Mental health problems constitute a significant demand on the caseload of GPs. Although most patients can be managed with joint understanding and agreement as to treatment, GPs will encounter patients deemed to have mental illness of such severity that the patients’ ability to consent to treatment, admission or ongoing management in the community is brought into question. Patients may refuse necessary treatment, or lack insight into their condition and the necessary treatment. The patient may not accept that they are unwell. This can put great demands on caregivers and also requires knowledge of the legal framework necessary to ensure treatment of patients safely, legally and ethically. This article aims to outline the Mental Health Act 1983 as it applies in England and Wales, and to give advice on its practical application.
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