or approved mentalhealth professional must be able tovisit you where you live.

Guardianship can be used to keep you safeand make sure you get the treatment youneed. It must not have rules that takeaway your freedoms.

The rules should not mean you arewatched and controlled all the time. Theyshould not stop you leaving the placewhere you live.

Doctors must think about whether this isthe best way to give you the care you needor whether it can be done another way.

If you lack capacity to make some or alldecisions about your treatment and care,your doctor should think about whether touse the Mental Capacity Act instead.

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7. Professional responsibilities

The Mental Health Act says what hospitalmanagers, doctors and otherprofessionals have to do.

The Code explains what paperwork tocheck and what instructions to follow.

Staff who are responsible for patientsbeing treated under Part 3 of the Act mustunderstand the rights of serious violentand sexual offenders (people who areinvolved with the police or courts.)

Hospital managers’ dischargepowers

The hospital manager is the person ororganisation in charge of the hospital.They can arrange for a panel (or group ofpeople) to carry out their powers.

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When doctors agree a detained patientcan leave hospital or no longer be on aCTO this is called being discharged.

Hospital managers cannot discharge somepatients, including those who are on ahospital order.

Hospital managers should think aboutwhether a patient is ready for dischargewhen:

· they think it needs to be done

· the patient’s doctor gives them areport to renew detention (hold themfor longer)

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· the patient asks them

· the nearest relative wants the patientto leave hospital but doctors want tostop this and give the hospitalmanagers a barring order to stop themleaving.

Hospital managers need to think aboutthe following if a person is detained fortreatment:

· does the patient still have a mentaldisorder?

· if so, is it the type or serious enough tomake treatment in hospital the righttreatment?

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· is detention necessary to protect thepatient’s health or safety or to protectothers?

· is the right medical treatmentavailable?

· have they thought about whether theMental Capacity Act could be used totreat the patient safely?

Hospital managers should tell patientsabout their decision and the reason forthem.

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Information for victims

Some victims of serious crimes bysomeone being treated under the MentalHealth Act have rights:

· people should listen to what the victimthinks when they decide about thingslike treatment, community leave anddischarge

· the victim has a right to know what ishappening with the patient. Forexample, if they are moving back intothe community

· victims should get support to deal withhow the crime has affected them. TheVictims’ Code says what support youcan get.

The Mental Health Act Code says whoshould give victims information and whatinformation they can give.

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What the words mean

Advance decisionAn advance decision says you do not want any specifiedtreatment. Doctors should not provide you with that treatmentbut there are powers in the Mental Health Act to treat youwithout your consent, so there are times when this can happen.

Advance statement of wishes and feelingsAn advance statement says how you want to be treated.Doctors have to think about this, but they do not have to dowhat you say.

Approved mental health professionalThis can be a social worker, psychologist and some specificother persons who have been approved by a local authority.

AssessmentFinding out what treatment and support you need.

AttorneyIf you find it difficult to make some decisions for yourself, anattorney or deputy can help you. A Lasting Power of attorney issomeone who you have said can make certain decisions for youin the future when you do not have capacity to make thatdecision.

You must follow the rules in the Mental Capacity Act 2005 tocreate a lasting power of attorney. The person you choose iscalled an attorney.

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Best interestsWhen doctors make a decision about treatment they have tothink about whether it is in the patient’s best interests. Thismeans thinking about what is important to the patient, whetherthis is the best treatment to help the patient, and consider whatother people think.

CapacityBeing able to understand and make a decision for yourself atthe time the decision needs to be made. If you cannot do thisyou lack capacity.

Care Quality Commission (CQC)An independent organisation that checks health and social careservices, including hospitals that detain and treat people underthe Mental Health Act.

Clinical commissioning groupThe NHS organisation that plans and pays for local healthservices.

Code of PracticeThe Code explains the Mental Health Act and tells people andservices how to use it properly to give safe care.

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Community treatment order (CTO)The doctor in charge of your care can put you on a communitytreatment order if specific requirements in the Mental HealthAct are met.

This means you are discharged from hospital but can berecalled. There will be conditions attached to the order,including to make sure that you allow a doctor to examine youfor specific purposes.

ConsentGive permission or agree to something.Court of protectionA special court that set up under the Mental Capacity Act to dealwith issues relating to people who lack capacity to makedecisions for themselves.

Definition or defineTo say what something means.

Deprivation of Liberty Safeguards (DOLs)Safeguards in the Mental Capacity Act for people who lackcapacity are deprived of their liberty. Services have to thinkabout these safeguards if they give you any care or treatmentthat takes away your freedom.

DeputyA deputy is someone who the court of protection says can makea decision for you because you lack capacity to make thatdecision.

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DetainTo hold or keep someone in hospital even if they do not want tobe there.

DischargeWhen you leave hospital or you are no longer on a CTO stops orsubject to guardianship.

Experts by ExperiencePeople who know what it is like to use a service. For example,being treated under the Mental Health Act.

GuardianshipA guardian is appointed to help and supervise a patient in thecommunity.

The guardian is the local authority or someone that theychoose.

Guiding principlesImportant things that everyone must think about when they usethe Mental Health Act.

Hospital directionWhen a court send you to hospital for a time limit like a prisonsentence. You can be moved to a prison when the hospitalcannot treat you any more.

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Hospital managerThe person or organisation who is responsible for the MentalHealth Act in a hospital.

Hospital orderWhen a court says you are detained in hospital until you do notneed to be treated there any more.

Immigration removal centreA place to hold people from other countries while the courtdecides if they can stay in this country or not.

Liaison and diversion servicesWhen people who might be at risk get involved with the policeor courts these services help them get the support and servicesthey need.

Mental Capacity Act 2005The law that protects people aged 16 or over who do not havecapacity to make decisions for themselves.

Mental disorderThis is sometimes called a mental illness. It means the personthinks, behaves or sees things differently and this makeseveryday things difficult for them.

Mental Health Act 1983This is the law about treating people with a mental disorder inEngland and Wales.

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Mental Health Tribunal (also called the First Tier Tribunal(Mental Health).

An independent organisation that has the power to dischargepatients from detention, community treatment orders andguardianship.

Nearest relative Your nearest relative is given information andinvolved in decisions about your treatment and care. The MentalHealth Act says who your nearest relative is.

Part 3 of the Mental Health ActYou can be kept in hospital for treatment under Part 3 of the Act.You might need the treatment for your health, your safety or tokeep other people safe.

Personality disorderWe each have different traits or things that make us the type ofperson we are and the way we act with other people. Forexample, we might be anxious or confident, quiet or full ofenergy.

If any of these things develop in ways that make it very difficultfor you to live your life or be with other people, doctors mightdecide this is a personality disorder.

Reasonable adjustmentsChanges to help a person with a disability. The NHS is requiredto take reasonable steps to avoid putting a person with adisability at a substantial disadvantage compared with peoplewho are not disabled.

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Responsible clinicianThe doctor in charge of your care and treatment under theMental Health Act.

Restrictive interventions (Restraint)This includes holding a person physically, or using a device like awheelchair strap, or putting them somewhere and not lettingthem leave (also called seclusion).

Victims’ CodeThis says what rights you have if you are the victim of a seriousviolent and sexual offence.

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Artwork includes material from theInspired EasyRead Collectionand cannot be used anywhere elsewithout written permission fromInspired Services.

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It has been user-checked by theMaking It Easier Group of people withlearning disabilities.

Credits

This paper has been designed andproduced for the Department of Health bythe EasyRead service at Inspired ServicesPublishing Ltd.Ref ISL 201/14. March 2015.

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It meets the European EasyRead Standard.