These rights help the nearest relative ensure the patient receives appropriate support and treatment.
Who is the nearest relative?
There is only one nearest relative. The approved mental health professional involved in sectioning chooses the nearest relative. This list from the Mental Health Act helps them decide:
- Husband, wife or civil partner
- Oldest son or daughter
- Oldest parent
- Oldest brother or sister
- Oldest grandparent
- Oldest grandchild
- Oldest aunt or uncle
- Oldest niece or nephew
The nearest relative is usually the person who is highest on this list. You are more likely to be the nearest relative if you live with the person who is unwell.
Sometimes the decision is not easy, for example if people are living together but separated, or someone lives outside the UK.
If you have any questions or concerns about how the nearest relative is chosen, speak to ward staff or an independent mental health advocate
What can a nearest relative expect?
In general, these rights depend on the patient giving their consent, unless they are so unwell that they have been assessed to lack capacity as defined by the Mental Capacity Act 2005.
As patients get better their capacity might change so we regularly check if patients give consent to these rights being used.
The nearest relative can expect to be informed if the person with mental health problems is:
- In hospital under section
- Given treatment and care
- Discharged from hospital
Involvement and consultation
If they wish, the nearest relative can be involved in decisions about the patient’s treatment and care.
Their knowledge of what might help, and not help, is important to the patient’s care team so they can expect staff to ask them for their views.
The nearest relative can also expect to be consulted if the treatment plan for the patient involves them in a caring role.
For example, if the patient is given overnight leave or weekend leave to stay with their nearest relative, or if they are an important part of the aftercare plan for when the patient leaves hospital.
Independent mental health advocate support
The nearest relative can ask for an independent mental health advocate to see a patient.
If they have serious concerns, the nearest relative can request a Mental Health Act assessment from the patient’s care team. This might lead to the patient being sectioned.
If they think a patient is well enough, the nearest relative can write to the hospital MHA office to request discharge.
If the responsible clinician disagrees, they can bar (refuse) discharge. The associate hospital managers review their decision. The nearest relative can also appeal to a mental health tribunal.
If a patient disagrees with their section, they can appeal and present their case at a hearing of either the mental health tribunal or the hospital managers.
Nearest relatives do not have an automatic right to attend a hearing. The patient decides.
If they do not attend, the care coordinator will make sure the nearest relative’s views are presented.
You could be entitled to help and support. To find out more visit our information for carers page.