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Section 47 and its use with mentally disordered people.

P Wolfson1, M Cohen, J Lindesay

  • 1St Thomas's Hospital, London.

Journal of Public Health Medicine
|February 1, 1990
PubMed
Summary

Compulsory removal of elderly individuals under Section 47 of the National Assistance Act (1948) resulted in high mortality. Reforms are needed to ensure civil liberties protections, similar to the Mental Health Act (1983).

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Area of Science:

  • Public Health
  • Geriatric Psychiatry
  • Health Law

Background:

  • Section 47 of the National Assistance Act (1948) allowed for compulsory removal from homes.
  • Implementations were surveyed in four Regional Health Authorities from 1983-1986.
  • Elderly individuals with psychiatric disorders were predominantly affected.

Purpose of the Study:

  • To survey the implementation of Section 47 of the National Assistance Act (1948).
  • To assess the outcomes and safeguards for individuals compulsorily removed.
  • To compare with provisions under the Mental Health Act (1983).

Main Methods:

  • Survey of Section 47 implementations.
  • Analysis of patient demographics and health status.
  • Review of mortality rates and available legal safeguards.

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Main Results:

  • Majority of compulsorily removed individuals were elderly, in poor physical health, with major psychiatric disorders.
  • High initial mortality rate: 41% died within three months.
  • Section 47 lacked appeal or review mechanisms, unlike the Mental Health Act (1983).

Conclusions:

  • Misunderstandings of the Mental Health Act (1983) and poor inter-service liaison led to underutilization of its safeguards.
  • Section 47's application resulted in significant negative outcomes and lacked civil liberties protections.
  • Recommendations include appropriate use of the Mental Health Act (1983) and reform of Section 47 for equivalent protections.