Psychiatric Bulletin (2004) 28: 384. doi: 10.1192/pb.28.10.384-a
© 2004 The Royal College of Psychiatrists
Psychiatric Bulletin (2004) 28: 384
© 2004 The Royal College of Psychiatrists
Mental health review tribunals: recent problems
Brian Crossley
Medical Member, South Region, MHRT. E-mail:
rbcrossley{at}hotmail.com
For the past 20 years, there has been a steady increase in the number of
applications to the MHRT. There were 5000 applications in 1986, rising to 20
000 in 2000 (Department of Health Statistical Bulletin, October 2000).
Applications outnumber hearings by 2:1 because so many patients are taken off
section after the request has been submitted. This generates a lot of work for
office staff, but is unavoidable. A decade ago, tribunal members received
reports in advance of hearings (except in Section 2 cases) and, with the help
of a clerk, the hearing could begin on time. Subsequent hearings were
therefore not endangered.
A consecutive sample of hearings (total 107) attended by the author in the
South Region (Hinchley Wood) beginning January 2002 and lasting 20 months was
studied and a number of shortcomings identified. In 81 hearings not involving
Section 2 patients, tribunal members received reports by post beforehand in
only a third of cases. This meant that the Mental Health Act 1983
administrator had to provide the reports for members when they arrived for the
hearing. At 69 of the 107 hearings in the sample, there was no clerk present
to assist the tribunal. The time required to read reports contributes to the
delay which is made worse because, in the absence of the clerk, members have
to undertake some additional tasks. Delays cause frustration for everyone but
the most serious consequence is that a later hearing may be cancelled or
postponed. Patients generally find the prospect of a tribunal quite stressful
and when a hearing is abandoned at the last moment it is not surprising that
the treatment team encounters extra difficulties. Cancellation also causes
inconvenience for legal representatives, witnesses, tribunal members and
Mental Health Act 1983 administrators. There were 10 occasions in the sample
when a key person was not present and the hearing had to be adjourned and
rearranged at a later date by the office.
A major reorganisation of the tribunal system is at present taking place
but it appears that many hearings are being arranged at the last moment with
inevitable problems for everyone involved.
