Summary of the Mental Health Care Act no. 17 of 2002 (SA)

Summary of the Mental Health Care Act, no. 17 of 2002

Make sure you know your rights and responsibilities!

The purpose of this Act is to regulate mental health care so that the best possible treatment and rehabilitation services are made available to citizens. The Act aims to co-ordinate access to services and to make sure that mental health care services become a part of the general health system. The Act regulates access to services for voluntary, assisted and involuntary patients, State patients and mentally ill prisoners. The Act sets out the rights and duties of patients and providers, and explains how the property of mentally ill persons may be dealt with in a court of law.

What is the State’s duty?

The State has a duty to ensure the provision of mental health care services and to promote the provision of community-based care, treatment and rehabilitation services. It must protect the rights and interests of patients and promote the mental health status of the population in general.

Health establishments must provide the appropriate level of care or refer a person in need of care to a suitable establishment. A health establishment may not give psychiatric medication to a patient for more than six months unless the medication has been authorised by a registered mental health care practitioner.

To provide inpatient secondary level care for more than two months a health establishment must be given permission by the head of the mental health care part of the establishment.

Only tertiary health establishments or psychiatric hospitals may provide tertiary level (i.e. intensive) mental health care to patients.

Psychiatric hospitals may admit and offer treatment to voluntary, assisted and involuntary patients, as well as State patients and mentally ill prisoners. They may also examine persons referred by the Court and persons who are admitted for long periods of care as part of their treatment.

Care and rehabilitation centres may provide care for individuals with severe or profound intellectual disabilities (both assisted and involuntary patients).

Rights and Duties of patients

Patients have the right to respect, human dignity & privacy Patients must usually consent to treatment
The physical and emotional dignity and privacy of patients must be respected at all times.Patients must be provided with care that improves their mental capacity and seeks to reintegrate the person into community life.

Care and treatment must be proportionate to the patient’s condition.

Treatment can only be given to patients if they have agreed to it, if it has been authorised by the Mental Health Review Board, or if delay in treating the patient may result in their death or injury (or the injury of others).
Patients must be protected from exploitation & abuse Patients’ information is confidential
All health establishments and workers must take steps to prevent the exploitation and abuse of patients. This includes preventing forced labour and making sure that treatment is not given to patients as a form of punishment.Any abuse must be reported to authorities by witnesses. Patients’ information may not be revealed to anybody unless withholding information would in some way be harmful to the patient or to other people. In this case, only the head of a health establishment is entitled to disclose the information.
Only mental health is relevant in status determinations Patients cannot be unfairly discriminated against
When a person’s mental health status is being determined, only their mental health must be taken into account. Their socio-political or economic status and cultural or religious background is not relevant. Patients may not be unfairly discriminated against because of their mental health status, and they should get the same treatment as other patients.Institutions have policies and programmes that try to improve mental health status.
Patients’ sexual relationships can be limited Patients must be given discharge reports
The head of a health establishment may only limit intimate adult relationships if the patient suffers from mental illness or if the patient is not able to consent. When a patient leaves and establishment, they must be given a discharge report.
Patients have the right to legal representation Patients must have their rights explained to them
All mental health patients are entitled to a legal representative when submitting applications, lodging appeals or appearing before a magistrate, judge or Review Board. Mental health patients with no money are entitled to legal aid provided by the State. All mental health care patients must be informed of their rights before they are given treatment, unless any delay might result in their death or injury or the death or injury of another person (or their property).

Procedures for patients

The treatment, care and rehabilitation of mental health patients will vary depending on their status. There are three different categories of patient: voluntary, assisted, involuntary and emergency. The table below sets out the procedures for admitting and treating mental health care patients:

Voluntary patient Assisted Patient Involuntary Patient Emergency Patient
Consent Capable of consent Incapable of making an informed decision. May be admitted without consent May be admitted without consent
Treatment May be admitted to any private or State facility that is registered as a hospital where they are entitled to appropriate care. May not receive sleep therapy May be admitted to a private (or State) hospital that is licenced to give electro convulsive treatment and to admit patients who aren’t able to give consent. Any treatment must be approved by the head of the department A patient can only be admitted to an institution for a period of 24 hours
A person cannot be treated as an assisted patient unless a written application (made by a person close to the patient or by a mental health care practitioner) is approved by the head of the establishment. The application will only be approved if the patient is believed to be suffering form mental illness or profound disability and they are thought to be incapable of making their own decision about care or treatment. The person making the application must have seen the potential patient within the previous seven days of making the application.


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