Mental Disorder
| Author | Michael Butler |
| Pages | 23-30 |
Chapter 3
Mental Disorder
3.1 INTRODUCTION
Mental disorder is the cornerstone of the MHA 1983. At the Act’s very beginning, section 1(1) makes clear that its provisions only apply ‘to the reception, care and treatment of mentally disordered patients, the management of their property and other related matters’. It is only to patients with mental disorder that the Act applies, and no other patient may be admitted or treated under its provisions.
In legal terms, what constitutes a mental disorder is rarely a source of dispute since the MHA 1983 defines the term broadly and there is a large amount of consensus on the types of condition that will fall within the definition, the law generally tending to fall in line with what the medical profession regards as a mental disorder. The Act’s definition of mental disorder is, however, drafted so that special provisions apply in the case of certain conditions (learning disability, and drug and alcohol dependency) which would otherwise be regarded as mental disorder.
3.2 STATUTORY DEFINITION OF MENTAL DISORDER
3.2.1 Section 1(2) of the Mental Health Act 1983
The MHA 1983 defines mental disorder as ‘any disorder or disability of the mind’ (section 1(2)). This is a simple, flexible definition designed to provide clinicians with significant discretion when deciding whether to admit someone to hospital under the Act. It applies without variation throughout the Act, whether the proposal is to admit someone for a short period for assessment or for a longer period for treatment. There is no requirement to classify the type of mental disorder before a person is admitted under the Act’s provisions.
24 A Practitioner’s Guide to Mental Health Law
3.2.2 Removal of classifications of mental disorder
The flexibility of the definition is best illustrated by a comparison with the definition which existed before the MHA 1983 was amended by the MHA 2007. Before then, the definition of mental disorder necessarily involved classification since a person had to be suffering from a certain type of disorder before detention in the longer term for treatment could be authorised. The MHA 1983 defined mental disorder as ‘mental illness, arrested or incomplete development of the mind, psychopathic disorder and any other disorder or disability of the mind’, and went on to state that only those with one of the main classifications within that definition (mental illness, arrested or incomplete development of the mind, psychopathic disorder) could be detained for treatment. Those with ‘any other disorder or disability of the mind’ could only be detained for assessment.
That someone could only, therefore, be detained for treatment if shoe-horned into one of those particular types of mental disorder, meant an unhelpful focus on classification at the outset of any admission, and also, inevitably, that many who ought to have been eligible for detention for treatment were not because they fell into the ‘any other disorder or disability of the mind’ category. A person diagnosed with personality disorder, for example, could only be detained for treatment if he fell within the classification of ‘psychopathic disorder’, defined by the MHA 1983 as ‘a persistent disorder or disability of the mind (whether or not including significant impairment of intelligence) resulting in abnormally aggressive or seriously irresponsible conduct’.
Faced with what many regarded as an unsatisfactory situation, the MHA 2007 amended the MHA 1983 and did away with the notion that only certain types of mental disorder should merit detention for treatment. As had always been the case for assessment, any disorder might now also justify detention for treatment, and so the need to classify was removed. There was no longer any need to incorporate classification within the definition itself and the new, more flexible definition was created.
3.3 MEANING OF THE TERM ‘MENTAL DISORDER’
3.3.1 Reliance on good clinical practice and accepted...
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