New guidance to support “nearest relatives” navigating the Mental Health Act

Families supporting relatives detained under mental health legislation have helped develop new resources aimed at improving support and understanding of their legal rights, following a research project led by the University of Bristol.

The initiative brings together researchers, carers, mental health professionals and charities to provide free online guidance for people acting as a “nearest relative” under the Mental Health Act 1983. The role gives certain family members legal powers when a person is detained for psychiatric treatment.

The project has produced a set of accessible online resources explaining nearest relatives’ rights and responsibilities, offering practical advice on how to use them and providing self-care guidance for carers navigating the system.

The work has been funded by UK Research and Innovation and supported by organisations including Mind, Rethink Mental Illness and Bristol City Council.

Researchers said the project was prompted by concerns about the experiences of nearest relatives after early research found many felt overwhelmed and unsupported when trying to navigate the mental health system.

The work has taken almost a decade to develop and was co-created with carers who have direct experience of supporting relatives detained in hospital.

One of them, Hannah from London, has spent more than 15 years supporting her son, who remains in hospital care. She said the complexity of the system can be daunting even for those with professional experience.

“When first faced with the situation, I felt unprepared and overwhelmed,” she said. “Even with my experience working in multi-agency teams, navigating the mental health system is complex. If I’m struggling to get my head around it all, I dread to think what it’s like for others with no background whatsoever, especially at such a traumatic time.”

Hannah said the resources had helped fill gaps in knowledge and would provide both information and emotional support for others facing similar situations.

Under the current legislation, the nearest relative role is automatically assigned according to a legal hierarchy, usually involving a close family member. Nearest relatives have a number of rights, including requesting a mental health assessment, being informed if a patient is detained, objecting to some types of detention and applying for discharge.

They can also ask their local authority or social worker for a carers’ assessment.

However, upcoming reforms to the Mental Health Act will replace the nearest relative role with a “nominated person”, allowing patients to choose someone from their support network to represent them.

Project leaders say the new resources will be particularly important as more people could find themselves asked to take on responsibilities for safeguarding a relative or friend’s rights in mental health care.

Judy Laing, professor of mental health law, rights and policy at the University of Bristol, said the project had brought together a wide range of expertise.

“We’ve brought together a large team from different perspectives and backgrounds to develop the resources, which crucially have been co-created by people with lived experience of the nearest relative role,” she said.

“The feedback we’ve received so far has been really positive. Ultimately, this reform means more people could find themselves being asked to safeguard the rights of a relative or friend in mental health care.”

The team plans to expand the resources further, including producing easy-read versions and Welsh-language materials, as well as updating them once the nominated person reforms come into effect.

Carers involved in the project say the work also reflects wider challenges within the system, including the strain on mental health services.

Hannah said her son had recently been accepted for a rehabilitation ward placement but could face a wait of a year or more for a bed.

“Navigating the system is exhausting and uncertain,” she said. “Sharing our experience through these resources feels meaningful if it helps even a little.”

Another contributor to the project, JJ from Bristol, has supported a family member who has experienced repeated hospital admissions and now helps other carers through a local support service run by Rethink Mental Illness.

“My message and my reason for being part of this project is ‘don’t lose hope’,” he said. “We deserve support.”

Emma Mack, head of legal at Mind, said the new guidance would help relatives better understand their rights under the Mental Health Act and support loved ones more effectively.

“Supporting a loved one when they are detained under the Mental Health Act and at their most vulnerable can feel overwhelming,” she said. “By helping nearest relatives understand and exercise their legal rights, we hope to empower them to navigate the law with confidence.”

Stian Westlake, executive chair of the Economic and Social Research Council, said the project demonstrated how research funding could lead to practical improvements in people’s lives.

“It serves as a perfect example of the power of public investment to ensure social and legal research has real impact that improves lives across the UK,” he said.