(a) was admitted to hospital on [date of admission to hospital under the Mental Health Act 1983];

(b) was absent without leave from hospital or the place where he ought to be beginning on [date absence without leave began];

(c) was/is* liable to be detained for a period ending on [date authority for detention would have expired, apart from any extension under section 21, or date on which it will expire]; and

(d) returned/was returned* to the hospital or place on [date].

(a) mental illness/severe mental impairment* and the patient's mental disorder is of a nature or degree which makes it appropriate for him to receive medical treatment in a hospital and either - 


(i) such treatment is likely to alleviate or prevent a deterioration of his condition

     or

(ii) the patient, if discharged, is unlikely to be able to care for himself, to obtain the care which he needs or to guard himself against serious exploitation,

(b) psychopathic disorder/mental impairment* and the patient's mental disorder is of a nature or degree which makes it appropriate for him to receive medical treatment in a hospital and such treatment is likely to alleviate or prevent the deterioration of his condition.

I am of the opinion that it is necessary - 

Delete the indents not applicable

(i) in the interests of the patient's own health

(ii) in the interests of the patient's own safety

(iii) with a view to the protection of other persons



that this patient should receive treatment and it cannot be provided unless the patient continues to be detained under the Act, for the following reasons: - 

[Reasons should indicate whether other methods of care or treatment (e.g. out-patient treatment or local social services authority services) are available and if so why they are not appropriate, and why informal admission is not appropriate].

Complete if appropriate
This report shall/shall not have effect as a report duly furnished under section 20(3) for the renewal of the authority for the detention of the patient.

[The above declaration should be completed if the authority for the detention of the patient is due to expire within a period of two months beginning with the date the report is to be furnished to the managers].

Signed

Delete the phrase which does not apply

(a) was received into guardianship on [date];

(b) was absent without leave from the place where he is required to reside beginning on [date absence without leave began];

(c) was/is subject to guardianship for a period ending on [date authority for guardianship would have expired, apart from any extension under section 21, or date on which it will expire]; and

(d) returned/was returned to that place on [date].

* Insert mental illness, severe mental impairment, psychopathic disorder or mental impairment
I am of the opinion that this patient is suffering from* of a nature or degree which warrants the continuation of the guardianship.

It is necessary

Delete (i) or (ii) unless both apply

(i) in the interests of the welfare of the patient

(ii) for the protection of other persons



that the patient should remain under guardianship under the Act for the following reasons - 

[Reasons should indicate why other methods of care are not appropriate].

Complete if appropriate
This report shall/shall not have effect as a report duly furnished under section 20(6) for the renewal of the authority for the guardianship of the patient.

[The above declaration should be completed if the authority for the guardianship of the patient is due to expire within a period of two months beginning with the date the report is to be furnished to the responsible local social services authority].

Signed

Delete whichever does not apply