Implications of the Bournewood decision Sir: The House of Lords is due to deliver a decision in June on the case of L. v. Bournewood Community and Mental Health NHS Trust. It is expected to uphold the Court of Appeals decision that a hospital could informally admit a person for treatment for a mental disorder under section 131 of the Mental Health Act only with his consent (The Times, Inability to consent makes detection illegel. L. u Bournewood Community and Mental Health NHS Trust, 8 December

more »

... 1977). In the meantime, it is clear that it is unlawful to detain patients without capacity as informal patients and that there are many informally detained in-patients whose capacity to consent ought to be reviewed. I have been told by one second opinion doctor that he has been asked by the Mental Health Act Commission if he would be prepared to work on weekends! This is hardly surprising. However, the more far reaching implications in having a dramatic increase in the number of formally detained in-patients are likely to impact on all health care workers within the psychiatric services. First, there is the added burden of the paperwork involved in preparing the section documentation. Second, increased time will have to be spent attending mental health tribunals, not to mention the effect that these tribunals will have on the Lord Chancellor's legal aid budget. If the House of Lords uphold the court of appeals decision, is there not a case for the introduction of a new section in the Mental Health Act which pertains to those patients who lack the capacity to consent or dissent? DAMIÕN MOHÕN, Lecturer in Forensic Psychiatry,