There are a number of different clinical circumstances in which the issue of incoming and outgoing mail to or from a patient in a psychiatric hospital, whether detained or not, may present particular difficulties. Under current mental health legislation there is provision for post to be stopped or inspected on clinical and legal grounds (Jones, 1999), but these are fairly limited and concern only outgoing mail in specific circumstances, other than for patients detained in special hospitals (Mental Health Act (MHA) 1983). The issue of patients' mail may lead to problems in day-to-day practice where patients' desire to send or receive correspondence is linked to their abnormal mental state, is a direct result of symptoms of their illness or when it might constitute a potential or actual criminal offence. This paper reviews the relevant part of the MHA 1983 and describes three case vignettes that illustrate some of the difficulties and potential solutions to problems associated with patients' correspondence.
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