Q&A - What is meant by a nearest relative in respect of a psychiatric patient?

Q: I was telephoned by a social worker to say my uncle is detained in a psychiatric hospital. I explained that I have had no contact with him for many years, though I was aware he suffers bouts of depression. I suggested I was not the best person to inform but she said this was standard procedure as I am his ‘Nearest Relative’.  What is the implication of this?

A: Your uncle has been detained in a psychiatric hospital because it is thought he has a mental disorder which requires hospital treatment and for his health or safety, or for the protection of others, it is necessary that this happens on a compulsory basis. 

If people are detained under the Mental Health Act a family member is appointed as their Nearest Relative, giving them the right and responsibility to be involved in decisions concerning the patient’s detention and treatment.  Subject to certain safeguards, they can apply for their relative to be discharged from hospital.

The appointment of a Nearest Relative follows a quite arbitrary set of rules that can result in someone being appointed who has had little or no contact with their relative for many years. Nearest Relative is not the same as ‘next of kin’.  In fact, ‘next of kin’ for a patient in hospital does not actually have a significant legal meaning.  The term Nearest Relative only relates to decisions made in relation to the Mental Health Act 1983.

If you do not wish to be your uncle’s Nearest Relative you can delegate your rights and responsibilities to someone else, provided everyone involved agrees. The Social Worker who contacted you should be able to help. If agreement cannot be reached, a Judge can decide in court.  If no family member is willing, a local authority employee dealing with the patient can be appointed. Taking detailed expert legal advice is advisable.

(Article published 20/02/2017)