Navigating Power and Care: A Sociological Analysis of Mental Health Act 1983 Use for People with Dementia

The Mental Health Act 1983 allows people with ‘mental disorders’ to be detained and treated against their will in defined circumstances. Socio-legal scholars have identified the role of mental health law in framing paternalistic responses towards those deemed unable to care for themselves, with empirical research identifying a focus on individuals’ risk when conducting such assessments. This literature has been valuable, but few papers have examined mental health law in relation to people living with dementia and their families. Our paper presents findings from a qualitative, exploratory study that examines legal decision-making in this context. Focus groups with eighteen mental health professionals and eight family carers were conducted. Themes emerged around insufficient communication, the exclusion of family members from decision-making, and the resulting confusion and emotional toll. These findings point to a larger crisis in health and social care, where structural limitations hinder the ability of people with dementia, their families, and professionals to access sustained, multidisciplinary support. The study argues for more holistic, ongoing care, enhanced communication during MHA processes, and the reform of legal and policy frameworks to enable greater flexibility in providing support for people living with dementia.