This document summarizes the Mental Health Care Act of South Africa, which aims to provide care, treatment and rehabilitation for mentally ill persons. It outlines the objectives of the act, advantages, definitions, rights of mental health care users, and principles of care. It describes procedures for voluntary, assisted and involuntary admission, as well as 72-hour assessments and appeals processes. Key points include integrating mental health into overall healthcare, treating patients nearer home, preventing premature discharges, and reducing stigma.

1.  Presented by: Celente French –Nursing
Services Manager

2.  Determining the objectives of the act
 Advantages of the MHCA
 Definitions
 Rights of the MHCU
 Principles for provision of care, treatment and
rehabilitation.
 Consent
 Voluntary, assisted and involuntary admission
 72 hours assessment
 Appeals

3.  To provide for the care, treatment and
rehabilitation of persons who are mentally ill;
to set out different procedures to be followed in
the admission of such persons; to establish
Review Boards in respect of every health
establishment; to determine their powers and
functions; to provide for the care and
administration of the property of mentally ill
persons; to repeal certain laws; and to provide
for matters connected therewith.

4.  Integrates psychiatric into overall healthcare.
 MHCU’s treated nearer to home, least
restricted environment, enhances contact with
family.
 No premature discharges, no overcrowding
psychiatric institutions.
 More quality time with inpatients.
 Destigmatisation

5.  Assisted care, treatment and rehabilitation:
Provision of health implementation to persons
incapable of making informed decisions due to
their mental health status and who do not
refuse the health interventions.
 Assisted mental healthcare user:
A person receiving assisted care, treatment and
rehabilitation.

6.  Associate:
Individual with substantial or material interest
in the well-being of the MHCU.
 Care and rehabilitation centers:
Health establishment providing care, treatment
and rehabilitation to individuals with mental
health disorders.

7.  Health establishment:
Registered healthcare facility: hospital/clinic.
 Mental illness:
Positive diagnosis of a mental health related
illness in terms of diagnostic criteria guidelines,
and diagnosed by a mental healthcare
practitioner.

8.  Maximum security facility
A ward or unit within a psychiatric hospital
that is designated in a manner to ensure secure
holding of a mental healthcare user; staff with
security training are deployed to ensure that
MHCU does not abscond.

9.  Best interest of MHCU
 Respect, human dignity and privacy,
 Consent to care, treatment and rehabilitation,
 Refuse treatment/admission unless:
emergency/assisted/involuntary/state pt,
 No unfair discrimination due to mental illness,
 Exploitation or abuse – (report MHCA 2)

10.  Determinations concerning mental health
status,
 Disclosure of information,
 Limitations on inmate adult relationships,
 Right to legal representation,
 Discharge reports – (form MHCA 03)
 Knowledge and information of rights

11. Voluntary Assisted Involuntary

12.  Provide care, treatment and rehabilitation if:
 - User has given consent /
 - Authorized by court or review board /
 - Due to mental illness, any delay may result in
death or serious harm to the user or others, or
serious damage /loss of property of user or
others .
 Emergency admission
 Report to review board in 24 hours.

14.  Voluntary
 Assisted
 Involuntary
 Emergency involuntary

15.  Capable of full informed consent.

16.  Requires C,T&R for own safety/safety of others,
 MHCU incapable of making informed decision,
 MHCU does not resist, application by family
member/”associate”,
 If under 18, parent/guardian must apply
 If family member/associate unavailable, HC
provider makes application- states efforts to
contact family
 Applicant must have seem MHCU within last 7/7

17.  User has a mental illness that is likely to inflict
serious harm to self/others or necessary to
protect financial interests or reputation of user.
 MHCU incapable of giving consent
 MHCU unwilling to receive C,T&R
 EMERGENCY: (MHCA01) to RB in 24hrs.
 Application (MHCA04)- as in assisted
 2 MHC practitioners examine- (MHCA05)
 Head of establishment (MHCA 07)
 Admit within 24 hrs., 72 hr assessment

18.  User may recover quickly, especially in
substance abuse case.
 Exclude general medical condition
 Users treated closer to home
 Avoid stigma / unnecessary psych. Admission
 Decentralization and integration of MHC

19.  1 Dr & 1 MHC practitioner to reassess physical
en mental status every 24hrs for 72 hrs,
 Must investigate, make diagnosis and start
treatment,
 May transfer user to psyc unit in unable to
cope due to risk of harm (MHCA11),
 Head of establishment may discharge user
during 72hr. Period if warranted.

20.  Head of establishment:
 Discharge user (MHCA 03)
 Convert to voluntary user
 Discharge user as an “involuntary outpatient”
 Apply to Review Board for further involuntary
CT&R as inpatient
 If user requires further involuntary care
beyond 72 hrs, transfer to psyc. Unit .

21.  Mental healthcare user
 Spouse
 Next of kin
 Partner
 Guardian

22.  Appeal within 30 days of head of
establishments decision.
 Appeal must contain facts and grounds for
appeal
 Appeal must be considered within 30 days of
receipt, if upheld the MHCU must be
discharged.

23.  South Africa. 2002. Mental Health Care Act 17 of 2002.
http://www.capementalhealth.co.za/Images/Act.pdf
Date of access: 17 February 2015.