A guide to mental health tribunals
This leaflet is for anyone who:
- has been admitted to hospital under section 2 or section 3 of
the Mental Health Act;
- is being treated outside hospital under a Community Treatment
If you feel that this is unfair or unnecessary, you can
challenge the decision to keep you in hospital or to keep you on a
CTO. This is called an "appeal". If you do appeal, a mental health
tribunal will be held.
What is the Mental Health Tribunal?
It is a formal meeting where an independent panel looks at the
decision to keep you in hospital.
There are 3 people on the panel:
- a Judge (who is in charge of the hearing);
- a tribunal doctor who is a Consultant Psychiatrist. He or she
works with the First Tier Tribunal and is fully independent of the
hospital in you are detained;
- a Specialist Lay member who has detailed knowledge of the
Mental Health Act and mental health care.
The panel comes to the hospital for the meeting when they will
hear evidence from you, your lawyer and your clinical team. The
meeting is called a hearing.
What can the tribunal do?
The panel's powers depend on the Section of the Mental Health
Act you are detained under - see below.
When can I apply to the tribunal?
That depends on the section used to detain you. Hospital staff
on the ward and in the Mental Health Office should tell you about
your rights. If you are treated with a CTO, a tribunal will
regularly review your case.
Can I have a lawyer?
You are entitled to legal aid and free legal representation for
a tribunal hearing. The Mental Health Act office at the hospital
will give you a list of solicitors you can choose from. Your
solicitor will advise you on when to apply for a tribunal and how
to give your evidence. They may suggest you invite your
partner and/or your nearest relative to come to the hearing. You
also have the right to an Independent Mental Health Advocate (IMHA)
who can support you in doing this.
Can I represent myself?
You can do, but the tribunal will ask your doctor whether you
are able to do this properly - the phrase they will use is do you
It is generally not recommended - it is a legal meeting and your
lawyer will be familiar with the issues the tribunal will be
interested in. He or she will know how best to put your case.
Can I have someone else with me for support?
You may want to have your partner and/or nearest relative with
you - this is allowed.
Will I see the tribunal doctors before the hearing?
If you are on a Section 2, the tribunal doctor will always come
to see you before the hearing. This is called a 'pre-hearing
examination'. The interview is usually just you and the tribunal
doctor, in a room where you can be private. You can choose if you
want someone else with you, such as a nurse. If you are upset or
agitated, your clinical team may advise that someone does sit in
If you are not on a Section 2, then either you or
your lawyer must ask for the interview with the tribunal
doctor. You must ask for this in writing at least 14 days before
the day of the tribunal hearing. You will need to use a form T129
that the Mental Health Act administrator can give you.
Before the hearing
Before the hearing starts, the panel and your lawyer will
read the reports written about you by your care team. There will be
a medical report, a nursing report and a report from your care
co-ordinator. You should be able to see these yourself before the
What happens at the hearing?
You can ask to see the room where the tribunal hearing will be
held so that you know what to expect - this is the seating
You will sit opposite the judge, next to your lawyer.
The judge will begin by introducing the panel to you, then
confirming that the correct witness have come.
The members of the panel will then, one by one, put questions to
the psychiatrist, the ward nurse and the care co-ordinator. Your
lawyer will then put questions to the psychiatrist, the ward nurse
and the care co-ordinator.
When can I speak at my hearing?
Your lawyer will advise you as to how and when you can ask
questions. For example, even if you disagree strongly with what is
being said, you must not interrupt the psychiatrist, nurse or care
co-ordinator when they are answering questions from the panel or
from the lawyer. And they cannot interrupt you when you are
speaking or answering a question.
Your lawyer will advise you as how you can best make your views
clear to the tribunal. They will be very aware that you may not be
used to speaking to a group of strangers in this way.
Your lawyer will ask you questions before the panel members ask
you anything. You may want to speak to the tribunal panel early in
the hearing, so that you are sure the panel knows what you want.
Ask the lawyer about this. You may also be invited to have the last
word at the end of the hearing.
Do I have to stay for the whole hearing?
No. In fact you do not have to attend the hearing. Do ask your
lawyer about this. Make sure that if you do leave early, your
lawyer knows what you want from the hearing.
What does the panel ask my clinical team?
The hearing is a legal meeting and so some of the questions
sound complicated as they are about the legal basis for your
detention. These are the sort of questions and words you will hear.
You'll see that the panel member and your lawyer write notes of the
answers to their questions.
|1. Question to your doctor and nurse
|Q. Is the patient suffering from a mental
||If you were admitted on a Section 2, for
assessment, you may not have had a clear diagnosis when you were
admitted. Your doctor will be asked about your diagnosis now.
|Q. Is the patient's disorder of a nature that
||'Nature' means that the type of disorder you
have. This will include your diagnosis, whether you improve with
treatment, what you think about
|Q. Is the patient's disorder of a degree that
||This is now you are at the moment. Your
doctor may talk about any symptoms of depression, delusions,
hallucinations, and whether you are looking after yourself.
|Q. Is the assessment of the patient completed?
(For patients detained on Section 2)
||This question will
be asked if you are detained on a Section 2. The hospital has only
up to 28 days to do an assessment.
|Q. What is the appropriate treatment for the
This is everything the hospital, or your community team, are
doing to try and help. This includes medication, nursing care,
occupational therapy, psychology, accommodation, carers support,
employment support, and benefits advice.
It also includes what follow-up arrangements will be made when
you leave hospital. This would usually involve a community mental
health team or Crisis/Home Treatment team.
Q. What is the risk if your Section is lifted?
There are 3 categories of risk:
Risk to your health
Risk to your safety
Risk to others by something that you might
Risk to your health: this can include your mental and emotional
health, being distressed by symptoms, and sometimes your physical
health if you have not been looking after yourself.
Risk to your safety: by self-harm, or suicide, or whether you
put yourself in risky situations when you are unwell.
Risk to others: if you become threatening, either verbally or
physically, when you are unwell.
2. Questions to your care co-ordinator
If you have a care co-ordinator, this will be someone from the
community mental health team. They will know more about your social
situation and any follow-up arrangements for you after you leave
Your care co-ordinator may be asked similar questions to your
doctor and nurse, but will also be asked about your accommodation,
finances, and what the views of your nearest relative are.
3. Questions to the ward nurse
If you have been an in-patient on the ward, they will ask the
ward nurse about your behaviour on the ward, how you get on with
staff and other patients, and how you seem to have responded to any
What does my legal advocate ask?
Your lawyer will ask the team to say exactly why you have to
stay on the section. After all the questions have been asked by the
panel and your lawyer, he or she will give a summary of your cases
to the panel as to why the section should be lifted.
When do the panel decide?
At the end of he presentation of evidence, everyone part from
the panel is asked to leave the room. Sometimes, however, hearings
do not proceed (the panel adjourns) if there is missing information
hat would mean that your case cannot be properly heard.
The panel stay in the hearing room and decide whether the legal
criteria for detention are met. They consider the information in
the reports and you care team's evidence and what you and your
lawyer have said. This takes about 15-30 minutes.
What can the panel decide?
It can decide on:
- Immediate discharge from you section of the panel feels that
the criteria have not been met. You can agree to stay voluntarily
in hospital and/or to leave hospital immediately. You can then stop
any treatment if you wish.
- Deferred discharge: this means your section will be lifted at a
particular date in the future - usually a few days. This is usually
to allow time for follow-up arrangements to be made.
- To continue the section - but the panel will make
recommendations to you care team about your continuing care.
- To continue the section with the current treatment plan.
- To continue the section, but to suggest that your care team
consider a Community Treatment Order (CTO). Please ask your team
for more information about this.
- If you are on a 'restriction order', the Secretary of State's
opinion has to be taken into account. Your lawyer will advise you
How will I be told the decision?
You will either come back to the room with your lawyer and be
told, or told separately by your advocate. A written version of the
decision will be sent to the hospital and to your lawyer in the
next few days.
What if I'm not discharged from the section?
If you wanted to be discharged from Section but that does not
happen, your lawyer will advise you on when you can apply again for
Some people may feel that the tribunal was helpful even though
the section wasn't lifted as they heard why the clinical team were
detaining them, and felt they had had a fair hearing. One question
that may be useful to ask the care team is: "What would need to
happen for the team to lift the section?". The answer may help you
in the future to work with your team.
Other useful information
- Rethink Mental
Illness: Helpline: 0300 5000 927 (10.00 am to
2.00 pm Mon - Fri)
- Mind: Info
Helpline: 0300 123 3393 (9.00 am to 6.00 pm Mon - Fri)
0845 767 8000 (6.00 pm to 11.00 pm every day)
- Information from the RCPsych on 'Being
- Information about tribunals is online at yougov.
Original Author: Dr Joan Rutherford
Series Editor: Dr Philip Timms
User and Carer input: members of the Public Engagement Editorial
© June 2015. Due for review: June 2018. Royal
College of Psychiatrists.
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