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Nearest Relative Hierarchy — MRCPsych Paper B MCQ

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ModerateMental Health LawNearest Relative HierarchyMRCPsych Paper B

In England, an unmarried 40-year-old patient has lived with their partner as if they were married for the past 8 months. The patient also has both parents, a 20-year-old child and an older full sibling. No relative has been appointed or displaced by a court, none is disqualified, and no other relative ordinarily lives with or cares for the patient. Under the Mental Health Act 1983 provisions currently in force, who is the patient's nearest relative?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — The patient's cohabiting partner

Explanation lettering: B = shown as A · D = shown as B · A = shown as D

B is correct. Under section 26 of the Mental Health Act 1983, a person who has lived with the patient as if they were a spouse or civil partner for at least six months is treated within the highest relationship category. The partner has cohabited with the patient for eight months and therefore takes priority over the patient's child, parents and sibling. An adult child ranks below a spouse, civil partner or qualifying cohabitant but above parents; parents rank above siblings. The stem excludes statutory factors that could alter this result, particularly disqualification, court displacement and the rule that a relative with whom the patient ordinarily resides or by whom they are ordinarily cared for may be promoted above other relatives.

Reference: Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust. Sections 26–30: Your nearest relative under the Mental Health Act 1983, Part 1, 2026. https://www.cntw.nhs.uk/resources/sections-26-30-your-nearest-relative-under-mental-health-act-1983