Practise
The Mental Health Act Code of Practice, and the source pack
89 sources gathered on 29 October 2026: the Acts, the Codes, the judgments and the guidance. Start with a reading path, jump straight to a chapter, or search the lot.
What is the Mental Health Act Code of Practice?
It's statutory guidance, made under s118 of the Act, on how to use the Act in practice. The 2015 Code came into force on 1 April 2015, and it's still the one that applies in England. Doctors, approved clinicians, managers and staff of providers, and AMHPs must have regard to it.
You can depart from it only with cogent reasons, and you should record them (Munjaz). Where the Code says must, it reflects the law. Where it says should, record any departure and why (Code introduction, IX). It's free as a PDF on GOV.UK, and Wales has its own Code, from 2016.
The five guiding principles
- Least restrictive option and maximising independence. If you can treat someone safely and lawfully without detaining them, don't detain them.
- Empowerment and involvement. Involve patients fully in decisions, consider the family's views, and explain any decision that goes against them.
- Respect and dignity. For patients, their families and carers, who should be listened to.
- Purpose and effectiveness. Care with clear therapeutic aims that promotes recovery and follows current guidelines.
- Efficiency and equity. Services working together, with mental health given equal priority to physical health and social care.
They're of equal importance, but how much each weighs depends on the decision (Code 1.1). The 2025 Act will write four principles into s118 for the next Code: choice and autonomy, least restriction, therapeutic benefit, and the person as an individual. More on the principles.
The chapters you'll use most
- Chapter 13. Mental capacity and deprivation of liberty, and when the MCA, not the MHA, is the answer.
- Chapters 14 and 18. Applications for detention, and the holding powers.
- Chapters 24 and 25. Medical treatment, and the treatments with special rules, such as ECT.
- Chapter 26. Restraint, rapid tranquillisation, seclusion and long-term segregation. Seclusion is supervised confinement away from other patients, when it's immediately necessary to contain severe behavioural disturbance likely to harm others (26.103).
Seclusion has its own reviews: nurses at least every two hours, and doctors every four hours until the first MDT review (26.131, 26.134). The restraint page has more.
The MCA and DoLS Codes of Practice
The MCA Code was issued by the Lord Chancellor on 23 April 2007 and has never been revised. Attorneys, deputies, IMCAs and anyone acting in a professional capacity or for pay must have regard to it (MCA s42(4)). Chapters 2 to 5 cover the principles, supporting decisions, the capacity test and best interests.
The DoLS Code of 2008 supplements it. Its account of what counts as a deprivation of liberty is overtaken by AGNI, so read DHSC's 2026 guidance alongside it.
Is there a 2025 Code of Practice?
Not yet. The 2025 Act needs one, and DHSC is amending the 2015 Code rather than starting again. Consultation on a draft is indicatively early 2027. As of 29 October 2026 no draft has been published, so the 2015 Code is the guidance in force. Follow it on the 2025 Act page.
Start here
MHA Code of Practice 2015 (England)
The Code. Read chapters 13, 14, 18 and 24 before your first on-call.
Open PDFGOV.UK
MHA Reference Guide 2015
The best map of who can do what and when. Ignore its old s136 times.
Open PDFGOV.UK
MCA Code of Practice 2007
Chapters 2 to 5 are the capacity test and best interests in plain English.
Open PDFGOV.UK
39 Essex guidance note - assessment and recording of capacity (May 2025)
How to assess and write up capacity so it stands up.
Open PDF39essex.com
DHSC - UK Supreme Court 2026 judgment on what constitutes a deprivation of liberty
Nine pages on what changed in June 2026. Read it before any DoLS work.
Official sourceGOV.UK
Practice Direction - statements and reports in mental health cases (2013)
What your tribunal report must cover. Short and essential.
Open PDFjudiciary.uk
Mental Health Act 2025 - explanatory notes
What each 2025 change does, section by section. Read the overview first.
Open PDFlegislation.gov.uk
DHSC - The new Mental Health Act, next steps towards implementation (Mar 2026)
DHSC's own timetable for the reforms.
Open PDFmoderngov.kingston.gov.uk
Reading paths
- Holding powers: s5(2) and s5(4) MHA Code of Practice 2015, ch. 18
- Police powers and places of safety MHA Code of Practice 2015, ch. 16
- Capacity, and when the MCA is the answer MHA Code of Practice 2015, ch. 13
- Medical treatment and Part 4 MHA Code of Practice 2015, ch. 24
- What counts as deprivation of liberty now
- The Practice Direction: the contents of each report
- The Code on tribunals MHA Code of Practice 2015, ch. 12
- The Tribunal Rules (rule 37 for hearing times)
- Renewal and discharge MHA Code of Practice 2015, ch. 32
- Reference Guide: time limits and who can do what
- Applications for detention MHA Code of Practice 2015, ch. 14
- Treatments with special rules: ECT and s58 MHA Code of Practice 2015, ch. 25
- CTOs MHA Code of Practice 2015, ch. 29
- Assessing capacity MCA Code of Practice 2007, ch. 4
- Best interests MCA Code of Practice 2007, ch. 5
- AGNI in two pages
- Cheshire West, for the history
- The five principles MCA Code of Practice 2007, ch. 2
- Assessing capacity MCA Code of Practice 2007, ch. 4
- 39 Essex: assessing and recording capacity
- Relevant information for each kind of decision
- NICE NG108
- The Code on patients in criminal proceedings MHA Code of Practice 2015, ch. 22
- How the restricted patient system works
- Asking MHCS for leave
- Recall after conditional discharge
- Transfers from prison, and remission
- Fitness to plead and the special verdict: ss4 to 5
- How courts sentence offenders with mental disorders
Jump into the Codes
- 1Guiding principles
- 2Mental disorder definition
- 3Human rights, equality and health inequalities
- 4Information for patients, nearest relatives, carers and others
- 5The nearest relative
- 6Independent mental health advocates
- 7Attorneys and deputies
- 8Privacy, dignity and safety
- 9Wishes expressed in advance
- 10Confidentiality and information sharing
- 11Visiting patients in hospital
- 12The Tribunal
- 13Mental capacity and deprivation of liberty
- 14Applications for detention in hospital
- 15Emergency applications for detention
- 16Police powers and places of safety
- 17Transport of patients
- 18Holding powers
- 19Children and young people under 18
- 20People with learning disabilities or autism
- 21People with personality disorders
- 22Patients concerned with criminal proceedings
- 23The appropriate medical treatment test
- 24Medical treatment
- 25Treatments subject to special rules and procedures
- 26Safe and therapeutic responses to behavioural disturbance
- 27Leave of absence
- 28Absence without leave
- 29Community treatment orders
- 30Guardianship
- 31Guardianship, leave of absence or CTO?
- 32Detention and CTO: renewal, extension and discharge
- 33After-care
- 34Care programme approach
- 35Receipt and scrutiny of documents
- 36Allocating or changing a responsible clinician
- 37Functions of hospital managers
- 38Hospital managers' discharge power
- 39Conflicts of interest
- 40Information for victims
Everything in the pack
89 sources
- Mental Health Act 1983 - revised text (legislation.gov.uk, current to 3 Aug 2026)The Act as currently in force, with every amendment to 3 August 2026, including the 2025 Act provisions already commenced. Outstanding (not yet commenced) 2025 Act changes are listed at the end.
- MHA Code of Practice 2015 (England)Statutory guidance for England, in force since April 2015. Still current: it will be replaced by a new Code written for the 2025 Act.
- MHA Reference Guide 2015DHSC's section-by-section explanation of how the 1983 Act works. Not statutory guidance, but the clearest map of the Act's mechanics (time limits, who can do what). It predates the 2017 police-powers changes: its 72-hour figures for ss135-136 are now 24 hours.
- MHA Code of Practice 2016 (Wales)The separate Welsh Code under the same Act. Needed for anyone training or working in Wales.
- Police powers and places of safety guidance 2017 (s135-136)DH and Home Office guidance on the Policing and Crime Act 2017 changes: 24-hour s135/136 limit, the 12-hour extension, consultation before s136, no police cells for under-18s.
- Mental Health Act 1983 (Places of Safety) Regulations 2017When a police station may still be used as a place of safety for an adult.
- Mental Health (Hospital, Guardianship and Treatment) (England) Regulations 2008 - as made, with statutory formsThe procedural regulations and Schedule 1, the prescribed forms (A1-A11, H1-H6, CTO1-11, G1-G10, M1-M2, T1-T6), as originally made. legislation.gov.uk holds no revised version. Later amendments are missing, including Form CTO12 and the 2020 changes allowing electronic forms.
- Electronic communication of statutory forms - guidance 2021DHSC guidance on sending and signing MHA forms electronically (2020 amendment regulations).
- Mental Health Units (Use of Force) Act 2018Seni's Law: restraint policy, recording, training and the responsible person in each mental health unit.
- Mental Health Units (Use of Force) Act 2018 - statutory guidance 2021Statutory guidance to the 2018 Act for NHS organisations in England and police forces.
- Discharge from mental health inpatient settings - statutory guidance 2024DHSC statutory guidance (January 2024) on discharge planning, including section 117 aftercare.
- Mental Health Act 2025 - as enactedThe amending Act (c. 33), Royal Assent 18 December 2025. It amends the 1983 Act and does not replace it.
- Mental Health Act 2025 - explanatory notesOfficial section-by-section explanation of the final Act. The best single document for teaching what each change does.
- Mental Health Act 2025 (Commencement No. 1) Regulations 2026Brought ss51-52 into force on 6 April 2026 (Human Rights Act duty on private providers; review of CQC notification of under-18 inpatients). The only commencement regulations made so far.
- Keeling schedule - unofficial update to the final Act (Ruck Keene, Jan 2026)Alex Ruck Keene's unofficial update of the DHSC Keeling schedule to the Act as passed. Unofficial and by his own note incomplete, but the most useful 'what will the 1983 Act look like' text available.
- DHSC - Mental Health Bill implementation policy paper (2025)DHSC paper deposited in Parliament (DEP2025-0184) setting out the phased implementation plan and its dependencies (workforce, community services, the new Code).
- DHSC - The new Mental Health Act, next steps towards implementation (Mar 2026)DHSC summary of the implementation timetable, published as an annex to Kingston Council papers (4 March 2026). Code drafting in 2026, consultation in early 2027 and training on the new Code in 2027/28. The prison-transfer time limit is due by December 2027.
- Mental Health Act 2025 - easy read (DHSC, Jan 2026)DHSC easy read summary of the final Act. Useful for patient-facing teaching and for a plain overview.
- Mental Health Bill - impact assessment (DHSC, Nov 2024)The government's costs and expected effects, including projected reductions in detentions and the workforce needed.
- Commons Library - Mental Health Bill 2024-25 briefing (CBP-10260)House of Commons Library briefing on the Bill as it reached the Commons (May 2025).
- Joint Committee on Human Rights - legislative scrutiny of the Mental Health Bill (May 2025)JCHR's 3rd report 2024-26 (HC 601): the Bill's human rights issues, including race disparities, CTOs and children.
- Supervised discharge guidance (MoJ, Feb 2026)MoJ/HMPPS guidance on the new supervised discharge. It covers conditionally discharging restricted patients on conditions that amount to a deprivation of liberty. 2025 Act, in force 18 February 2026, reversing SSJ v MM.
- Supervised discharge FAQs (MoJ, Feb 2026)Companion FAQs to the supervised discharge guidance.
- Supervised discharge application form (MoJ, Jan 2026)The responsible clinician's application form to the Mental Health Casework Section.
- Independent Review of the MHA - final report (Wessely, Dec 2018)'Modernising the Mental Health Act: increasing choice, reducing compulsion'. The origin of the four principles (choice and autonomy, least restriction, therapeutic benefit, the person as an individual) and of most of the 2025 Act.
- Independent Review of the MHA - summary (Dec 2018)Short version of the Wessely review.
- White paper - Reforming the Mental Health Act (Jan 2021)The government's consultation white paper responding to the review.
- Government response to the white paper consultation (Jul 2021)What the government decided after consultation.
- Joint Committee on the Draft Mental Health Bill - report (Jan 2023)Pre-legislative scrutiny of the 2022 draft Bill (HC 696 / HL Paper 128).
- Government response to the Joint Committee (Apr 2024)Which Joint Committee recommendations the government accepted before introducing the Bill.
- POST note 671 - MHA reform, race and ethnic inequalities (2022)Parliamentary Office of Science and Technology evidence summary: why Black people are detained at higher rates.
- POST note 685 - MHA reform, children and young people (2022)POST evidence summary on under-18s and the Act.
- POST note 695 - MHA reform, approaches to improve patient choice (2023)POST evidence summary on advance choice documents and shared decision-making.
- POST note 722 - MHA reform, autistic people and people with a learning disability (2024)POST evidence summary on removing autism and learning disability from the scope of section 3.
- Tribunal Procedure Rules (HESC Chamber) 2008 - consolidated Aug 2025MoJ consolidated text of the First-tier Tribunal (Health, Education and Social Care Chamber) Rules, current to 8 August 2025.
- Practice Direction - statements and reports in mental health cases (2013)What the RC's, nursing and social circumstances reports must contain. Still the current practice direction (HMCTS form HQ1 of August 2026 still points to it). Essential for any trainee writing a tribunal report.
- Practice Statement - delegation of judicial functions to staff, mental health (Dec 2025)Senior President's practice statement (12 December 2025) on what tribunal staff can decide.
- Section 12 approval instructions 2015Secretary of State's instructions on approving s12 doctors (in force 5 January 2016): eligibility, training, the five-year approval period.
- Approved clinician approval instructions 2015The matching instructions for approved clinicians, including the competencies in the AC Directions.
- Approved clinician status - portfolio route guidanceHow to evidence the AC competencies by portfolio. Relevant to higher trainees approaching CCT.
- Restricted patient system - MoJ background briefing (2017)MoJ Mental Health Casework Section overview of ss37/41, 45A, 47/49, 48/49, leave, transfer, recall and discharge.
- MHCS leave guidance for clinicians (MoJ, Oct 2024)How to apply to the Justice Secretary for s17 leave for a restricted patient, and each kind of leave MHCS can agree, from escorted day leave to overnight leave.
- Recall of conditionally discharged restricted patients (MoJ, 2009)MoJ's statement (February 2009, republished 2017) of when and how the Justice Secretary recalls a conditionally discharged patient, and the weight given to the supervisors' views.
- MAPPA and the restricted patient system (MoJ, 2021)How MAPPA works alongside MHCS for restricted patients: categories, levels and information sharing.
- Mental Capacity Act 2005 - revised text (legislation.gov.uk)The MCA as in force, including Schedule A1 (DoLS). The LPS amendments of 2019 are shown as not yet in force.
- MCA Code of Practice 2007The statutory Code. Never revised since 2007, so parts are overtaken by case law; read it with the 39 Essex guidance notes below.
- NICE NG108 - Decision-making and mental capacity (2018)NICE guideline on supporting decision-making, assessing capacity, best interests and advance care planning.
- 39 Essex guidance note - assessment and recording of capacity (May 2025)The standard practitioner guide to carrying out and writing up a capacity assessment, with the case law the Code predates.
- 39 Essex guidance note - best interests (May 2025)Best interests decision-making under s4, after Aintree and later cases.
- 39 Essex guidance note - relevant information for different categories of decision (Apr 2026)What a person must be able to understand for each kind of decision (residence, care, contact, sex, marriage, social media, treatment, tenancy and so on), from the case law.
- 39 Essex guidance note - mental capacity for care providers (Jun 2026)New in 2026: the MCA in day-to-day care, including s5 protection from liability.
- Mental capacity assessments - supportive questioning tool (Mar 2026)Practice guide of suggested questions for each category of decision. Good material for an assessment workshop.
- DoLS Code of Practice 2008The DoLS supplement to the MCA Code (re-published on GOV.UK June 2026). Still the authorising regime for hospitals and care homes. Its Cheshire West-era material on what counts as a deprivation of liberty is overtaken by AGNI.
- DoLS - guidance to the forms (ADASS, 2015)How the standard and urgent authorisation forms are used.
- DHSC - UK Supreme Court 2026 judgment on what constitutes a deprivation of libertyDHSC's initial guidance after AGNI (first published 15 June 2026, updated 22 September 2026).
- AGNI - Court of Protection note for Re X judges (Jun 2026)Note for Court of Protection judges dealing with 'Re X' streamlined deprivation of liberty applications after AGNI.
- AGNI - Ruck Keene, deprivation of liberty after AGNI slides (Jun 2026)Slides from Alex Ruck Keene's explanatory video on the meaning of deprivation of liberty after the decision. A ready-made teaching outline.
- AGNI - ADASS DoLS priority tool after AGNIADASS triage tool for local authorities, revised after AGNI.
- AGNI - CQC statement (Jun 2026)CQC: the judgment has immediate effect; MCA duties and Regulation 11 consent duties are unchanged.
- LPS - Mental Capacity (Amendment) Act 2019The Act creating the Liberty Protection Safeguards. Passed in 2019, still not commenced.
- LPS - 2022 consultation documentThe 2022 consultation on LPS and a new MCA Code.
- LPS - 2022 draft MCA Code of Practice including LPSThe 2022 draft of a new MCA Code. Never issued, and written before AGNI, but its non-LPS chapters show how the main Code was to be modernised.
- LPS - DHSC announcement of a 2026 consultation (Oct 2025)DHSC press release, 18 October 2025, promising a joint DHSC/MoJ consultation on LPS and a revised MCA Code in 2026. As of late October 2026 it has not been launched.
- 39 Essex guidance note - deprivation of liberty and under-18s (Jan 2024, pre-AGNI)Children and DoL (Re D, the inherent jurisdiction, s25 Children Act). Written before AGNI: the framework stands, the threshold analysis does not.
- 2026 UKSC 16 - AGNI (Cheshire West overruled) - judgmentA Reference by the Attorney General for Northern Ireland [2026] UKSC 16, 2 June 2026. Unanimous seven-justice court. The Cheshire West 'acid test' is overruled, and whether there is a deprivation of liberty is multi-factorial. A person who lacks capacity under the MCA can still give valid consent for Article 5 purposes.
- 2026 UKSC 16 - AGNI - press summaryCourt's own summary of AGNI.
- 2014 UKSC 19 - P v Cheshire West (overruled 2026) - judgmentThe 'acid test' (continuous supervision and control and not free to leave). Overruled by AGNI but needed to understand twelve years of DoLS practice and the DoLS Code.
- 2014 UKSC 19 - P v Cheshire West - press summaryCourt's own summary.
- 2012 UKSC 2 - Rabone v Pennine Care - judgmentArticle 2 operational duty to protect an informal psychiatric inpatient from suicide.
- 2013 UKSC 67 - Aintree v James - judgmentBest interests: the patient's welfare in the widest sense, and their own point of view.
- 2018 UKSC 60 - SSJ v MM - judgmentConditional discharge cannot impose conditions amounting to a deprivation of liberty. Reversed for restricted patients by the 2025 Act's supervised discharge.
- 2018 UKSC 66 - Welsh Ministers v PJ - judgmentA CTO cannot authorise a deprivation of liberty.
- 2019 UKSC 42 - Re D (a child) - judgmentParents cannot consent to the confinement of a 16-17 year old so as to avoid Article 5. Its reasoning now has to be read with AGNI.
- 2021 UKSC 52 - A Local Authority v JB - judgmentCapacity to engage in sexual relations; how 'relevant information' is identified.
- CQC - Monitoring the Mental Health Act 2024-25 (Jan 2026)CQC's annual report on how the Act is used: SOAD, racial disparity, autism and learning disability, children, restrictive practice.
- NHS England - Mental Health Act statistics 2025-26 (Oct 2026)Summary chapter (key facts) of the official detention and CTO statistics for England, published 15 October 2026. The detailed chapters are online; the numbers are in the main tables below.
- NHS England - Mental Health Act statistics 2025-26 - main tablesThe underlying tables (detentions by section, ethnicity, age, CTOs).
- NHS England - Mental Health Act statistics 2025-26 - easy readEasy read summary of the 2025-26 figures.
- DHSC - DoLS statistics England 2024-25 - commentary (Mar 2026)Applications, completion times and backlog for 2024-25, the last full year before AGNI.
- Mental Capacity Report Oct 2026 - Mental Health Matters39 Essex monthly report, MHA strand (October 2026).
- Mental Capacity Report Oct 2026 - Health, Welfare and Deprivation of LibertyOctober 2026 HWDOL strand, including 'the most comprehensive first instance run at AGNI so far' ([2026] EWCOP 45 (T2)).
- Mental Capacity Report Oct 2026 - Children's CapacityOctober 2026 children's strand: deprivation of liberty and consenting to confinement after AGNI.
- Mental Capacity Report Oct 2026 - Practice and ProcedureOctober 2026: 'the AGNI effect starts to show in the statistics' (Court of Protection).
- Criminal Procedure (Insanity) Act 1964 - revised textFitness to plead and the special verdict: s4 (the judge decides fitness, on two doctors' evidence), s4A (the trial of the facts) and s5 (the disposals).
- Homicide Act 1957 - revised textSection 2, diminished responsibility, in the form substituted by the Coroners and Justice Act 2009.
- Sentencing Council - offenders with mental disorders guideline (2020)The overarching guideline, in force since 1 October 2020: how courts assess culpability and choose between hospital and prison.
- NHS England - transfer and remission of adult prisoners (2021)NHS England guidance on s47 and s48 transfers from prison and on remission back, with the time standards for each stage.
- Fitness to plead - resuming a prosecution (MoJ guidance, 2022)What MHCS needs when a patient found unfit to plead becomes fit, so the prosecution can resume.
- MRCPsychiatrist: CASC chapter 17, mental health law and capacityOur own CASC revision chapter on the same law, checked 7 October 2026.
GOV.UK, legislation and NHS material is Crown copyright under the Open Government Licence. Parliamentary papers are under the Open Parliament Licence. The 39 Essex Chambers notes, NICE guidance and the Mental Capacity Report belong to their authors: link to them rather than sharing the files.
Questions trainees ask
What is the Mental Health Act Code of Practice?
Statutory guidance under s118 on how to use the Act. The 2015 Code is the current one for England, and departing from it needs cogent reasons that you record.
Is there a Mental Health Act Code of Practice for 2025?
Not yet. DHSC is drafting one for the 2025 Act, with consultation indicatively early 2027. Until it's issued, the 2015 Code applies.
What are the guiding principles in the Code of Practice?
Least restrictive option and maximising independence, empowerment and involvement, respect and dignity, purpose and effectiveness, and efficiency and equity (Code chapter 1).
What does chapter 26 of the Code cover?
Safe and therapeutic responses to behavioural disturbance: restraint, rapid tranquillisation, seclusion and long-term segregation, including how often seclusion should be reviewed.
What is the Mental Capacity Act Code of Practice?
The statutory guidance to the , issued in April 2007. Anyone acting for a person who lacks capacity in a professional capacity or for pay must have regard to it (s42(4)).
Does Wales have its own Code of Practice?
Yes. The 1983 Act covers England and Wales, but Wales has its own Code, from 2016, and its own forms.
Is the 2008 Code of Practice still in use?
No. The 2015 Code revised it and came into force on 1 April 2015. If a source quotes the 2008 Code, check the point against the 2015 one.
How do I reference the Mental Health Act Code of Practice?
Cite it as Department of Health (2015), Mental Health Act 1983: Code of Practice, London, TSO. For a specific point add the paragraph number, such as 26.103, in the style your university or journal asks for.