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Mental Health Act (Cap. 262) Consolidated

CHAPTER 262

MENTAL HEALTH ACT

To provide for the treatment and care of mentally disordered persons and for purposes connected therewith or ancillary thereto.

14th September, 1981

ACT XVIII of 1976, as amended by Acts XIII of 1983 and VI of 2001; and Legal Notice 423 of 2007.

ARRANGEMENT OF ACT

Short title. l. The short title of this Act is Mental Health Act.

PART I

PRELIMINARY

Interpretation. 2. (1) In this Act, unless the context otherwise requires -

"absent without leave" has the meaning assigned to it by article
25;
"h ospit a l" means th e Moun t Car m el Hospi t al, th e Chambrai hospital, and any other place declared by the Minister, by notice in the Gaze tte * , to be a hospital for the purposes of this Act, and
(without prejudice to the generality of article 36), in relation to a person liable to be detained in a hospital, includes a mental nursing home;
"manager" means -
(i) in relation to the Mount Carmel Hospital or to the Chambrai Hospital, the Physician Superintendent of such hospital, or the medical officer acting in his place in that capacity;
(ii) in relation to any other hospital or to any mental nursing home, the person or persons responsible for the management of that hospital or nursing home;
"Medical Council" means the Medical Council constituted under

Cap. 94.

article 20 of the Department of Health (Constitution) Ordinance;
"medical practitioner" means any person whose name is entered in the Medical Register kept by the Medical Council;
"medical treatment" includes nursing, and also care and training under medical supervision;
"mental disorder" means mental illness, arrested or incomplete development of mind, psychopathic disorder, and any other disorder or disability of mind;
"Men tal H ealth Revi ew Tr ibun al" means the Mental He alth
Review Tribunal established by article 38;
"mental nursing home" means any premises, not being a hospital, used or intended to be used for the reception of, and the provision of nursing or other medical treatment for, one or more mentally disordered patients (whether exclusively or in common with other persons);
"mental welfare officer" means a person who, irrespective of his appointment, title or designation, is by the Minister either charged with performing the functions of a mental welfare officer for the purposes of this Act or otherwise detail ed to perform those functions;
"Minister" means the Minister responsible for public health; "nearest relative" and "relative" in relation to a patient has the

*See Legal Notice 169 of 1994.

meaning assigned to it in Part III of this Act;
"patient" means a person suffering, or appearing to be suffering, from mental disorder;
"prescribed" means prescribed by regulations under this Act;
"psychopathic disorder" means a persistent disorder or disability of mind (whether or not including subnormality of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the patient, and requires or is susceptible to medical treatment;
"residential home for mentally disordered persons" means an establishment the sole or main object of which is, or is held out to be, the provision of accommodation, whether for reward or not, for persons suffering from mental disorder, not being a mental nursing home or a hospital;
"responsible medical officer", in relation to a patient liable to be detained in a hospital, means the medical practitioner in charge of the treatment of the patient;
"severe subnormality" means a state of arrested or incomplete development of mind which includes subnormality of intelligence and is of such nature or degree that the patient is incapable of living an independent life o r of g u ardin g hi mself again s t seri ous exploitation, or will be so incapable when of an age to do so;
"s ubnormality" means a state of arrested or incomplete developm ent of min d (n ot amo untin g to severe subn orm a l ity) which includes subnormality of intelligence and is of a nature or degree which requires or is susceptible to medical treatment or other special care or training of the patient.
(2) Nothing in this article shall be construed as implying that a person may be dealt with under this Act as suffering from any form o f men t al d i sor d er d e scri bed i n thi s arti cl e by reaso n onl y o f promiscuity or other immoral conduct.

3. (1) Nothing in this Act shall be construed as preventing a patient who requires treatm ent for mental disorder from being admitted to any hospital or mental nursing home in pursuance of arra ngements made in that behalf and without any application, or de r or di re cti o n r e n d e r i n g su ch p a ti en t li ab le to b e det a i n ed therein under this Act, or from remaining in any hospital or mental nursi ng hom e i n pu rsuan ce of such arrangem e nts after he has ceased to be so liable to be detained.

(2) In the case of a minor who has attained the age of sixteen y e ar s, and i s cap a ble of expr essi ng hi s o w n wi shes, an y su ch arrangements as are mentioned in subarticle (1) may be made, carried out and determined notwithstanding any right of custody or control vested by law in his parent or tutor.

Informal admission of patients.

PART II

Provision of hospital services, etc.

PROVISION OF SERVICES FOR MENTALLY DISORDERED

4. The Minister may, in respect of or in relation to persons who are or have been suffering from mental disorder, provide or mak e arr a n g emen ts for , or con tin ue th e p r ov ision of or arrangements made for, all or any of the following:

(a) services for the care and treatment of such persons in hospitals;
(b) centres or other facilities for training or occupation, and the equipment and maintenance of such centres;
(c) any ancillary or supplementary services for or for the benefit of any such persons.

Power to make regulations in respect of hospitals, etc.

5. (1) The Minister may make regulations as to the organization, management and conduct of any hospital and of any other premises in which facilities for training or occupation are provided in respect of or in relation to persons referred to in article

4 of this Act.
(2) Without prejudice to the generality of the foregoing, any such regulations may in particular confer upon any officer of the Dep a rtmen t of Health o r on su ch oth e r person as m a y be prescribed, such powers of inspection as may be prescribed by the regulations.

Licence to manage mental nursing homes.

Amended by: XIII. 1983.5;

L.N. 423 of 2007.

6. (1) No person shall keep or manage a mental nursing home without a licence issued by the Superintendent of Public Health, and no such licence shall be issued unless the relative premises have been registered with the said Superintendent as a mental nursing home.

(2) Any person who keeps or manages a mental nursing home without a licence issued under this article shall be guilty of an offence and shall be liable, on conviction, to a fine (multa) not exceeding fone thousand and one hundred and sixty-four euro and sixt y-nin e cen ts (1,164.69) an d to a fine ( multa ) not exceeding eleven euro and sixty-five cents (11.65) for each day during which the offence continues.

Conditions for registration and for management and conduct of mental nursing homes.

7. (1) The Minister may make regulations providing for the conditions of registration and for the management and conduct of mental nursing homes.

(2) Without prejudice to the generality of the foregoing, such regulations may in particular make any provisions the Minister may deem appropriate in respect of -
(a) the type of nursing or other medical treatment to be provided in such homes;
(b) the form and content of applications for registration; (c) the issue, form and content of certificates of
registration;
(d) the facilities and services to be provided in such
homes; and
(e) any other matter ancillary to or connected with any of the matters aforesaid.

8. (1) Any application for the registration of a mental nursing home shall specify whether or not it is proposed to receive therein patients who are liable to be detained under the provisions of this Act.

(2) It shall be a condition of the registration of any mental nursing home that the number of persons kept at any one time in the home (excluding the persons managing or employed in the home a n d the i r fa milies ) does not ex ceed such number as may be specified in the certificate of registration, and, without prejudice to the foregoing provisions, the registration may be effected subject to su ch co nd it io ns (to b e sp eci f ied i n th e cer t i f icat e) as t h e Sup e ri nt en de nt of Pub l i c H eal th may c o nsider appropriate for regulating the age, sex or other category of persons who may be received in the home.

Special provisions as to registration of mental nursing homes.

9. (1) Any person who fails to comply with any provision of any regulation made under article 7 (other than a regulation made in respect of matters referred to subarticle (2)(b) or (c) thereof) or with any condition imposed by or under article 8 shall be guilty of an offence and shall be liable, o n a first con v ic tio n, t o a fin e (multa) not exceeding eleven euro and sixty-five cents (11.65) and, on a second or subsequent conviction, to a fine ( mu lta ) not exceeding forty-six euro and fifty-nine cents (46.59) and in the case of a continuing offence to a fine (multa) not exceeding four euro and sixty-six cents (4.66) for each day during which the offence continues.
(2) Where a person is convicted more than once under this article, the Superintendent of Public Health may cancel any licence issued by him under this Act in favour of such person.

Offences against articles 7 and 8 of this Act.

Amended by: XIII. 1983.5;

L.N. 423 of 2007.

10. (1) Any person authorised in that behalf by the Superintendent of Public Health may at any time, after producing (if so requested) some duly authenticated document showing that he is so authorised, enter and inspect any premises which are used, or which are reasonably suspected by him to be used, as a mental nursing home, and may require the production of and inspect any records kept therein, other than records relating to the treatment of particular patients.

(2) A person authorised under subarticle (1) to inspect a mental n u rsi ng ho me may v i sit and in tervi e w in p r iv at e an y men t all y disordered patient in the home -
(a) for the purpose of investigating any complaint as to his treatment made by or on behalf of the patient; or
(b) in any case where the person so authorised has reasonable cause to believe that the patient is not receiving proper care;
and where the person so authorised is a medical practitioner, he

Inspection of mental nursing homes.

Continuance in force of licence on cancellation or death.

may examine the patient in private and require the production of and inspect any medical records relating to treatment of the patient in the nursing home.

11. (1) Where any licence issued in favour of any person with respect to any mental nursing home has been cancelled under the provisions of article 9 and, at the time of the cancellation, there is at that home any patient liable to be detained in the home under any of the provisions of this Act, the licence shall, notwithstanding its cancellation, continue in force for a period of two months from the date of cancellation or until every such patient has ceased to be so liable, whichever first occurs.

(2) Where any person licensed under article (not being one of two or more persons licensed in respect of the same mental nursing home) dies and, at the time of his death, there is at the relative mental nursing home any patient liable to be detained therein under any of the provisions of this Act, the relative licence shall continue in force for the ben e fit of any person approved by the Superintendent of Public Health until the expiration of two months fr om that death, or until ever y such patient has ceased to be so liable, o r until a p e rson ot her t h an the deceased has been so licensed, whichever first occurs.

Applicability of certain articles to residential homes.

Powers of entry and inspection by mental welfare officer.

12. The provisions of article 6(1), article 7(2)(b), (c), (d) and ( e ), ar ticle 8(2), ar ticle 9 a nd article 10(1) shall apply mut a tis mutandis to residential homes for mentally disordered persons.

13. A mental welfare officer may, at all reasonable times, after producing (if so requested) some duly authenticated do cument showing that he is such an officer, enter and inspect any premises (n ot being a hospital) in which a mentally di sordered person is living, if he has reasonable cause to believe that the patient is not under proper care.

PART III

Compulsory admission for observation or for treatment.

COMPULSORY ADMISSION TO HOSPITAL

14. (1) A patient may be admitted to a hospital, and there detained for such period or periods as are specified in this Act, -

(a) for observation, in pursuance of an application for that purpose (in this Act referred to as an application for admission for observation), or
(b) for treatment, in pursuance of an application for that purpose (in this Act referred to as an application for admission for treatment),
made in each case in accordance with the following provisions of this article.
(2) An application for admission under this article may be made in respect of a patient on the grounds -
(a) that he is suffering from mental disorder of a nature or
degree which warrants the detention of the patient in a hospital; and
(b) that it is necessary that he be so detained in the interests of his own health or safety or with a view to the protection of other persons.
(3) An application for admission under this article shall be founded on the written recommendations in the prescribed form, given either joi ntl y or separately by two medi cal pr act itio ners, i n cl udin g in each case a stat ement that in the op inio n of the practitioner the conditions set out in subarticle (2)(a) and (b) are complied with:
Provided that, in the case of an application for admission fo r treatm ent , th e tw o med ical practi ti one rs sh all gi ve deta iled reasons for their opinion and must specify whether other methods o f d e al ing wi th th e pati en t are av ai labl e an d, i f so , wh y such methods are not appropriate.
(4) Nothing in this article contained shall preclude a patient admitted to a hospital in pursuance of an application for admission fo r o b se rv at io n f r o m re cei vi ng su ch me dical treatment as the responsible medical officer considers appropriate.

15. (1) In any case of urgent necessity, a patient may be admitted to a hospital for observation and there detained for such period and under such conditions as are specified in this article, in pursuance of an application made in accordance with the following provisions of this article, and any such application is in this Act referred to as an emergency application.

(2) An emergency application shall include a statement by the app licant (to be verified b y th e medical reco mmend ati on f i rst referred to in subarticle (3)) that it is of urgent necessity for the patient to be admitted and detained for observation under article 14, and that compliance with the other provisions of this Part of this Act relating to applications for admission for observation would involve undesirable delay.
(3) An emergency application shall be sufficient if founded on one of the medical recommendations required by article 14, given, if practicable, by a practitioner who has previous acquaintance with t h e pat i en t and ot herwise compl y ing with the req u irement s of
article 17 of this Act so far as appli c abl e to a sing le recommendation, but shall cease to have effect on the expiration of
a period of seventy-two hours from the time when the patient is admitted to the hospital unless -
(a) the second medical recommendation required by article 14 is given and received by the manager within that period; and
(b) that recommendation and the recommendation first referred to in this subarticle together comply with all the requirements of article 17.

Compulsory admission for observation in case of emergency.

16. (1) Subject to the provisions of this article, an application

General provisions as to applications.

for the admission of a patient to a hospital may be made either by the nearest relative of the patient or by a mental welfare officer, and an application under article 15 in respect of a patient who is serving a sentence of imprisonment as defined in article 44(4) may also be made by the Director of Prisons; and every such application shall be addressed to the manager of the hospital to which admission is sought and shall specify the qualification of the applicant to make the application.
(2) An application for admission for treatment shall not be made by a mental welfare officer if t h e near est r e lat i ve of the patient has in writing notified that officer or the Superintendent of Public Health that he objects to the application being made, and, without prejudice to the foregoing provision, shall not be made by such office r except after consulta t i on wit h the person (i f any) appearing to be the nearest relative of the patient unless it appears to that officer that in the circumstances such consultation is not reasonably practicable or would involve unreasonable delay.
(3) No application for the admission of a patient shall be made by any person unless that person has personally seen the patient within the period of fourteen days, or, in the case of an emergency application, of three days, in either case ending with the date of the application.

General provisions as to medical recommendations.

17. (1) The recommendations required for the purposes of an application for the admission of a patient under this Part of this Act (in this Act referred to as "the medical recommendations") shall be given by medical practitioners who have personally examined the patient either together or at an interval of not more than three days.

(2) Of the medical recommendations given for the purposes of any such application, one shall be given by a practitioner whose name appears on a list, approved by the Minister after consultation with the Medical Council, of medical practitioners having special experience in diagnosis or treatment of mental disorder; and, unless that practitioner has previous acquaintance with the patient, the othe r such recommendation shall, if practicable, be given by a medical practitioner who has such previous acquaintance.
(3) A medical recommendation for the purposes of an application for the admission of a patient under this Part of this Act shall not be given by any of the following persons, namely:
(a) the applicant;
(b) a partner of the applicant or of a practitioner by whom another medical recommendation is given for the purposes of the same application;
(c) a person employed by the applicant or by any such practitioner as aforesaid;
(d) a person who receives or has an interest in the receipt of any payments made on account of the maintenance of the patient; or
(e) the husband or wife, or a relative by consanguinity or affinity up to the second degree of the patient, of any
such person as aforesaid, or of a practitioner by whom another medical recommendation is given for the purpose of the same application.

18. (1) Where a patient is already an in-patient in a hospital, b u t i s n o t li able to be detai n ed th erein un der th e fo rego in g provi sio n s o f thi s Part o f thi s Act, an appl icat ion m a y, t h is notwithstanding, be made for his admission to that hospital for observation or for treatment.

(2) Where a patient is already an in-patient in a hospital, liable to be detained therein having been admitted to that hospital for observation, an application may, this notwithstanding, be made for his admission thereto for treatment.
(3) Where an application is made under the provisions of subarticle (1) or of subarticle (2), the patient shall be treated, for the purposes of this Part of this Act, as if he had been admitted to the hospital at the time when that application was received by the manager.
(4) Without prejudice to the provision of subarticle (1), where a patient is already an in-patient in a hospital, but is not liable to be detained therein und er th is Par t of thi s A ct, if i t appear s to t he medical practitioner in charge of the treatment of the patient that an application ought to be made under this Part of this Act for the admission of the pati ent to ho spital for observati on or for treatment, he may furnish to the manager a report in writing to that effec t; and in any such ca se the p at ien t m ay be d eta in ed i n th e hospital for a period of three days beginning with the day on which the report is so furnished.

Applications in respect of patients already in hospital.

19. (1) An application for the admission of a patient to a hospital under this Part of this Act, duly completed in accordance with the f o regoing provisions of this Part o f this Act, shall be sufficient authority for the applicant, or any person authorised by him in writing, to take the patient and convey him to the hospital at any time within the period of fourteen days beginning with the date appeari ng on the medi cal recommen d at ion last giv e n for the purposes of the application as the date on which the patient was last ex amin ed by the m e d i cal pract itio ner b e fore givin g that recommendation:

Provided that, in the case of an emergency application, such period shall be of two days beginning with the date appearing on the medical recommendation first referred to in article 15(3) as the d a te on wh ich t h e p a ti ent was last examine d by the medical practitioner before giving that recommendation.
(2) Where a patient is admitted within the said period to the hospital specified in such an application or, being already an in- patient in that hospital, is treated by virtue of article 18 as if he had been so admitted, the application shall be sufficient authority for the manager to detain the patient in the hospital in accordance with the provisions of this Act.
(3) A patient who is admitted to a hospital in pursuance of an

Effect of application for admission.

application for admission for treatment may apply to the Mental Health Review Tribunal within the period of six months beginning with -
(a) the day on which he is so admitted, or
(b) in the case of a child who is so admitted before having attained the age of sixteen years, the day on which he has attained such age,
whichever is the later.
(4) Where a patient is admitted to a hospital in pursuance of an application for admission for treatment, any previous application under this Part of this Act by virtue of which he was liable to be detained in a hospital under this Act shall cease to have effect.

Rectification of application and recommendations.

20. (1) Any application for admission for observation or for treatment, or any medical recommendation given for the purposes of any such application, may, within fourteen days beginning with th e day o n wh ich a p a ti en t has been admi tt ed to a h o sp it al i n pursuance of any such application, and with the consent of the manager of that hospital, be amended by the person by whom it was signed if found to be incorrect or defective; and such an application or medical recommendation shall have effect and shall be deemed to have had effect as if it had originally been made or given as so amended.

(2) Without prejudice to the provisions of subarticle (1), if within the period therein mentioned it appears to the manager of the hospital that one of the two medical recommendations on which an application for the admission of a patient is founded is insufficient to warran t t h e d e t e n t i on of th e pati en t i n pur su ance of th e application, he may, within that period, give notice in writing to that ef fect to the applican t and thereupo n such m e dical recommendation shall be disregarded:
Provided that if, within the said period, -
(a) a fresh medical recommendation complying with the relevant provisions of this Part of this Act (other than the provisions relating to the interval between examinations) is given to the manager; and
(b) that recommendation, and the other recommendation on which the application is founded, together comply with those provisions,
the application shall be, and shall be deemed always to have been, sufficient.
(3) Where the medical recommendations upon which an app licati on for admission is found ed are, tak e n together , insufficient to warrant the detention of the patient in pursuance of the application, a notice under subarticle (2) may be given to the applicant in respect of either of those recommendations and the provisions of that subarticle shall apply as if that recommendation were insufficient for the purpose aforesaid.
(4) Nothing in this article shall be construed as authorising the
gi vin g of n ot ice in respe ct of an em ergen cy ap pli cat io n, o r th e detention of a patient admitted in pursuance of such an application, after the period of seventy-two hours referred to in article 15(3), u n less the conditi ons set ou t in paragrap hs ( a ) and ( b ) of that subarticle are complied with or would be complied with apart from any error or defect to which this article applies.

21. (1) Subject to the following provisions of this Part of this Act, a patient admitted to hospital in pursuance of an application for admission for observation may be d etained for a period not exceeding twenty-eight days beginning with the day on which he is so admitted, but shall not be detained thereafter unless, before the expiration of that period, he has become liable to be detained by virtue of a subsequent application, order or direction under any provision of this Act, not being an application for admission for observation.

(2) Subject to the following provisions of this Part of this Act, a patient admitted to hospital in pursuance of an application for admission for treatment may be detained in a hospital for a period not exceeding one year beginning with the day on which he was so admitted, but shall not be so detained for any longer period unless the aut h o r i t y fo r hi s det e nt ion i s renew e d u n d e r th e foll ow ing provisions of this article.
(3) Authority for the detention of a patient as is referred to in subarticle (2) may, unl ess th e patient has been dischar g ed pre v i o usl y, be re ne we d u n d e r t h e fol l o w i ng pro v i s i o n s of th i s article for a further period of one year from the expiration of the period referred to in the said subarticle and, thereafter, for further periods of two years at a time.
(4) Within the period of two months ending on the day on which a patient who is liable to be detai ned in pursuance of an application for admi ssion for treatment would cease under this article to be so liable in default of the renewal of the authority for his detention, it shall be the duty of the responsible medical officer to examine the patient; and, if it appears to the said officer that, in the interests of the patient’s health or safety or for the protection of other persons, it is necessary that the patient should continue to be so liable to be detained, he shall furnish to th e mana ge r of the hospital where the patient is liable to be detained a report to that effect in the prescribed form.
(5) Where a report is duly furnished under subarticle (4), the authority for the detention of the patient shall be thereby renewed for the period prescribed in that case by subarticle (3).
(6) Where a report under subarticle (4) is furnished in respect of a patient who has attained the age of sixteen years, the manager shall, unless he discharges the patient, cause him to be informed as early as practica ble, and the patien t ma y, wi th in t he per i od f or which the authority for his detention is renewed by virtue of that report, apply to the Mental Health Review Tribunal.

Duration of authority for detention.

22. (1) Any postal article addressed to a patient detained in a hospital under this Part o f th is Act m a y be wi thheld fro m t h e

Correspondence of patients.

patient if, in the opinion of the responsible medical officer, the receipt of the article would be calculated to interfere with the treatment of the patient or to cause him unnecessary distress; and any article so withheld shall, if the name and address of the sender are sufficiently identified therein, be returned to him.
(2) Subject to the following provisions of this article, any postal article addressed by a patient so detained and delivered by him for despatch may be withheld by the manager of the hospital -
(a) if the addressee has given notice in writing to the manager of the hospital or to the responsible medical officer requesting that communications addressed to him by the patient should be withheld; or
(b) if it appears to such manager or officer that the postal article would be unreasonably offensive to the addressee, or is defamatory of other persons (other than persons on the staff of the hospital) or would be likely to prejudice the interests of the patient:
Provided that the provisions of this subarticle shall not apply to any postal article addressed to -
(i) any member of the House of Representatives; (ii) the manager of the hospital;
(iii) any other authority or person having power to discharge the patient under this Part of this Act; or
(iv) the Mental Health Review Tribunal, at any time when the patient is entitled to make application to the said Tribunal:
Provided further that the Minister may, by regulations, excep t from the provision s o f this subart icle, su bject to such conditions or limitations as may be prescribed by the regulations, postal articles addressed to such other classes of persons as may be so prescribed.
(3) Neither the manager nor a responsible medical officer shall open or examine the contents of any postal article for the purpose of subarti cle (2)(b) unl ess t he responsible medical officer is of opinion that the patient is suffering from mental disorder of a kind calculated to lead him to send such communications as are referred to in that paragraph.
(4) In this article, "postal article" means any letter, postcard, package, newspaper, printed matter, parcel or other article or thing whatsoever transmissible by post, in any case whether it is in fact transmitted by post or delivered or sent by hand, and includes a telegram and a telex.
(5) The provisions of this article shall apply notwithstanding any provision to the contrary contained in any other enactment.

Visiting and examination of patients.

23. For the purpose of advising whether an application to the Mental Health Review Tribunal should be made by or in respect of a patient who is liable to be detained in a hospital under this Part of

th is A c t, or of furnishing information as to the cond ition of a patient for the purposes of such an application, or of advising as to the exercise by the nearest relative of any such patient of any power to order his discharge, any medical practitioner authorised by or on behalf of the patient or other person who is entitled to make or has made the application, or by the nearest relative of the patient, as the case may be, may, at any r easonable tim e, visit, interview and examine the patient in private and, for such purpose, may require the production of and may inspect any documents relating to the detention of the patient and any other medical records relating to the treatment of the said patient.

24. (1) Subject to the following provisions of this article, the responsible medical officer may grant to any patient who is for the time being liable to be detained in that hospital under this Part of this Act leave to be absent fr o m th e ho spi t a l subject to s u ch conditions, if any, as he may consider necessary in the interests of the patient or for the protection of other persons.

(2) Such leave may be granted to a patient under this article eit h er i n d e fi ni tel y or f o r a spe c if ied p e ri od o r on spe c if ied occasions and, where leave is so granted for a specified period, that period may be extended by further leave.
(3) Where it appears to the responsible medical officer that it is necessary so to do in the interests o f the patient or for the protection of other persons, he may, upon granting leave of absence under this article, direct that the patient remain in custody during his absence; and in any such case the patient shall remain in the custody of the nearest relative, or of such other person designated in writing by the manager of the hospital, as the said manager may direct.
(4) Where a patient is absent from a hospital in pursuance of leave of absence granted under this article, and it appears to the responsible medical officer that it is necessary so to do in the interests of the patient’s health or safety or for the protection of o t h e r perso n s, t h at of f i cer may, subj ect to t h e p r ov isio ns o f subarticle (5), by notice in writing given to the patient and to the person for the time being in charge of the patient (if any), revoke the leave of absence and recall the patient to the hospital.
(5) A patient to whom leave of absence is granted under this article shall not be recalled under subarticle (4) after he has ceased to be liable to be retained under this Part of this Act.
(6) The Minister may make regulations providing for the exercise by the nearest relative or other person in whose custody a patient is placed during his leave of absence (in this Act referred to as the person for the time being in charge of the patient) of such po wers as h e m a y de em ap pro p riate and for imposing on such persons such duties as he may consider necessary or expedient in the interest of the patient, and such regulations may in particular make provision for requiring the patient to be visited by mental w e lfare o ffi cer s or ot her person o n such occasi ons or at su ch intervals as may be prescribed by the regulations:

Leave of absence from hospital.

as affecting the powers of the manager of the hospital or of the responsible medical officer under this Act.

Return of patients absent without leave.

25. (1) Where a patient who is for the time being liable to be detained under this Part of this Act in a hospital -

(a) is absent from the hospital without leave granted under article 24; or
(b) fails to return to the hospital on any occasion on which, or at the expiration of any period for which, leave of absence was granted to him under that article, or upon being recalled thereunder; or
(c) is absent without permission from any place where he is required to reside in accordance with conditions imposed on the grant of leave of absence under that article,
he may be taken into custody and returned to the hospital or place by any mental welfare officer, by any officer of the staff of the hospital, by any Police officer, or by any person authorised in writing by the manager of the hospital.
(2) In this Act "absent without leave" means absent from a hospital or other place and liable to be taken into custody and retu rned under this articl e , and kin d red expressio n s shall b e construed accordingly.

Special provisions as to patients absent without leave.

26. (1) If, at any time within the period of one week ending with the day on which, apart from this article, a patient would cease to be liable to be detained under this Part of this Act, the patient is absent without leave, he shall not cease to be so liable until the expiration of sixty days beginning with the first day of his absence without leave or, if he is returned or returns himself to the hospital or place where he ought to be prior to the expiry of such period, until the expiry of one week beginning with the day of such return.

(2) Where the period for which a patient is liable to be detained is extended by virtue of this article, any examination and report to be made and furnished under articl e 21(4) may be made and furnished within that period as so extended.
(3) Where the authority for the detention of a patient is renewed by virtue of this article after the day on which, apart from this article, that authority would have expired under article 21, the renewal shall take effect as from that day.

Regulations as to transfer of patients.

27. (1) In such circumstances and subject to such conditions as may be prescribed by regulations made by the Minister under this article, a patient who is for the time being liable to be detained in a hospital by virtue of an application under this Part of this Act may be transferred to another hospital.

(2) Where a patient, being liable to be detained in a hospital by v i rt ue o f a n ap pl ic at io n for ad mi ssi on fo r o b s erva ti on or fo r treatment, is transferred to an oth e r h o spit al in pu rsuance of regulations made under this article, the provisions of this Part of
this Act shall apply to him as if the application were an application for admission to that other hospital and as if the patient had been admitted to that other hospital at the time when he was originally admitted in pursuance of the application.
(3) Regulations made under this article may make provision for regulating th e conveyance to th ei r destination of patients authorised to be transferred in pursuance of the regulations.

28. (1) Subject to the provisions of this article and of article

29, a patient who is for the time being liable to be detained under this Part of this Act shall cease to be so liable if an order in writing
discharging him from detention (in this Act referred to as an order for discharge) is made in accordance with the following provisions of this article.
(2) An order for discharge may be made in respect of a patient - (a) where the patient is liable to be detained in a hospital
in pursuance of an application for admission for
observation, by the responsible medical officer or by
the manager of the hospital; and
(b) where the patient is liable to be detained in a hospital in pursuance of an application for admission for treatment, by the responsible medical officer, by the manager of the hospital or by the nearest relative of the patient.
(3) Where the patient is liable to be detained in a mental nu rsing ho me in pursuance of an application for admission for observation or for treatm ent, an order for his di scharg e may, without prejudice to the provisions of subarticle (2), be made by the Superintendent of Public Health.

Discharge of patients.

29. (1) An order for the discharge of a patient who is liable to be detained in a hospital for treatment shall not be made by his nearest relative except after giving not less than seventy-two hours no tice in writing to the manager of the hospital; and if , within seventy-two hours after such notice has been given, the responsible medical officer furnishes to the manager a report that in the opinion of that officer the patient, if discharged, would be likely to act in a manner dangerous to himself or to other persons, -

(a) any order for the discharge of the patient made by that relative in pursuance of the notice shall be of no effect; and
(b) no further order for the discharge of the patient shall be made by that relative during the period of six months beginning with the date of the report.
(2) In any case where a report under subarticle (1) is furnished in respect of a patient, the manager of the hospital shall cause the nearest relative of the patient to be informed, and that relative may, within the period of twenty-eight days beginning with the day on whi c h he is so in fo rm ed, appl y to th e Men t al H ealth Re view Tribunal in respect of the patient.

Restrictions on discharge by nearest relative.

relative and nearest relative.

Cap. 16.

following, namely:
(a) the husband or wife; (b) the son or daughter; (c) the father;
(d) the mother;
(e) the brother or sister; (f) the grandparent;
(g) the grandchild;
(h) the uncle or aunt;
(i) the nephew or niece.
(2) For the purposes of this article, the relationship of an adopted person shall be the same as is provided in article 121 of the Civil Code and, subject as aforesaid, any relationship of the half- blood shall be treated as a relationship of the whole blood and an illegitimate person shall be treated as the legitimate child of the parent by whom he was recognized and, i f that person was recognized by both parents, as the child of the father.
(3) In this Part of this Act, subject to the provisions of this article and to the following prov isions of th is Part of this Act, "nearest relative" means the person first described in subarticle (1) who is for the time being surviving, relatives of the whole blood being preferred to relatives of the same description of the half- blood and the elder or eldest of two or more relatives described in any paragraph of that subarticle being preferred to the other or others of those relatives, in any case regardless of sex.
(4) Where the person who, under subarticle (3), would be the nearest relative of a patient -
(a) is not ordinarily resident in Malta; or
(b) being the husband or wife of the patient, is permanently separated from the patient, either by a judgment or by mutual consent authorised by a decree, in either case given by the competent court, or has deserted or has been deserted by the patient for any period which has not come to an end; or
(c) not being the husband, wife, father or mother of the patient, is for the time being under eighteen years of age; or
(d) is a person who has been divested by any court in Malta of authority over the patient and has not been reinstated; or
(e) has been found guilty by a court in Malta of a sexual offence with a patient or of incest,
the nearest relative of the patient shall be ascertained as if that person were dead.
(5) Where a person of minor age is placed under the tutorship o f an y perso n by a decree of the compet ent cou r t, the perso n appo inted or con f irmed as t u tor, a s t h e ca se ma y be , s h al l be deemed to be the nearest relative of the patient in preference to any other person except the mother of the patient, unless the mother had not been appointed tutrix in view of article 163(c), (e) or (f) of the Civil Code:
Provided that the provisions of this subarticle shall not apply where the minor has contracted marriage notwithstanding that the court shall not have re lease d t h e min or fr om tu to rsh i p i n accordance with the provision of article 158 of the said Code.

Cap. 16.

31. (1) The Civil Court, Second Hall, may, upon application mad e to it in accordance with the provisions of this article in respect of a patient, by decree direct that the functions under this Part of this Act of the nearest relative of the patient shall, during the continuance in force of th e decree, be exercisable by the appli c ant, or b y an y oth e r person wh eth e r specifi e d i n the application or not, in any case being a person who, in the opinion of the court, is a proper person to act as the patient’s nearest relative and is willing to do so.

(2) A decree under this article may be made by the court on the application of -
(a) any relative of the patient;
(b) any other person with whom the patient is residing (or, if the patient is then an in-patient in a hospital, was last residing before he was admitted); or
(c) a mental welfare officer.
(3) An application under this article may be made upon any of the following grounds, namely:
(a) that the patient has no nearest relative, or that it is not reasonably practicable to ascertain whether he has such a relative, or who that relative is;
(b) that the nearest relative of the patient is incapable of acting as such by reason of mental disorder or other illness;
(c) that the nearest relative of the patient unreasonably objects to the making of an application for admission for treatment in respect of the patient; or
(d) that the nearest relative of the patient has exercised without due regard to the welfare of the patient or the interests of the public his power to discharge the patient from hospital under this Part of this Act, or appears likely to do so.
(4) If immediately before the expiration of the period for which a patient is liable to be detained by virtue of an application for admission for observation, an application under this article, being an application made on the ground specified in paragraph (c) or (d) of the last foregoing subarticle, is pending in respect of the patient,

Appointment by court of acting nearest relative.

that period shall be extended -
(a) in any case, until the application under this article has been disposed of by the said court; and
(b) if the application is allowed by the court, for a further period of seven days.
(5) While a decree under this article is in force, the provisions of this Part of this Act (other than this article and article 32) shall apply in relation to the patient as if for any reference to the nearest r el ati ve of t he pat ien t th ere we re sub sti tu ted a ref er ence t o t he person having the functions of that relative and (without prejudice to the provisions of article 33) shall so apply notwithstanding that the person who was the patient’s nearest relative when the decree was made is no longer his nearest relative.
(6) Where a decree is made under this article in respect of a patient who is or subsequently becomes liable to be detained under this Part of this Act, the nearest relative of the patient may make an application to the Mental Health Review Tribunal in respect of the patient within the period of twelve months beginning with the date of the decree and in any subsequent period of twelve months during which the decree remains in force.

Revocation and variation of orders made under article

31.

32. (1) A decree made by the court under article 31 in respect of a pat i en t may be rev o k e d by the court upon an application made -

(a) in any case, by the person having the functions of the nearest relative of the patient by virtue of that decree; or
(b) where the decree was made on the ground specified in article 31(3)(a) or (b), or where the person who was the nearest relative of the patient when the decree was made has ceased to be his nearest relative, by the nearest relative of the patient.
(2) A decree made under the said article 31 in respect of a patient may be varied by the said court, on the application either of the person having the functions of the nearest relative by virtue of the decree or of a mental welfare officer, by substituting for the person having the said functions of a nearest relative any other perso n who in the opinion of the court is a proper person to exercise those functions and who is willing to do so.
(3) If any person having the functions of the nearest relative of a patient by virtue of a decree under the said article 31 dies, such fun c t i on s shall thereupo n v e st in th e men t al wel f are of fi cer responsible for the district in which the patient resides, and such officer shall, within two days from the death of that person or from
the day in which such death shall have com e to his knowledge, whichever shall be the later date, file an application before the said
court in terms of subarticle (2).
(4) A decree made under the said article 31 shall, unless previously revoked under subarticle (1), cease to have effect -
(a) if the patient was on the date of the decree liable to be detained in pursuance of an application for admission for treatment under this Part of this Act, or being so liable within the period of three months beginning with that date, when he ceases to be so liable (otherwise than on being transferred in pursuance of article 27); or
(b) if the patient was not on the date of the order, and has not within the period aforesaid become, so liable, at the expiration of that period.

33. (1) Subject to the provisions of article 16(2), it shall be the duty of a ment al welfare of ficer to make an appli c at ion for admission to hospital in respect of a patient in any case where he is sat i sfied th at such an app licati on ough t t o be mad e and is of opinion, having regard to any wishes expressed by relatives of the patient or any other relevant circumstances, that it is necessary or proper for the application to be made by him.

(2) Nothing in this article shall be construed as restricting the power of a mental welfare officer to make any application under this Act.

Duty of mental welfare officer to make applications.

34. (1) The Minister may make regulations for prescribing anything w h ich, under this Part of this Act, is required or authorised to be prescribed, and otherwise for carrying this Part of this Act into full effect.

(2) Without prejudice to the generality of the foregoing, any regulations made under this article may in particular -
(a) prescribe the form of any application, recommendation, report, order, notice or other document to be made or given under this Part of this Act;
(b) prescribe the manner in which any such application, recommendation, report, order, notice or other document may be proved, and provide for regulating the service of any such application, report, order, notice or other document;
(c) provide for requiring the managers of hospitals to keep such registers and other records as may be prescribed by the said regulations in respect of patients liable to be detained under this Part of this Act, and to furnish or make available to those patients and to their relatives such written statements of their rights and powers under this Act as may be so prescribed; and
(d) provide for the determination of the age of any person whose exact age cannot be ascertained by reference to the registers of acts of birth kept by the Director of the Public Registry.
(3) Without prejudice to the foregoing provisions of this article, regulations under this article may determine the manner in which functions under this Part of th is Act of the managers of

Power to make regulations for purposes of this Part of this Act.

hospitals are to be exercised and such regulations may in particular specify the circumstances in which, and the conditions subject to which, any such functions may be performed by officers of or other persons acting on behalf of those managers.

Power of Minister to refer to Tribunal.

Applicability of the provisions of this Part to mental nursing.

Extension of provisions of the Act to persons interdicted or homes incapacitated by a court.

35. The Minister may, if he thinks fit, at any time refer to the Mental Health Review Tr ibunal th e case o f any patient who i s liable to be detained under this Part of this Act.

36. Except where otherwise expressly provided, this Part of this Act applies in relation to a mental nursing home, being a home registered for the reception of patients liable to be detained therein un der t h e p r ov isi ons of th is A c t , as i t ap pl ies in rel a t i o n t o a hospital, and references in this Part of this Act to a hospital, and any reference in this Act to a hospital to which this Part of this Act applies, shall be construed accordingly.

37. (1) The Minister may make regulations extending to any p er s on i n ter d icted or incapacit a ted b y a cou r t in Mal t a on any ground other than prodigality any one or more of the provisions of this Act as if any such person were a person liable to be detained in a hospital under this Part of this Act, and may so extend any such provision in such manner, subject to such conditions, limitations and qualifications and with modifications and adaptations as he m a y deem appro p riate; and w h ere any such provision is so extended it shall, subject as aforesaid, apply to a person interdicted or incapacitated as if he were a person liable to be detained in a hospital under this Part of this Act.

(2) Regulations under this article may make different provision for persons interdicted and for persons incapacitated and for other different cases or different purposes.

Mental Health Review Tribunal. Amended by: VI.2001.13.

38. (1) There shall be a Mental Health Review Tribunal (in this Act also referred to as the Tribunal) which shall consist of a chairman, who shall be a person who is qualified to hold or has held the office of judge of the superior courts, and of two other members of whom one shall be a person possessing such medical qualifications and experience as the Minister may deem appropriate for the purpose.

(2) The members of the Tribunal shall be appointed by the Minister, and shall hold and vacate office under the terms of the instrument under which they are appointed, but may resign office by notice in writing to the Minister; and any member who ceases to hold office shall be eligible for re-appointment.
(3) There shall be a secretary to the Tribunal, who shall be a public officer designated for the purpose by the Minister.
(4) Whenever a member of the Tribunal is absent or cannot for any reason sit on the Tribunal, or it is not proper for him so to sit, the Minister may appoint another person to act in his stead.

Functions and powers of the Tribunal.

39. (1) It shall be the function of the Tribunal to consider and determine or otherwise deal with applications made to it under this Part of this Act and to deal with cases referred to it under this Act

in such manner as the reference may require.
(2) Where application is made to the Tribunal by or in respect of a patient who is liable to be detained under this Part of this Act, the Tribunal may in any case direct that the patient be discharged, and shall so direct if they are satisfied -
(a) that he is not then suffering from mental disorder; or
(b) that it is not necessary in the interests of the patient’s health or safety or for the protection of other persons that the patient should continue to be liable to be detained; or
(c) in the case of an application under article 29(2), that the patient, if released, would not be likely to act in a manner dangerous to other persons or to himself;
and where a direction discharging a patient is given by the Tribunal, that person shall cease to be liable to be detained under this Part of this Act.
(3) This article applies in relation to any reference to the Tr ibunal made by the Minister under arti cle 35 as it applie s in relation to an application made to the Tribunal by or in respect of a patient, but subarticle (2) shall not apply in relation to any other reference under this Act.

40. (1) Where, under any provision of this Part of this Act, an application to the Tribunal is authorised to be made by or in respect of a p ati ent, the app lic atio n sh all be m ade b y not ice in wr it ing addressed to the Secretary of the Tribunal.

(2) No application may be made to the Tribunal by or in respect of a patient except in the cases and at the times expressly specified in this Part of this Act; and where under any provision of this Part of this Act an application by or in respect of a patient is authorised to be made to the Tribunal within a specified period not more than one such application may be made by or in respect of that patient within that period.

Applications to

Tribunal.

41. (1) The Minister responsible for justice may make rules with respect to the making of applications to the Tribunal and with respect to t h e p r oceedi ngs of the T r ibunal and the matt ers incidental to or consequential on such proceedings.

(2) Without prejudice to the generality of the foregoing provisions of this article, rule s made under t h is article may in particular make provision -
(a) for enabling the Tribunal to postpone the consideration of any application by or in respect of a patient, or of any such application of any specified class, until the expiration of such period (not exceeding twelve months) as may be specified in the rules from the date on which an application by or in respect of the same patient was last considered and determined by the Tribunal;

Rules of procedure.

(b) for enabling the Tribunal to dispose of an application without a formal hearing where such hearing is not requested by the applicant or it appears to the Tribunal that such a hearing could be detrimental to the health of the patient;
(c) for enabling the Tribunal to exclude members of the public, or any specified class of members of the public, from any proceedings of the Tribunal or to prohibit the publication of reports of any such proceedings or the names of any persons concerned in such proceedings;
(d) for regulating the circumstances in which, and the persons by whom, applicants and patients in respect of whom applications are made to the Tribunal may, if not desiring to conduct their own case, be represented for the purpose of these applications;
(e) for regulating the methods by which information relevant to an application may be obtained by or furnished to the Tribunal, and in particular for authorising the members of the Tribunal, or any one or more of them to visit and interview in private any patient by or in respect of whom an application has been made;
(f) for making available to any applicant, and to any patient in respect of whom an application is made to the Tribunal, copies of any documents obtained by or furnished to the Tribunal in connection with the application, and a statement of the substance of any oral information so obtained or furnished except where the Tribunal considers it undesirable in the interests of the patient or for other special reasons;
(g) for requiring the Tribunal, if so requested in accordance with the rules, to furnish such statements of the reason for any decision given by the Tribunal as may be prescribed by the rules, subject to any provision made by the rules for withholding such a statement from a patient or any other person in cases where the Tribunal considers that furnishing it would be undesirable in the interests of the patient or for other special reasons;
(h) for conferring on the Tribunal such ancillary powers as may be thought necessary for the purposes of the exercise of their functions under this Act.
(3) The foregoing provisions of this article apply in relation to references to the Tribunal as they apply in relation to applications to the Tribunal by or in respect of patients.
(4) Any rules under this article may be so made as to apply to all applications or references or to applications or references of any specified class or classes and may make diff erent provision in relation to applications and to references or to different cases of reference or to other different cases or for different purposes.

PART IV

PATIENTS CONCERNED IN CRIMINAL PROCEEDINGS

42. (1) Where in the course of any proceedings on the charge of a criminal offence the question of the insanity of the accused, whether at the time of the offence or of the proceedings, arises, the court may, if it is of the opinion that it is necessary or expedient so

to do, order that the accused be admitted to a hospital for observation, and may also give such other directions as may be appropriate.
(2) Where an order is made as provided in subarticle (1), the period of the detention of the accused shall be regulated by the court by which the order has been made, and such order shall be sufficient authority for the detention of the accused in hospital for the period allowed by the court.
(3) For the purposes of this article, the expression "criminal offence" includes a military offence under the Malta Armed Forces Act.

Detention for observation of persons charged with criminal offence.

Cap. 220.

43. (1) Where an order has been made by a court of criminal jurisdiction under article 402(4), or of article 525(3) or of article

623 of the Criminal Code or by a court martial under article 122 of
the Malta Armed Forces Act, upon a finding that the accused was insane at the time of the offence, whether or not he is insane at the time of the criminal proceedings, or by any other court under any
oth er prov isio n of law u pon sim i lar grou nd s, direct ing t hat th e accused be kept in cu stody in a hospital, the accused shall be conveyed to and detained and kept in custody in that hospital by
virtue of the order of the court and shall be treated as if he were a patient liable to be detained in a hospital under Part III of this Act, but the provisions of that Part of this Act shall apply in respect of
any such p e rso n sub j ect to the special restrictio ns and other provisions of this article.
(2) The special restrictions and other provisions referred to in subarticle (1) are:
(a) none of the provisions of Part III of this Act relating to the duration, renewal and expiration of authority for the detention of patients shall apply, and the patient shall continue to be liable to be detained by virtue of the order of the court until he is discharged under the following provisions of this article;
(b) no application or reference may be made to the Mental Health Review Tribunal in respect of the patient under any provision of the said Part III, and the case of the patient may only be examined by that Tribunal on a reference to them by the Minister responsible for justice for advice;
(c) the following powers, that is to say -
(i) power to grant leave of absence to the patient under article 24;

Persons ordered to be kept in custody upon plea of insanity.

Cap. 9. Cap.220.

(ii) power to transfer the patient in pursuance of regulations made under article 27;
(iii) and power to order the discharge of the patient under article 28,
shall be exercisable only by the Minister responsible for justice after such consultation with the responsible medical officer and the manager of the hospital as he may deem appropriate and, if the case is referred by him to the Tribunal, after receiving the advice of the Tribunal, and where leave of absence is granted as aforesaid under article 24 the power to recall the patient under that article shall be vested in the said Minister, as well as in the responsible medical officer; and
(d) the power of the Minister responsible for justice to recall the patient under the said article 24 and the power to take the patient into custody and return him under article 25 may be exercised at any time;
and in relation to any such patient, the provisions of Part III of this Act shall, as the case may require, either not apply or shall have effect subject to such exceptions and modifications as may be necessary to give effect to the foregoing provisions of this article.
(3) Without prejudice to the generality of the foregoing pr ov isi o n s o f th is art i cle, i n relat i o n to a per s on l i ab le t o b e detained by virtue of a court order as is mentioned in subarticle (1) -
(a) articles 14, 15, 16, 17, 21, 23, 26, 29, 30, 31, 32, 33,
35 and 37 shall not apply; and
(b) in the other provisions of Part III of this Act -
(i) references to the Minister responsible for justice shall be substituted for, or added to, references to persons or authorities vested with powers made exercisable by the said Minister by this article; and
(ii) references to the order of the court by virtue of which the patient is liable to be detained shall be substituted for references to other instruments by virtue of which a patient is liable to be detained under Part III of this Act.
(4) Where the Minister responsible for justice has made an order discharging the patient, such patient shall thereupon cease to be liable to be kept in custody or to be detained in a hospital.
(5) If the order made by the court under any of the provisions referred to in subarticle (1) is made upon a finding that the accused is insane only at the time of the proceedings, the order shall have the like effect as is mentioned in the foregoing provisions of this article and those provisions shall apply as if the order had been one as is referred to in subarticle (1):
Provided that where the Minister responsible for justice is notified by the responsible medical officer or by the manager of the hospital that the accused has recovered sufficiently to stand trial, the said Minis t er may remit the accuse d to prison for the continuation of the proceedings on the charge preferred against him, subject to the application thereafter of the provisions of the Criminal Code relating to the granting of bail.
(6) Notwithstanding any other provision of this Act, the Minister responsible for justice may, if satisfied that the attendance at any place in Malta of a patient liable to be detained by virtue of a court order is desirable in the interests of justice or for the purpose of any public enquiry or for any other public interest, direct that he be taken to that place; and where a direction is so given the patient shall be so taken and, unless the said Minister otherwise directs, be kept in custody while being taken, while at that place and while being taken back to the hospital in which he is liable to be detained.

Cap. 9.

44. (1) If, in the case of a person serving a sentence of imprisonment, the Minister responsible for justice is satisfied, by reports from at least two medical practitioners one of whom shall be a medical practitioner whose name appears on the list referred to in article 17(2), that the s a id person is su ff ering fro m me ntal disorder of a nature or degree which warrants the detention of the patient in hospital for medical treatment, the said Minister may, if he is of opinion that it is expedient so to do, direct that the person be removed to and detained in a hospital.

(2) A direction under subarticle (1) shall be sufficient authority for the removal to and detention in a hospital of the patient and, subject to the following provisions of this article, such person shall, with effect from the date of the Minister ’s direction, be treated for all purposes of this Act, as if he were ordered to be kept in custody in a hospital by a court of criminal jurisdiction as mentioned in article 43(1).
(3) A direction under subarticle (1) shall cease to have effect, and the patient shall cease to be liable to be detained thereunder -
(a) on the expiration of the sentence of imprisonment or, as the case may require, on the day on which, had such person been detained or kept in custody elsewhere, he would have ceased to be detained or kept in custody in such other place, or
(b) when such person is certified by two medical officers, one of whom shall be a medical officer designated by the Minister responsible for justice, to be no longer suffering from such mental disorder as renders him liable to be detained in a hospital for treatment,
whichever shall be the earlier.
(4) References in this article to a person serving a sentence of imprisonment include references -
(a) to a person detained in pursuance of any sentence

Removal to hospital of persons serving sentences of imprisonment.

criminal proceedings;
(b) to a person who is serving a term of imprisonment or detention or is otherwise detained or kept in custody by order of a court of criminal jurisdiction;
(c) to a person committed in custody to await trial;
(d) to a person committed by a court of civil or commercial jurisdiction to imprisonment for debt.

Power to make regulations for this Part of the Act.

45. The Minister responsible for justice may make regulations f o r p r escr ib in g an yt hin g whi c h is req u ir ed or au th or ised to be prescribed under this Part of this Act and otherwise for carrying this Part of this Act into full effect.

PART V

Where person liable to be detained is already in hospital.

Correspondence of patients not subject to detention.

Provisions as to custody, conveyance and detention.

MISCELLANEOUS AND SUPPLEMENTAL

46. Where under any provision of this Act a person is liable to be conveyed, taken, transferred or moved to a hospital and that person is already in th at hospi tal , whether he is being detained there or not, such person may be detained and kept in custody in t h at ho sp ital as i f he had been conveyed , t ak e n, transferred or moved there under this Act.

47. Article 22 shall apply in relation to any patient who is receiving treatment for mental disorder in hospital, having been admitted for that purpose but not liable to be detained therein, as it applies in relation to a patient detained in hospital under Part III of this Act.

48. (1) Any person required or authorised by or by virtue of this Act to be conveyed to any place or to be kept in custody or detained in a place of safety or to any place to which he is taken un der art icle 43(6) shall, wh ile being so conveyed, detained or kept, as the case may be, be deemed to be in legal custody.

(2) In this Act "convey" includes any other expression denoting removal from one place to another.

Arrangements for the removal of patients to and from foreign countries.

49. (1) If it appears to the Minister, in the case of a patient, not being a citizen of Malta, who is detained in a hospital and is liab l e to be so d e tained under Part III of t h is Act, th at prop er arrangements have been made for the removal of the patient to a country outside M alta and for his care and treatment there, the Minister may in writing authorise the removal of the patient from the hospital and may give such directions as the Minister may think fit for the conveyance of the patient to his destination and for his detention in that country or territory and for his detention in any place or on boar d any ship or aircraft until his ar rival at any specified port or place in any such country or territory.

(2) If it appears to the Minister, in the case of a patient who is receiving treatment for mental disorder outside Malta other than a
patient ordered by a court of criminal jurisdiction to be detained in a mental hospital upon a plea of insanity, that proper arrangements have been made for the removal of the patient to Malta for his care and treatment in Malta, and fo r h i s conveyance t o Malta, the Mi ni st er may dir e ct t h at t h e p a tie n t be rece ived in M a lta and thereupon be conveyed to a hospital, and may give such further directions as to his detention and conveyance as the Minister may deem appropriate.
(3) A direction under subarticle (2) shall be sufficient authority for the conveyance, admission and detention of the patient named in the direction, and where any such direction is given the patient shall for all purposes be liable to be detained under Part III of this Act and the provisions of that Part of this Act shall apply to him accordingly.
(4) The foregoing provisions of this article shall apply to persons detained in custody in a hospital under a court order upon a p l ea o f in sani ty as th ey apply to oth e r patients su bject to the following provisions, that is to say -
(a) the authority that may authorise the removal from Malta, or the admission to Malta, of a patient shall be the Minister responsible for justice, and accordingly the foregoing provisions of this article shall apply as if for all references in subarticles (1), (2) and (3) to the Minister there were substituted references to the Minister responsible for justice; and
(b) a patient removed to Malta and admitted to a hospital in Malta by virtue of this subarticle shall be treated as if he were a person in respect of whom the court order had been made by a court of criminal jurisdiction in Malta, and the provisions of this Act shall apply to him accordingly.
(5) Where a patient is removed from Malta under any of the provisions of this article, the patient shall cease to be liable to be detained in a hosp ital in Malta when he is duly received into a hospital or other institution or place in p u rsuance of the arrangements made for that purpose.

50. The Minister may make regulations for prescribing anything which is required or authorised to be prescribed under any provision of this Act and otherwise for carrying into full effect any provision of this Act, being in each case a provision in respect of which there is not in force a similar power to make regulations under another provision of this Act; and without prejudice to the generality of the foregoing and of any other powers under this Act, regulations under this article may provide for the procedure to be fol l ow ed, and ot her ru les and provi sion s of any kin d t o b e observed, by any body of persons established by or under this Act or having powers exercisable under or by virtue of this Act.

51. (1) Any patient who, immediately before the commencement of Part III of this Act was detained or liable to be

Further power to make regulations.

Transitory provisions.

Cap. 9.

shall continue to be liable to be detained in the hospital as if he had been admitted in pursuance of an applicat ion for admissi on for treatment on the date of the commencement of the said Part III and the provisions of this Act shall apply to that patient accordingly.
(2) Where a patient to which subarticle (1) applies was, immediately before the commencement of P a rt II I of t h i s Act, absent from the hospital, on leave given in accordance with the procedure then followed for the purpose, articles 24 and 25 shall apply to such patients as if leave of absence had been granted under article 24 for an indefinite period and accordingly, but subject to article 24(5) as applied to that patient by subarticle (1), the patient may be recalled at any time.
(3) A patient who, immediately before the commencement of Part IV of this Act, was detained or kept or liable to be detained or kept in custody in a hospital by virtue of an order of a court of criminal jurisdiction, shall continue to be so detained and kept in custody, and to be so liable, in accordance with and subject to the appropriate provisions of this Act, as if the order were made after the commencement of the said Part, and the provisions of this Act shall apply to such patient accordingly; and this subarticle shall have effect as aforesaid notwithstanding any amendment to the
Criminal Code made by this Act*.

*Article 52 of the Act as originally enacted, which incorporated amendments to the Criminal Code, has been omitted under the Statute Law Revision Act, 1980.