East London and the City Mental Health NHS Trust and Snazell, ex p Brandenburg [2003] UKHL 58

Mental health – human rights – mental health review tribunal

The House of Lord dismissed an appeal against the CA’s decision that it was lawful to readmit a patient to hospital under s2 or s3 Mental Health Act 1983, even where a mental health review tribunal had ordered his or her discharge, notwithstanding that the relevant professionals had not satisfied themselves, where it was practicable for them to do so, that there had been a relevant change of circumstances.


The House of Lords held that no one may knowingly act in a way that had the object of nullifying the decision of a mental health review tribunal. The regime prescribed by Part V of the 1983 Act would plainly be stultified if proper effect were not given to tribunal decisions by those making application for the admission of a patient under the Act. Where an Approved Social Worker was aware of a decision by the mental health tribunal to discharge a patient, the ASW could only apply for the re-admission of that patient, under section 2 or 3 of the Act, if the ASW had formed the reasonable and bona fide opinion that he possessed significant information not known to the tribunal. It was undesirable to prescribe in advance the information that might justify such an opinion. Further, an ASW’s decision to seek admission would not necessarily be vitiated if he failed to take account of a tribunal decision of which he was unaware. The principle that mental health review tribunal decisions should be respected required that, if an application for admission inconsistent in effect with an earlier decision was made by an ASW, a patient should be informed why an earlier tribunal decision was not thought to govern his case. Such a duty had to be limited, since the ASW could not be required to make any disclosure harmful to the patient or others. It could be necessary for an ASW to give reasons in very general terms. In this case, the ASW’s decision to apply for the patient’s re-admission was reasonable having regard to the fact that, following the MHRT’s decision, the patient had failed to continue taking his medication with the result that his condition had deteriorated significantly.

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