The majority of patients admitted to psychiatric hospitals are voluntary or informal. The Mental Health Act 1983 (henceforth called 'the Act') is concerned with the minority who are unwilling to accept hospitalization or treatment that others consider essential. It applies to England and Wales. Scotland and Northern Ireland have separate legislation.

The government recently published a Bill that proposes, among other highly controversial measures, preventive detention of those with 'dangerous and severe personality disorder', and detention of those with substance misuse only (who are explicitly excluded from the current Act). Perhaps as an illustration of how centralized health care has become, conferences, courses, and publications on 'implementing the Bill' have been popular, even though it is self-evidently impossible to 'implement' something which, as a Bill, is just a proposal before Parliament rather than an actual law. Most mental health professionals and organizations expressed opposition to these proposals. At the time of writing, plans for an Act are on hold. Accordingly, few changes are currently necessary to the version of this chapter in the previous edition.

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