The use of mental health law by relatives with patients with mental health problems: The case of the Nearest Relative

The concept of ‘family burden’ has been used by sociologists to explore the emotional strains and economic difficulties experienced by the families of psychiatric patients. Through drawing on published research, this paper considers the way in which subjective burdens experienced by families might impact on decisions relating to the compulsory admission of patients who have been diagnosed as being mentally unwell. The paper focusses specifically on the role of the Nearest Relative under the Mental Health Act 1983 in England and Wales. Nearest Relatives are given powers to prevent an admission in hospital for treatment or to request an independent review of detention. Conversely, they are also empowered to apply for detention or to request that professionals consider this. The paper highlights a number of tensions related to the Nearest Relative role. First, quantitative research has shown that family members view admission more positively than the users of mental health services. Second, studies have shown that patients and carers hold different perspectives on the degree to which compulsory admission may be justified. Third, users of mental health services may view the actions of Nearest Relatives as detrimental to their recovery. We conclude by considering ways in which the current system may be improved.