MENTAL HEALTH ACT [1975]

Mental Health Act [1975], reused in 1979 is an act for the admission, care and treatment of persons who are
mentally ill and for matters connected therewith. It consists of eight parts:

Part I Outlines the six [6] parts of admission and detention to a psychiatric hospital/ward. They are:
1. Urgent admission [UA],
2. Voluntary admission [VOL],
3. Medically recommended [MR],
4. Order of the court [CO],
5. Order of the Minister with responsibility for prisons and
6. Application of a Mental Health Officer [MHO]

Part II & III Consist of the duties and composition of the psychiatric hospital tribunal and mental health
review tribunal. They are responsible for:
1. Reviewing at least once annually every MR patient hospitalized
2. Review every 6 months every CO patient hospitalized
3. Inspection of psychiatric hospital, home, ward annually
4. Application for discharge

Part IV Deals with the power and duties of the psychiatric hospital director namely in:
1. Granting home leave
2. Transferring patients
3. Issuing apprehension orders

Part V Gives authority to the Minister to approve any house for the mentally ill in need of treatment.

Part VI Deals with the criteria for admission to a psychiatric hospital of an individual in need of care and
treatment. It also explains under what circumstances a patient should not be admitted:
1. Suffering a communicable disease
2. Conditionally discharged
3. Is in lawful custody

Part VII Deals with the protection of patient’s property at the time of admission to a psychiatric ward

Part VIII Consists of the rights of patients and the fines and penalty should they be breached. Namely in:
1. Ill treatment/negligence
2. Sexual acts
3. Aiding escaping hospital care
4. Obstruction and fraud
TYPES OF ADMISSION

URGENT

 Made by any person

 Accompanied by a certificate of a medical practitioner other than the duly authorized medical officer
responsible for the admission of the person.
 A person shall not be admitted to a hospital as an urgent admission patient if more than three [3] days
have elapsed since the date of issue of the medical certificate
 A medical officer shall, within forty-eight hours of admitting to a hospital examine whether or not the
patient is mentally ill and in need of care and treatment in a hospital

VOLUNTARY

 Any person who voluntarily makes a written application if he is competent to make the application
 Where the person to be admitted is under the age of eighteen years, the application shall be made on his
behalf by a parent, guardian or any other person in loco parentis

 The Psychiatric Hospital Director or a duly authorized medical officer may at any time discharge a
voluntary patient if he is satisfied that it is in the interest of the patient to discharge him; and the patient is
not in need of any further care and treatment in a hospital.

 When a voluntary patient who has given notice not be kept in a hospital, the CMO has seven days [7] from
the date of the notice to decide if to keep in a hospital as a medically recommended patient. If no response
after the seven days, the patient cannot be kept warded.

MEDICALLY RECOMMENDED

 Patient is unable or unwilling to express themselves to be in need of treatment

 Made by relative or friend
 2 refferals – 1 Government Medical Officer

A medical certificate issued shall not be valid if

a. More than seven days have elapsed since the date of the last examination referred to therein
b. It is not completed within twelve hours following such last examination
c. Both certificates are not completed within seven days of each other
d. It is made, issued, given, completed or signed by a medical practitioner who is by blood or marriage related
to the patient or the other medical practitioner.

A person who fails or refuses to be admitted to a hospital may by Order be apprehended at any time and in any
place by a police officer or any person designated in writing

Conditional Discharge:

When a letter by the relatives or friends of a medically recommended patient is received the CMO may authorize the
conditional discharge of such a patient if he considers it conducive to the recovery of the patient

If within twelve months - satisfied that he has become so mentally he may by Order direct that the patient be
apprehended and brought back to the hospital
For a period of twelve months from the date of his discharge, be deemed to continue to be a patient of the hospital
or psychiatric ward and may be discharged at any time

On the expiration of twelve months from the date of the conditional discharge, the patient shall be deemed to have
been absolutely discharged.

ORDER OF THE COURT

Judge/Magistrate writes to the CMO for:

 Admission stay < 14 days

 Examined asap to determine the presence of a mental illness
 Submit a report to the court

Court upon receiving report may:

 Cancel order to St. Ann’s and deal with patient as necessary

 Lengthen stay until CMO is satisfied

MINISTER OF NATIONAL SECURITY

Medical certificates of two medical practitioners, one of whom shall be a psychiatrist, until the Psychiatric Hospital
Director is satisfied that he is no longer in need of care and treatment in a hospital.

The Minister, authorize the transfer of a prisoner from a hospital to any other hospital or general hospital,

A person who is discharged from a hospital and prison time continues, shall on discharge be sent back to the place
from which he was originally transferred.

A person, shall be deemed to be a medically recommended patient, if on the expiration of the time during which he
was in lawful custody, he is still a patient

MENTAL HEALTH OFFICER

A person found wandering at large on a highway or in any public place and who by reason of his appearance,
conduct or conversation, a mental health officer has reason to believe is mentally ill and in need of care and
treatment in a psychiatric hospital or ward may be taken into custody for admission for observation.

The authorised medical officer, shall examine patient to determine whether or not the person is in need of care and
treatment.

If yes - the person shall be deemed to be a medically recommended patient and all the provisions relating to a
medically recommended patient shall apply to such a person.

A police officer shall render such assistance for the apprehension and safe conveyance to a psychiatric hospital or
ward of a person

A person shall not be liable to any suit or action in respect of any act done pursuant to the provisions of this section,
if he acted in good faith and on reasonable grounds.
PSYCHIATRIC HOSPITAL TRIBUNAL
The Tribunal shall consist of the Chief Medical Officer, the Chief Magistrate and three medical practitioners. The
Chief Medical Officer and the Chief Magistrate shall each have two alternates. Holds office for a term of three years
but is eligible for reappointment; may resign or be removed at any time. The Chief Medical Officer or either of his
alternates shall be the Chairman of the Tribunal and shall preside over all meetings of the Tribunal.

FUNCTION OF TRIBUNAL

 Review medically recommended patient who has been hospitalised for more than one year
 Review every six months the case of a patient who has been hospitalised for more than six months
 Inspect at least once annually each psychiatric hospital, psychiatric ward or approved home

MENTAL HEALTH REVIEW TRIBUNAL

The Review Tribunal shall consist of the following members:

1. Judge of the High Court

2. Psychiatric Hospital Director
3. a suitably qualified person, not employed by Ministry of Health or National Security, and appointed by the
President on the advice of the Trinidad and Tobago Association for Mental Health

The President shall appoint an alternate member, (a) the Judge—his alternate shall be another Judge of the High
Court; (b) the Psychiatric Hospital Director—his alternate shall be a psychiatrist.

PATIENT MAY APPLY TO REVIEW TRIBUNAL FOR DISCHARGE

A person who is a patient at a hospital, a psychiatric ward, an approved home or a private hospital or a relative or
friend of such person, may make an application to the Review Tribunal requesting his discharge.

Does not apply to a person who was admitted as an order of the Court or an order of the Minister with responsibility
for prisons

Once an application is made the tribunal is summoned and the patient, or his relative or friend where the application
is made on his behalf, may be allowed to attend any meeting of the Review Tribunal

The Review Tribunal, if it is satisfied that a patient is not mentally ill may direct that the person be discharged. A
patient in respect of whom an order is made shall not be kept in a hospital, psychiatric ward or an approved home for
more than two [2] days

POWERS OF HOSPITAL DIRECTORS

Every patient is subject to the authority and control of the Psychiatric Hospital Director and any medical
Does no
practitioner attached to the hospital or psychiatric ward
is a
May prescribe and administer to any patient any treatment that he considers necessary

Permit a patient to be away from a hospital or a psychiatric ward

Authorize the transfer of the patient to an approved home or a private hospital

Apprehension of AWOL patient who has been absent for less than 18 months
APPROVED HOMES
Minister may issue certificate approving use of home as approved home. Applicable for (a) an urgent admission
patient; (b) a voluntary patient; or (c) a medically recommended patient who will be under care and supervision of a
medical officer. The certificate is to be displayed in the public’s view of the home.

LEGALITIES
Protection against civil proceedings - No person is liable to any suit or action in respect of any act done under
lawful direction and authority pursuant to the provisions of this Act

Ill Treatment/Neglect - It is an offence for any person to ill-treat or willfully neglect a person suffering from a
mental disorder who is in his custody or under his care and protection. Any person who is guilty of an offence under
is liable

 On summary conviction - $1000 and to imprisonment for 6 months;

 On conviction on indictment - $4000 and to imprisonment for 2 years

Sexual Activities – It is an offence for any person who is in employed in an approved home, hospital, private
hospital or psychiatric ward to have sexual intercourse with a person who is—(a) a patient; or (b) on the premises as
an outpatient.

 On conviction on indictment to imprisonment for 7 years.

______________________________________________

It is an offence for any person to have sexual intercourse with a person who is suffering from a mental disorder and
who is in his custody or under his care and protection.

It shall be a defence for a person who is charged to prove that he did not know or had no reason to believe or to
suspect that the person was suffering from a mental disorder.

 On conviction on indictment - $10,000 and to imprisonment for 5 years.

Escaping Hospital - a person who aids, abets or assists a patient to leave a hospital is liable.

 On summary conviction - $1000 and to imprisonment for 3 months.

Summary conviction - A person is liable on summary conviction to a fine of $1000 and to imprisonment for 3
months if;

 Neglects patients physiologic needs

 Refuses visitation from medical officer
 Neglect terms of conditional discharge

Obstruction - $500 & 3 months jail Fraud - $10,000 & 2 years jail

The Minister may designate as mental health officers for the purpose of this Act any of the following persons: (a)
PSW; (b) RMN with 6 months supervised experience in social work; (c) DHV with 6 months supervised experience
in social work and in psychiatric nursing, (d) RN with equivalent training and experience as DHV and with 6
months supervised experience in social work and in psychiatric nursing