M v S

Under section 29(3)(c) of the Mental Health Act 1983, the question whether a nearest relative unreasonably objects to an application for admission for treatment is assessed objectively, by asking what a reasonable person in the relative’s position would do in all the circumstances.

The court must have evidence that compulsory admission and detention for treatment are necessary. An objection cannot be treated as unreasonable merely because it challenges medical opinion. On an appeal concerning factual findings, the appellate court will intervene only where the conclusion was not open to the judge, or was plainly wrong or unsupported by the evidence.

The applicant, the eldest son and nearest relative of a woman diagnosed with paranoid schizophrenia, sought permission to appeal against an order made by the Leeds County Court on 28 October 1999. The order under section 29 of the Mental Health Act 1983 authorised the functions of the nearest relative to be exercised by the local social services department because he unreasonably objected to an application for his mother’s admission for treatment.

He contended that her conduct was explained by physical illness and anxiety about surgery, and challenged the medical evidence and the fairness of the hearing. The central issues were whether the judge applied the correct statutory test and whether his factual conclusions were open to him.

1. Application dismissed. Lady Justice Hale refused permission to appeal because the proposed appeal had no realistic prospect of success.
2. The judge correctly applied the test under section 29(3)(c) of the Mental Health Act 1983. The relevant question was what a reasonable person in the nearest relative’s position would do in all the circumstances. The judge also correctly recognised that there had to be evidence supporting the necessity of compulsory admission and detention for treatment.
3. The judge was entitled to accept the consultant psychiatrist’s evidence and find that physical problems and anxiety about surgery had exacerbated the patient’s mental illness. The applicant’s disagreement with the doctors, and his criticisms of the medical records, did not by themselves establish that his objection was reasonable.
4. Although the judge may have misstated aspects of the evidence, the Court of Appeal would not interfere with his fundamental findings of fact unless they were perverse, plainly wrong or contrary to the evidence. The judge had heard the witnesses and the applicant had been able to put his principal criticisms in cross-examination.
5. The court observed that this was not an especially strong case for admission for treatment and hoped that this would be considered when the admission was reviewed. That observation did not affect the refusal of permission. The application was dismissed, and a copy of the transcript was to be provided to the applicant at public expense.

• Court of Appeal (Civil Division): Permission to appeal from the Leeds County Court was refused. The application was dismissed.
• Leeds County Court: His Honour Judge Grenfell made an order under section 29 of the Mental Health Act 1983 on 28 October 1999.