The views of approved mental health professionals to the nearest relative role in England

Involuntary detention for people with a mental disorder is widely used across Europe. Although relatives have a right to be informed of detention in 12 European countries, their role in the process remains under-researched. This paper focusses on the interaction between mental health professionals and ‘Nearest Relatives’ in England. The Nearest Relative role is defined under the Mental Health Act 1983 and gives named relatives the power to object to discharge a patient from hospital, to object to some forms of treatment and to apply for or request detention of a family member. The paper reports on findings of a survey with 55 Approved Mental Health Professionals (AMHPs) and focus group discussions with 33 AMHPs in 2017-18, who were responsible for co-ordinating and conducting Mental Health Act assessments. Survey data indicates that AMHPs consulted with Nearest Relatives in a high proportion of cases. However, qualitative findings revealed that AMHPs also struggled to balance the legal rights of Nearest Relatives and patients. AMHPs considered several factors before contacting Nearest Relatives including, the actual or assumed wishes of service users, the actual or assumed mental capacity of the service user and the environment in which the Mental Health Act assessment would take place.