C, R (on the application of) v Mental Health Review Tribunal

An emergency admission under section 4 of the Mental Health Act 1983 is not invalid merely because the approved social worker and medical practitioner describe the patient’s prior acquaintance differently. The statutory requirement is qualified by practicability and involves judgment, fact and degree. Previous acquaintance is not an absolute condition precedent to the legality of admission.

The Mental Health Review Tribunal’s primary, and perhaps exclusive, function is to determine the medical necessity of continued detention under section 72. It is not generally a substitute court for reviewing the legality of the original admission. The tribunal must act promptly under Article 5.4, but an adjournment is unlawful only if, assessed in its factual context, it exceeds the proper exercise of its discretion.

The claimant was detained for assessment following an emergency application under section 4 of the Mental Health Act 1983. The application relied on one medical recommendation. The approved social worker stated that the claimant was not known to any psychiatrist at the centre, while the recommending doctor asserted that he had previous acquaintance with her.

The claimant argued that the apparent inconsistency invalidated the admission and the subsequent detention. She also challenged the Mental Health Review Tribunal’s decision to adjourn her application for release for seven days. The central issues were whether the admission was arguably unlawful, whether the tribunal could review the legality of the original admission, and whether the adjournment was incompatible with the requirement of prompt review under Article 5.4.

1. Permission and interim relief refused. There was no arguable basis for treating the admission or continuing detention as unlawful. The applications for interim release and for an order requiring the tribunal to reconvene were therefore refused.
2. Any inconsistency between the forms was theoretical rather than destructive. The social worker might have lacked information about the doctor’s previous dealings with the claimant, or might have understood “known to” differently from “previously acquainted”. The statutory language and the form did not require those descriptions to be identical.
3. Section 4 does not make previous acquaintance an absolute condition precedent to lawful admission. It directs the use of a practitioner with previous acquaintance where practicable. Practicability involves judgment, fact and degree. A doctor who had personally examined the claimant on the preceding day could properly fall within the statutory concept of previous acquaintance.
4. There was no requirement for a further application merely because the social worker’s form left some uncertainty. It was sufficient that the second medical practitioner could examine the first practitioner’s certification and assess the relevant qualifications and experience.
5. The tribunal’s primary, and perhaps exclusive, function was to consider the medical necessity of continued detention under section 72. The legality of the original admission could instead be challenged promptly by habeas corpus, without permission. Article 5.4 requires the tribunal to determine matters within its jurisdiction speedily, but the concept of promptness is fact-sensitive.
6. The seven-day adjournment was to the first available date after a hearing involving substantial factual and expert material. In those circumstances it was not shown to be an unlawful exercise of discretion under domestic law or Article 5.4. Permission for judicial review was refused on all grounds, including the challenge to the adjournment. The claimant’s costs were subject to legal services assessment.