The old definition in s145 was:

"medical treatment" includes nursing, and also includes care, habilitation and rehabilitation under medical supervision;

From 3/11/08, under the MHA 2007 changes, s145 states that:

"medical treatment" includes nursing, [psychological intervention and specialist mental health habilitation, rehabilitation and care (but see also subsection (4) below)

Subsection (4) states:

Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations.

There are two main effects of this change:

1. Medical treatment no longer must be given under medical supervision. See also Responsible Clinician replaces Responsible Medical Officer
2. The effect of the abolition of the "treatability test" is diminished by subsection (4). See also Appropriate treatment test replaces treatability test and applies to all patients under long-term detention

Extract from Explanatory Notes

Section 7: Change in definition of "medical treatment"

38. Subsection (1) of section 7 amends the definition of medical treatment in section 145(1) to read:

"medical treatment" includes nursing, psychological intervention and specialist mental health habilitation, rehabilitation and care (but see also subsection (4) below)".

39. Accordingly, the definition covers medical treatment in its normal sense as well as the other forms of treatment mentioned. Practical examples of psychological interventions include cognitive therapy, behaviour therapy and counselling. "Habilitation" and "rehabilitation" are used in practice to describe the use of specialised services provided by professional staff, including nurses, psychologists, therapists and social workers, which are designed to improve or modify patients' physical and mental abilities and social functioning. Such services can, for example, include helping patients learn to eat by themselves or to communicate for the first time, or preparing them for a return to normal community living. The distinction between habilitation and rehabilitation depends in practice on the extent of patients' existing abilities ­ "rehabilitation" is appropriate only where the patients are relearning skills or abilities they have had before.

40. Subsection (2) inserts a new subsection (4) in section 145 of the 1983 Act (interpretation) to provide that references in the 1983 Act to medical treatment for mental disorder mean medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations. This applies to all references in the 1983 Act to medical treatment in relation to mental disorder, including references to appropriate medical treatment to be inserted by sections 4 to 6 above.

Commencement

Date in force	Commencement order	MHA 2007 section	MHA 1983 sections affected
3/11/08	Mental Health Act 2007 (Commencement No.7 and Transitional Provisions) Order 2008	7	s145

Summary of effect of amendments in Chapter 1 of Part 1

Table from Explanatory Notes, page 9.

Provision	Currently applies to	Will apply in future to	Learning disability provision to apply in future	"Treatability" test applies now	Appropriate medical treatment test to apply in future
Civil Patients (Part 2 of the Act)
Admission for assessment for up to 28 days (section 2)	Mental disorder	Mental disorder	No	No	No
Admission for treatment (s3)	MI, MM, PD, SMM	Mental disorder	Yes	Yes	Yes
"Holding power" for patients already in hospital (s5)	Mental disorder	Mental disorder	No	No	No
Guardianship (s7)	MI, MM, PD, SMM	Mental disorder	Yes	No	No
Patients concerned in criminal proceedings (Part 3 of the Act)
Remand to hospital for report (s35)	MI, MM, PD, SMM	Mental disorder	Yes	No	Yes
Remand to hospital for treatment (s36)	MI, SMM	Mental disorder	Yes	No	Yes
Hospital order (s37)	MI, MM, PD, SMM	Mental disorder	Yes	Yes	Yes
Hospital order without conviction (s37(3) and 51(5))	MI, SMM	Mental disorder	Yes	No	Yes
Interim hospital order (s38)	MI, MM, PD, SMM	Mental disorder	Yes	No	Yes
Hospital and limitation directions (s45A)	PD	Mental disorder	Yes	Yes	Yes
Transfer direction - sentenced prisoner (s47)	MI, MM, PD, SMM	Mental disorder	Yes	Yes	Yes
Transfer direction - other (s48)	MI, SMM	Mental disorder	Yes	No	Yes

Key: MI = mental illness, MM = mental impairment, PD = psychopathic disorder, SMM = severe mental impairment

Resources

Mental Health Act 2007 Explanatory Notes - page 8