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A GUIDE TO:
Mental Health Review Tribunals & Managers Appeals
 If
you have been detained under the Mental Health Act 1983 (MHA83), or are
subject to its powers, you may well have the right to have your case
reviewed by a panel. This could result in alterations or recommendation
to change your treatment or suggestions for more (Section 17) leave, or
even the rescinding (removal) of your detention section and subsequent
discharge.
What
Types of Appeal Are There?
Who can Appeal?
How do you Appeal?
What Information is used for The Appeal?
Who can
attend the Appeal?
How does The
Appeal Run?
What Types of Appeal Are There?
There
are two types of appeal, The Mental Health Review Tribunal (MHRT) and
the (Hospital) Managers Appeal.
The
MHRT is a department of the Lord Chancellors Office. The panel consists
of medical members, legal members and lay members (includes people with
experience in social services). There is specific guidance on how these
hearings are run.
The
Hospital Managers refers to the Hospital Trust Managers, who set up a
special committee to hear such hearings, whose members are usually a
mixture of non-executive directors (not paid) of the Trust Board
together with volunteers. There is no specific guidance given for how to
run a Managers Appeal, so in general they follow the same structure as
those given for Mental Health Review Tribunals. The Managers have
powers, given in Section 23, to discharge people detained under Section
2, Section 3 and Section 37 and therefore appeals to the Managers can be
made.
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The following sections will assume an application is made to the MHRT.
Any differences for Managers Appeals will be noted.
Who can
Appeal?
Your
right to appeal for a hearing to the MHRT will depend on which Section
of the Mental Health Act 1983 applies to you. For most in-patients, the
most common detention order will be Section 2 or 3 (MHA83). If you do
have the right to appeal, you can usually do so once for each period of
detention.
E.g.
If you are detained under Section 2 (MHA83) for 28 days, you may appeal
once. If, after 28 days, you are then detained under Section 3 (MHA83),
you may appeal again.
Note:
There are no specific guidelines as to how many times you can appeal to
the Hospital Managers. As a rule of thumb, they will tend not to grant
your appeal if you have had a hearing within the last 28 days unless
there has been a significant change in your treatment or mental health.
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How do
you Appeal?
As
a matter of good practice, you should receive application forms for the
two different types of appeal along with your ‘section papers’ and
rights (admission pack). These can be filled in and give to a member of
staff, an advocate, or the Mental health Act Coordinator on site. In the
case of MHRT you can post them directly to the Mental Health Act Review
Tribunal offices. If you do not have the forms, then ask a member of
staff or the advocate for one.
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What Information is
used for The Appeal?
Upon
receipt of your appeal, a date is set for your hearing. This can be from
a week to a couple of months away, depending on availability of panel
members, length of your detention order, etc. The panel will request
reports, one of each from your Responsible Medical Officer (RMO- usually
your consultant), a Social Worker and a medical professional who sees
you most often (if you are on a ward, this will be a nurse, though this
does not always happen with MHRT).
The
doctor’s report will usually list some medical background, circumstances
around your admission, medication information, treatment plan, and a
recommendation about whether or not you should be discharged. Usually
this will recommend the ‘section’ remain.
The
Social Workers report will detail background family history, prior
admissions, circumstances around this admission, a plan of care in case
you are discharged (Care Programme Approach), the view of the nearest
relative about the detention, and a recommendation. It is not unusual
for the Social Worker to agree with the RMO in this case, but this is
not a given. The Social Worker may be someone you know, or may be
appointed specifically for the task. They may wish to come and interview
you. You may wish to have someone with you during this interview, which
may be a friend, relative, or advocate.
The
Nurses report will detail how you behave on a daily basis, if you are
compliant with medication and leave conditions, your general demeanour,
and a recommendation.
It
is recommended good practice that these reports are ready before the day
of the appeal. You have a right to see them, and your representative
(advocate or solicitor) will be able to have access to a copy and go
through them with you before the appeal. You may find inaccuracies or
points you wish to contest.
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Who can attend the Appeal?
The
panel, consisting of three members
RMO,
Social Worker and a Nurse
ou-
if you wish to. You do not have to attend, but be aware this may
decrease your chances.
Legal
representative, such as a solicitor who specialises in mental health
law. This is free if you are detained and are appealing to a MHRT. Some
solicitors will also attend Managers Hearings for free as well. The MHRT
prefers to see people with legal representation as you are detained
using complex legislation and they like to see that you have a ‘fair’
hearing.
A
Mental Health Advocate, upon your request and if they are available.
However, if you have a solicitor, then they are representing you at the
hearing, so think carefully about what the role of the advocate is.
Friends
and family members with your permission (see Hints & Tips)
Possibly
a clerk to record the events.
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How does The Appeal Run?
Everyone
will have seen the reports, and you will have had a chance to discuss
them and other points with your representative (if you have one). Upon
convening, the panel will introduce themselves and so will the other
attendees. They will explain the purpose of the hearing, and explain the
structure and what you can expect.
Usually
they will start with the RMO report, asking the RMO for a summary and
any updates, together with how they feel the treatment is going,
together with a recommendation. The panel members will then ask the RMO
questions. Upon completion your representative can then ask the RMO
questions, which may prompt the panel members asking more questions.
Next
the panel will move onto the Social Worker, repeating the same
procedures as above.
The
panel will then move onto the nurse, repeating the same procedure.
After
hearing the ‘evidence’, the panel will then ask you and/or your
representative questions.
Lastly
you will have a chance to make a statement (see hints & Tips)
The
hearing will convene, with the panel members discussing your case. You
can be informed verbally and/or in writing of their decision.
Do
not assume you have applied for a hearing just because you have asked
someone. In almost all cases you must sign the application form for it
to be accepted. If you have not done so, then you probably have not put
in the appeal.
Upon
completing the form, try and be patient waiting for a hearing date. As a
general rule, Managers hearings tend to be arranged faster, but can take
a few weeks to a month to be arranged. It is not unusual for MHRT to
take even longer.
Although
it can be good to have support of friends and family at hearings, be
aware that they may disagree with what you want to happen, and may well
say so if asked by the panel.
It
is your choice if you have legal representation, but remember that you
are being detained using specific mental health legislation that is very
involved and complex.
Remember,
you have the right to see the reports and check their accuracy. It can
be a good idea to go through them with your representative.
If
possible, request to see your solicitor before the hearing. That way,
you are not meeting them for the first time on the day of the hearing.
You
can request a male or female solicitor- whomever you feel most
comfortable with.
Upon
answering questions at the hearing, try and keep your answers brief and
stay on topic. Although being detained is often distressing and
frustrating, if you begin shouting or being aggressive this will not
help your case.
If
you make a statement, try and keep it brief and to the point. Although
the panel may indulge a lengthy statement, it may go against you,
especially if you drift off topic.
If
you feel very nervous, or need a break during the hearing, ask your
representative for a short recess. The panel appreciates that the
hearings can be very stressful and will allow a break.
Although
it can feel like it at the time, the hearings are not about ‘winning or
losing.’ They can often be very informative, and can change your
treatment for the better.
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