human rights and legislation who resource book on mental health

eing incorrectly admitted or where they would choose to be admitted), <strong>and</strong> these should be
taken into account when making decisions. Furthermore, the independent authority should
consult family members (<strong>and</strong> others close to the patient), the health practitioners involved <strong>and</strong>/or
a legal representative (if any) appointed by the patient.
The law can ensure that patients are informed immediately of the grounds for involuntary
admission, <strong>and</strong> that this is also conveyed promptly to the patients’ legal representatives <strong>and</strong>
family members as appropriate.
Moreover, an important element to be incorporated into legislative provisions on involuntary
admission is the right to appeal to quasi-judicial <strong>and</strong> judicial bodies. Legislative sections dealing
with involuntary admission should include this right <strong>and</strong> set out the process to be followed – for
patients, their families <strong>and</strong>/or legal representatives – for appeal to a mental health review body
<strong>and</strong>/or a court against the initial detention.
Involuntary admission: Key issues
• Involuntary admission is generally permitted only if all the following criteria are met <strong>and</strong>
the patient is refusing voluntary admission:
a) there is evidence of a mental disorder of specified severity, <strong>and</strong>;
b) there is a serious likelihood of immediate or imminent harm to self or others, <strong>and</strong>/or
a deterioration in the patient’s condition if treatment is not given,
c) admission includes a therapeutic purpose, <strong>and</strong>;
d) this treatment can only be given by admission to a mental health facility.
• Procedure to be followed for involuntary admission:
a) Two accredited mental health practitioners (one of <strong>who</strong>m ideally should be a medical
doctor) should certify that criteria for involuntary admission are fulfilled <strong>and</strong>
recommend involuntary admission.
b) An application for involuntary admission should be made in accordance with local
culture <strong>and</strong> conditions.
c) The mental health facility should be accredited as providing adequate <strong>and</strong>
appropriate care <strong>and</strong> treatment, <strong>and</strong> therefore permitted to admit involuntary
patients.
d) An independent authority (review body, tribunal or court) should authorize
involuntary admission. This should be done as soon as possible after an application is
made or, if not possible, as soon as possible after admission; <strong>legislation</strong> should lay
down the time frame required for such a review. The person should be entitled to a
legal representative at the hearing.
e) Patients, their families <strong>and</strong> legal representatives should be informed immediately of
the grounds for involuntary admission <strong>and</strong> of the patient’s <strong>rights</strong>.
f) Patients, their families <strong>and</strong>/or their legal representatives should have a right to
appeal to a review body <strong>and</strong>/or a court against involuntary admission.
• There needs to be a provision for regular, time-bound review of involuntary admissions by
an independent review body.
• Patients must be discharged from involuntary admission when they no longer fulfil the
criteria for involuntary admission. Voluntary treatment may follow.
The procedures for discharging a person from involuntary admission <strong>and</strong> treatment should be
as flexible as possible to ensure that a person is not retained for any period longer than is
necessary. Continued admission is only justified upon the persistence of the mental disorder of
a severity <strong>and</strong> form that prompted the involuntary admission. If involuntary admission is no
longer warranted, the patient may be discharged without further care, either by a doctor or a
professional as determined by law, or by the review board if it has considered the case. If
patients so choose, they may be transferred to voluntary status to continue care <strong>and</strong> treatment
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