Mental disorder — Admission for treatment — Compulsory treatment — Hospital order classifying patient as suffering from mental illness — Patient also diagnosed as suffering from psychotic disorder — Decision to detain patient on ward for treatment of personality disorder — Whether lawful — Mental Health Act 1983, ss 37, 41, 63 — Human Rights Act 1998, Sch 1, Pt I, arts 3, 5(1)(e), 8.
A patient detained for treatment under the Mental Health Act 1983 could be treated compulsorily under s 63 of that Act for any disorder from which he suffered, and not only for the particular form of disorder from which he was classified as suffering under the application or order which authorised his detention.
The House of Lords so held when allowing an appeal by Ashworth Hospital Authority from the Court of Appeal (2003) 1 WLR 1886 which had allowed B's appeal from the dismissal of his judicial review claim by Sir Richard Tucker, sitting as a judge of the High Court on 1 July 2002, of the Hospital's decision to transfer him to a personality disorder ward for compulsory treatment under s 63 of the Act for a psychopathic disorder from which he was also diagnosed as suffering.
Following B's conviction of manslaughter he was classified by the court as suffering from mental illness and detained under hospital and restriction orders under ss 37 and 41 of the 1983 Act. He claimed that s 63 did not permit his compulsory treatment for psychopathic disorder unless and until he was classified as suffering from that disorder.
BARONESS HALE OF RICHMOND said that, having regard to the statutory context and history, on the natural and ordinary meaning of its wording s 63 authorised a patient to be treated for any mental disorder from which he suffered irrespective of whether that fell within the form of disorder from which he was classified as suffering in the authorisation justifying his detention. Classification and reclassification related to criteria for admission and continued liability to detention, not to the treatment which might be given in hospital. Psychiatry was not an exact science, diagnosis was not easy or clear cut, and co-morbidity between personality disorders and mental illness was common. It was not easy to disentangle which features of the patient's presentation stemmed from a disease of the mind and which from underlying personality traits and the psychiatrist's aim should be to treat the whole patient. S 63, so construed, did not raise the potential for breaches of B's Convention rights: a patient's detention could not be justified under art 5(1)(e) unless the medical criteria were met and he was detained in an appropriate place, but beyond that the article was not concerned with suitable conditions or treatment; as a general rule a measure which was therapeutically necessary answered any allegation that treatment breached art 3 or 8.
LORD BINGHAM OF CORNHILL, LORD STEYN, LORD PHILLIPS OF WORTH MATRAVERS D and LORD CARSWELL agreed
R (B) v Ashworth Hospital Authority:  UKHL 20
HL: Lord Bingham of Cornhill, Lord Steyn, Lord Phillips of Worth Matravers, Baroness Hale of Richmond and Lord Carswell: 17 March 2005
Edward Fitzgerald QC, Oliver Thorold and Ulele Burnham (Capsticks) for the Hospital Authority; Richard Gordon QC and Hugh Southey (Roberts Moore Nicholas Jones, Birkenhead) for B.
Reported by: Diana Procter, barrister.