Mental disorder

From WikiMentalHealth

Effects of Mental Health Act 2007

From 3/11/08 the definition of mental disorder is changed by the Mental Health Act 2007. See the following articles for details:

• Mental disorder no longer split into separate classifications 3/11/08

• Abnormally aggressive or seriously irresponsible conduct is only a consideration for learning disability (not personality disorder) 3/11/08

• Some exclusions to definition of mental disorder have been removed 3/11/08

Historical information

Classifications

Mental disorder was defined in MHA 1983 s1 as meaning "mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind". There were four types of mental disorder in the Mental Health Act 1983:

1. Mental illness was undefined, but includes, for example, schizophrenia and bipolar affective disorder.
2. Psychopathic disorder "means a persistent disorder or disability of mind (whether or not including significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the person concerned".
3. Mental impairment "means a state of arrested or incomplete development of mind (not amounting to severe mental impairment) which includes significant impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned".
4. Severe mental impairment "means a state of arrested or incomplete development of mind which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned".

The various disorders within these classifications are often referred to according to their ICD-10 classification (which is entirely separate).

Treatability

The "treatability test" applied to detention (and discharge) for psychopathic disorder and mental impairment (minor disorders). In brief, the treatment must be "likely to alleviate or prevent a deterioration of his condition" (see, for example, s3(2)(b)). Medical treatment is defined widely in s145 as including nursing, care, habilitation and rehabilitation under medical supervision so, although possible, it is difficult to argue that the test is not met. This test has been abolished by the MHA 2007: see Appropriate treatment test replaces treatability test and applies to all patients under long-term detention 3/11/08

Some effects of classification

A hospital direction under s45A was only available to those suffering from psychopathic disorder. A detained patient could be treated for any mental disorder, nomatter what his classification: R (B) v Ashworth Hospital Authority (2005) UKHL 20. The treatability test for psychopaths and the mentally impaired had to be considered by the MHRT as it was part of the admission criteria, even though s72 did not mention it: Reid v Secretary of State for Scotland (1998) UKHL 43.

Exclusions

Patients cannot be detained "by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs" (s1(3)). However, in practice a paedophile who acts on his deviancy may be said to be manifesting a psychopathic disorder, and someone whose drink/drugs problems result from a detainable mental disorder could be detained. Most exclusions have been repealed by the MHA 2007: see Some exclusions to definition of mental disorder have been removed 3/11/08