Section 134 Mental Health Act 1983 Patients Correspondence Lead executive Medical Director Authors details Mental Health Act Manager - 01244 393167 Document level: Trustwide (TW) Code: MH10 Issue number: 4 Type of document Target audience Document purpose Policy All CWP staff who are authorised to receive Mental Health Act detention papers on behalf of the Hospital Managers To ensure that Mental Health Act detention (section) papers are received and scrutinised correctly by authorised officers so that patients are detained lawfully by way of compliance with the Mental Health Act Code of Practice (in respect of the application of the Mental Health Act 1983 as amended by the Mental Health Act 2007). Approving meeting Patient Safety and Effectiveness Sub Committee 18-Jun-15 Implementation date 18-Jun-15 followed by an annual compliance review CWP documents to be read in conjunction with MH9 Section 19 - Regulations as to the transfer of patients Document change history - Addition of a flowchart. What is different? - Minor amendments to bring in line with Code of Practice 2015 Appendices / electronic forms What is the impact of change? no Up-to-date information for nursing staff Training requirements Financial resource implications No - Training requirements for this policy are in accordance with the CWP Training Needs Analysis (TNA) with Learning and Development (L&D) None External references 1. Mental Health Act Manual 17th Edition, Richard Jones, 2014 2. Code of Practice for the Mental Capacity Act 2005, Ministry of Justice, 2007 3. Mental Health Act 1983 as amended by the Mental Health Act 2007, Department of Health, 2008 4. Mental Health Act: Code of Practice, Department of Health, 2015 5. Reference Guide to the Mental Health Act 1983, 2015 Equality Impact Assessment (EIA) - Initial assessment Yes/No Comments Does this document affect one group less or more favourably than another on the basis of: - Race No - Ethnic origins (including gypsies and travellers) No - Nationality No Page 1 of 7 Do not retain a paper version of this document, always view policy / guidance documents from the desktop icon on your computer
Equality Impact Assessment (EIA) - Initial assessment Yes/No Comments - Gender No - Culture No - Religion or belief No - Sexual orientation including lesbian, gay and bisexual people No - Age No - Disability - learning disabilities, physical disability, sensory impairment and mental health problems No Is there any evidence that some groups are affected differently? No If you have identified potential discrimination, are there any exceptions valid, legal and/or justifiable? N/A Is the impact of the document likely to be negative? No - If so can the impact be avoided? N/A - What alternatives are there to achieving the document without the impact? N/A - Can we reduce the impact by taking different action? N/A Where an adverse or negative impact on equality group(s) has been identified during the initial screening process a full EIA assessment should be conducted. If you have identified a potential discriminatory impact of this procedural document, please refer it to the human resource department together with any suggestions as to the action required to avoid / reduce this impact. For advice in respect of answering the above questions, please contact the human resource department. Was a full impact assessment required? No What is the level of impact? Low To view the documents Equality Impact Assessment (EIA) and see who the document was consulted with during the review please click here Page 2 of 7 Do not retain a paper version of this document, always view policy / guidance documents from the desktop icon on your computer
Content Quick Reference Flowchart... 4 1. Introduction... 5 2. Definitions... 5 2.1 Post Packet... 5 2.2 Human Rights Act... 5 2.3 Detained Patients... 6 2.4 Appointed Person... 6 2.5. Informal Patients... 6 3. Procedure... 6 3.1 Withholding Post (Section 134(1)(a))... 6 3.2 Inspection and opening of mail (Section 134(4))... 6 Page 3 of 7 Do not retain a paper version of this document, always view policy / guidance documents from the desktop icon on your computer
Quick Reference Flowchart Outgoing Post Post may be withheld if requested by the addressee in writing to the MHA Team, ward manager or Responsible Clinician Appointed staff for inspection and withholding of post: Ward Manager Nurse in charge Responsible Clinician MHA Team The withheld post to be kept in the ward safe in an envelope clearly marked Clinical team to agree action plan and document in clinical notes A register of any post withheld to be maintained by MHA Team Patient to be informed in writing by the appointed person of any outgoing post withheld Withheld post must be returned to the patient when he/she has been regraded to informal status Inspection and opening of outgoing post It should not be necessary for staff to open outgoing post unless it is suspected that it contains items address to a person who has already requested not to receive them If inspection of contents is necessary, and nothing is withheld, a note must be added to this effect before sending to the recipient If some items are withheld and the rest sent on, a note must be added to this effect before sending to the recipient NB Section 134 does not provide powers to withhold INCOMING post from patients except in high security hospitals Page 4 of 7
1. Introduction Section 134 of the Mental Health Act 1983 provides power to withhold detained patients outgoing or incoming post. The provision for withholding post addressed to patients only applies to high security psychiatric hospitals. Hospitals other than high security hospitals, may only withhold outgoing post if the recipient request, in writing to the hospital managers the patient s responsible clinician, or the Secretary of State, that the post should be withheld. There is no power under the Act to withhold incoming post. However, Section 3(1) of the Criminal Law Act 1967, and common law, provide authority for hospital staff to take reasonable measures to prevent the patient from receiving or keeping the articles of potential danger in his/her possession, eg: weapons, explosives, or matches (for further guidance see Chapter 5 Reference Guide to the MHA 2015). The Act provides wider powers to high security psychiatric hospitals in withholding outgoing and incoming post, although decisions made can be reviewed by the Care Quality Commission. As well las having the power to withhold post, if the recipient requests it, there are also other circumstances when hospital managers of high security hospitals may consider the same if it is thought that it would cause distress or danger to the addressee or any other person. There are also circumstances when the managers may withhold incoming post if it is considered that this would be in the interests of the patient or the protection of others. This policy provides relevant professionals with guidance to facilitate compliance with the requirements in respect of withholding detained patients outgoing post. 2. Definitions 2.1 Post Packet A postal packet has the same meaning in Section 134 as it does in the Postal Services Act 2000 which is: a letter, postcard, reply postcard, newspaper, printed packet or parcel and every packet or article transmissible by post (which includes a telegram). It could also include e-mails. 2.2 Human Rights Act The Human Rights Act 1998 confirms in Article 8(1) that everyone has the right to respect for his private and family life, his home and his correspondence. Section 134 of the Mental Health Act lays down strict criteria and procedures to be followed when withholding patients mail, thus preventing a breach of Article 8(1) and 8(2) of the Human Rights Act: Article (2) There shall be no interference by a public authority with the exercise of this right except such as in accordance with the lase and is necessary in a democratic society in the interests of national security, public safety or the economic well-being of the country, for the prevention of disorder or crime, for the protection of health or morals, or for the protection of the rights and freedoms of others. Page 5 of 7
2.3 Detained Patients This excludes patients who are subject to Community Treatment Orders, who have been recalled to hospital. 2.4 Appointed Person This will be a member of CWP staff appointed to withhold/inspect/open mail as follows: Ward manager or nurse in charge of the ward Responsible clinician or approved clinician in charge of the patient s treatment 2.5. Informal Patients There is no power to hold or inspect the mail of an informal patient. 3. Procedure 3.1 Withholding Post (Section 134(1)(a)) in hospitals other than highs security psychiatric hospitals Staff may only withhold post sent out by the detained patient if the recipient has requested not to receive any correspondence from that patient. The request must be made in writing, and sent to the Mental Health Act Team or Ward Manager/Responsible Clinician. On receipt of such a request the details must be documented as a clinical note in the patients electronic record and should include the following: A description of what has been withheld The date and reason for withholding post An alert must also be created on Carenotes. The appointed person will inform the patient, in writing, of the decision to withhold the post. The withheld post should be kept in the ward safe in an envelope with details clearly marked, until the patient s status has been regraded to informal. The clinical team, including approved clinician in charge of the patient s care, will be informed and an action plan formulated. 3.2 Inspection and opening of mail (Section 134(4)) There should be no necessity to open outgoing post, as the addressee s details will be evident on the envelope or cover of a parcel. However, if staff suspect that the patient is sending a post packet to a person and the contents may contain letters addressed to someone who has requested not to receive correspondence, then the packet may be opened and inspected by the appointed person (see 2.4 for definition of appointed person) Page 6 of 7
If a letter or packet is opened but nothing has been withheld, the ward manager or nurse in charge must place a note in the packet stating; That the packet has been opened and inspected That nothing has been withheld The name of the appointed person who opened the packet and the name of the hospital. If anything in the packet is withheld, and the rest of the packet sent to the addresses, the ward manager, or nurse in charge must place a note in the packet stating: That the packet has been opened and item(s) in the packet have been withheld The date and grounds for doing this A description of items withheld The name of the appointed person who opened the packed and the name of the hospital. If parts of a package are withheld and the rest of it allowed to be sent to the addressee, the patient will have the opportunity to ask the Care Quality Commission to review this decision. There is no statutory duty on staff to inform the patient that a request has been made not to receive their correspondence. Any post withheld should be retained in a safe place on the ward until the patient has been discharged from detention, at which point it should then be returned to the patient. A register must be kept to document withheld post. For further guidance on withholding patients correspondence refer the Reference Guide 2015 Chapter 5. Page 7 of 7