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Nearest relative
Explains what a nearest relative is, including what powers and rights they have and how you can change your nearest relative.
Sectioning and guardianships
- Can my nearest relative request a mental health assessment?
- When can my nearest relative section me or place me under a guardianship?
- Can my nearest relative object if I'm going to be sectioned or placed under a guardianship?
- Can my nearest relative discharge me from hospital?
- Can my nearest relative apply for a Tribunal?
The UK Government is changing the Mental Health Act.
Can my nearest relative request a mental health assessment?
Yes. Anyone can request a mental health assessment by contacting your local social services or community mental health team.
However, the local social services team only has a duty to consider a nearest relative's request. If they decide not to section you, they must give written reasons.
When can my nearest relative section me or place me under a guardianship?
If your nearest relative is concerned about your mental health, they can contact your local social services or community mental health team and apply to section you or place you under a guardianship. In reality though, it is normally an approved mental health professional who will make this application.
For more information about what happens when you get sectioned see our pages on sectioning.
Your nearest relative can apply to section you or place you under a guardianship in these circumstances:
Section 2
A section 2 is used if you need to be assessed. It is sometimes used if the doctors don't know you or if you are in a different area.
To section you, your nearest relative would need to:
- fill out a form A1 (England) or form HO1 (Wales) - the forms open in a new window
- get two doctors to agree that you should be admitted to hospital. One of the doctors should know you before the assessment, for example, your GP. At least one of the doctors must be a section 12 approved doctor. The doctors need to complete a specific form and give reasons as to why you meet the criteria.
Section 3
A section 3 is used if you have had your mental health assessed before and are already getting mental health treatment. For example, you already have a mental health diagnosis or are receiving support from a psychiatrist or community mental health team.
To section you, your nearest relative would need to:
- fill out a form A5 (England) or form HO5 (Wales) - the forms open in a new window
- get two doctors to agree that you should be admitted to hospital. One of the doctors should know you before the assessment, for example, your GP. At least one of the doctors must be a section 12 approved doctor. The doctors need to complete a specific form and give reasons as to why you meet the criteria.
Section 4
A section 4 is used in an emergency only, when you need to be admitted to hospital under section 2 but cannot wait for the second medical assessment. You could be detained for up to 72 hours.
To section you, your nearest relative would need to:
Guardianship
Guardianship is used for people that can be cared for in the community. It is only rarely used.
To place you under a guardianship, your nearest relative would need to:
- fill out a form G1 (England) or form GU1 (Wales) - the forms open in a new window
- get two doctors to agree that you should be admitted to hospital. One of the doctors should know you before the assessment, for example, your GP. At least one doctor should be a section 12 approved doctor. The doctors need to complete a specific form and to give reasons as to why you meet the criteria.
Can my nearest relative object if I'm going to be sectioned or placed under a guardianship?
Yes. You cannot be detained under section 3 or be placed under a guardianship if your nearest relative disagrees.
To object, your nearest relative needs to tell the approved mental health professional (AMHP) and give them reasons why they disagree. This can be done verbally or in writing.
But if the AMHP thinks that your nearest relative is being unreasonable by disagreeing, they can apply to change the nearest relative to someone else (also known as displacement).
You can be detained under section 2 and 4 even if your nearest relative disagrees.
Can my nearest relative discharge me from hospital?
Your nearest relative can write to the hospital managers to tell them that they want to discharge you if you are on a section 2, 3 or 4 or are subject to a community treatment order or guardianship from a section 3. These rules do not apply if you are on a section 37 or have been put on an order from a section 37.
If you are sectioned or on a community treatment order, the nearest relative must wait 72 hours before discharging you so the responsible clinician can decide whether to challenge it. The responsible clinician must prove that you are likely to act in a way that would be dangerous to yourself or others if you were discharged.
Flowchart: How can my nearest relative discharge me?
Can my nearest relative apply for a Tribunal?
Yes. There are different rules for applying for Mental Health Tribunals depending on which section you are detained on and whether your nearest relative has been displaced. The Tribunal Service website has a useful information sheet for nearest relatives.
Mental Health Tribunal (MHT)
This is a special court that deals with cases relating to the Mental Health Act 1983. The Tribunal decides whether you can be discharged from your section. It can sometimes make recommendations about matters such as hospital leave, transfer to another hospital, guardianship and community treatment orders (CTOs).
The court is made of a panel, which normally includes:
- a legally qualified chairperson
- a ‘lay member’ who has appropriate experience and qualifications in the area of mental health
- an independent psychiatrist, who will speak to you and examine you before the tribunal hearing in certain circumstances, and when you request to see them
Where you see a reference to the Mental Health Tribunal in this guide, it means:
- First Tier Tribunal (Mental Health), if you live in England, or
- Mental Health Review Tribunal for Wales, if you live in Wales.
Section
Being 'sectioned' means that you are kept in hospital under the Mental Health Act. There are different types of sections, each with different rules to keep you in hospital. The length of time that you can be kept in hospital depends on which section you are detained under.
See our pages on sectioning for more information.
Visit our full listing of Legal TermsDisplacement
Displacement is where you change your nearest relative. The process of changing the nearest relative is often known as ‘displacement proceedings’.
Your nearest relative can be displaced if you or the local authority have concerns about the way that they are behaving.
See our pages on the nearest relative for more information.
Visit our full listing of Legal TermsResponsible clinician (RC)
This is the mental health professional in charge of your care and treatment while you are sectioned under the Mental Health Act.
Certain decisions, such as applying for someone who is sectioned to go onto a community treatment order (CTO), can only be taken by the responsible clinician.
All responsible clinicians must be approved clinicians. They do not have to be a doctor, but in practice many of them are.
Visit our full listing of Legal TermsMental Health Act Code of Practice
This tells health professionals how they should follow the Mental Health Act. It is not law, so it cannot be enforced by going to court, but health professionals should follow it unless there is a good reason not to.
The Code covers some areas not specifically mentioned in the Mental Health Act, such as visiting rights and the use of seclusion.
If a health professional doesn’t follow the Code, you can make a complaint.
Visit our full listing of Legal TermsCommunity treatment order (CTO)
If you have been sectioned and treated in hospital under certain sections, your responsible clinician can put you on a CTO. This means that you can be discharged from the section and leave hospital, but you might have to meet certain conditions such as living in a certain place, or going somewhere for medical treatment. Sometimes, if you don't follow the conditions or you become unwell, you can be returned to hospital.
See our pages on CTOs for more information.
Visit our full listing of Legal TermsHospital managers (also known as Mental Health Act managers)
Hospital managers are an independent team of people in a hospital who make sure that the requirements of the Mental Health Act are properly applied. They have certain important responsibilities and can make decisions related to your detention.
In practice, most of the day-to-day decisions are taken by individuals authorised by the hospital managers to do so. This can include hospital staff. Decisions about discharge are normally delegated to a team of people who are independent of the hospital. You can apply to them to be discharged from your section and they will decide whether or not to discharge you.
Visit our full listing of Legal TermsDetained
A person is detained if they are being kept in hospital under section and are not free to leave.
Visit our full listing of Legal TermsApproved mental health professional (AMHP)
AMHPs are mental health professionals who have been approved by a local social services authority to carry out duties under the Mental Health Act. They are responsible for coordinating your assessment and admission to hospital if you are sectioned.
They may be:
- social workers
- nurses
- occupational therapists
- psychologists.
Nearest relative
The nearest relative is a family member who has certain responsibilities and powers if you are detained in hospital under the Mental Health Act. These include the right to information and to discharge in some situations.
The law sets out a list to decide who will be your nearest relative. This can sometimes be changed.
See our pages on the nearest relative for more information.
Visit our full listing of Legal TermsGuardianship
This is where someone called a 'guardian' is appointed instead of being sectioned and kept in hospital. Your guardian could be a person or a local authority.
You can only be placed under guardianship if it's necessary for your welfare or to protect other people. Your guardian has the power to make certain decisions about you and to make conditions that you will be asked to keep to, such as where you live.
Guardianship lasts for up to six months and can be renewed: initially for a further six months, and then for a year at a time. You can appeal to the Mental Health Tribunal once in each of these periods.
Visit our full listing of Legal TermsSection 12 approved doctor
This is a doctor trained and qualified in the use of the Mental Health Act, usually a psychiatrist. They may also be a responsible clinician, if the responsible clinician is a doctor.
Visit our full listing of Legal TermsView this legal guide as a PDF (opens new window)
This information was published in November 2020.
This page is currently under review. All content was accurate when published.
References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.
