The Mental Health NI Order (1986)

The Mental Health (Northern Ireland) Order 1986 covers the assessment, treatment and rights of people with a mental health condition.

Assessment and treatment

Many people receive specialist mental health care and treatment in the community. However, some people can experience severe mental health problems that require admission to hospital for assessment and treatment.

People can only be detained if the strict criteria laid down in the Order are met. The person must be suffering from a mental disorder as defined by the Order.

An application for assessment or treatment must be supported in writing by two registered medical practitioners. The recommendation must include a statement about why an assessment and/or treatment is necessary, and why other methods of dealing with the patient are not appropriate.

Admissions to hospital

Most people who receive treatment in hospitals or psychiatric units for mental health conditions are there on a voluntary basis and have the same rights as people receiving treatment for physical illnesses.

However, a small number of patients may need to be compulsorily detained under a section of the Mental Health NI Order 1986. The Order explains who is involved in the decision about compulsory admission or detention and the individual's or their nearest relative's right of appeal.

Approved social workers

Approved social workers are specially trained in both mental health and the law relating to it. They are appointed by local trusts to interview and assess people and can make an application for admission where they consider that detention is the most appropriate way of providing care and treatment.

Nearest relative

The Order gives certain rights to the nearest relative which can be used to protect the patient's interests. Usually, the nearest relative is the older of the two people who occur highest in the following list, regardless of gender:

husband, wife or civil partner
partner (of either sex) who has lived with the patient for at least six months
daughter or son
father or mother
brother or sister
grandfather or grandmother
aunt or uncle
nephew or niece

Out of the list above, a person who lives with, or cares for, the patient is likely to be regarded as the nearest relative. A person who is not a relative but who has lived with the patient for at least five years can also be regarded as the nearest relative.

The nearest relative has the right to:

make an application for compulsory assessment or treatment of the patient, or get the patient's social services in their local trust to ask an approved social worker to consider the patient's case
be told if an approved social worker applies for the patient to be detained for compulsory assessment
be consulted about, and object to, a social worker applying for the patient to be detained for compulsory treatment
discharge the patient
apply to a Mental Health Review Tribunal on behalf of the patient in certain situations
receive written information about the patient’s detention, rights and discharge unless the patient objects

The appointment of the nearest relative can only be changed by a court. The nearest relative’s power of discharge can be over-ruled by the doctor who is responsible for the patient’s treatment. This is if the doctor thinks the patient is likely to act dangerously if discharged.