Prime Minister Theresa May has been under considerable pressure over her handling of Brexit. It's quite feasible that this type of pressure would have an impact on her mental health.

Moreover within the media there has been a greater scrutiny of the UK's constitution, particularly around how to reign in the Prime Minister's Presidential approach within a Parliamentary system.

Let us assume, for the sake of this question, that it were to be convincingly shown that the Prime Minister is in a state of clinical insanity.

My question is, are there any mechanisms for removing a Prime Minister who has been diagnosed as being clinically insane?

N.B. I'm not a psychiatrist and I don't want to open a debate on an individual's actual mental health.

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    FYI insanity is a legal term not a medical one. So you can't actually be diagnosed clinically insane. But that aside, I think the rest of the question is valid i.e. can she be removed on grounds of insanity?
    – Alex
    Mar 22, 2019 at 13:41

2 Answers 2


There are three ways in which a Prime Minister can be removed from office involuntarily:

  1. Under the terms of the Fixed Term Parliaments Act 2011, lose a no confidence vote in the House of Commons, fail to win a confidence vote within two weeks, and then lose the subsequent election. An early election can also be called if 2/3 of the Commons votes for it.
  2. Be removed as party leader, by whatever mechanism is available under that party's rules. At the time of writing (22 March 2019), this is not possible, as Conservative Party rules forbid a party vote of no confidence if the leader has already survived one in the last 12 months (which she has).

Now, technically, both of the above are still resignations. The PM could still refuse to resign, though convention would weigh heavily against them. Which leads to the most drastic option, and the only actual way of removing an intransigent PM:

  1. Dismissal by the Queen. This last happened in the UK in 1834 (though the Australian PM was dismissed by the Queen's representative in 1975; this was regarded as extremely controversial). By long-standing convention, the Queen stays out of politics, so it is hard to determine the set of circumstances under which she would exercise her power to fire the PM.
  • Wouldn't loss of confidence resulting in a general election that they didn't win be forcing them out without a resignation?
    – user
    Mar 22, 2019 at 14:57
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    @user: No. The PM still has to resign after losing a general election. If there's a clear winner, this happens as soon as practical. However, after the inconclusive 2010 election, Brown waited 5 days while the Conservatives and Lib Dems thrashed out a coalition agreement. Mar 22, 2019 at 14:59
  • If the PM dies, does she have to be dismissed by the queen? Is there no fourth option?
    – JJJ
    Mar 22, 2019 at 21:31
  • @JJJ: no. Dying counts as vacating the post of PM (as it does for most jobs), so there's no need for any further action from the Queen or parliament if that happens. Mar 22, 2019 at 21:34
  • 3
    @user It’s not automatic. It’s unthinkable that a PM wouldn’t resign, and their position would be untenable, but it still has to happen. Mar 23, 2019 at 10:11

There is no special provision in the UK constitution for the removal of a Prime Minister on mental health grounds.

The Prime Minister is primus inter pares in the Cabinet system of government. In the unlikely situation of the Prime Minister suffering from a serious mental breakdown, the Cabinet could remove her. The office of Prime Minister is appointed by the Crown on the advice of her Ministers. A Prime Minister that had suffered a mental breakdown could be removed by the Crown, on the advice of her Ministers. Such a situation would be extremely unusual, indeed without precedent.

Under UK law, a person can be detained involuntarily. This is called "sectioning" (because you are detained under powers described in one or another section of the Mental Health Act). While sectioning would de facto prevent a Prime Minister from chairing the Cabinet, leading the government, or representing the country, it is extremely unlikely that sectioning would occur.

Far more likely, in the case of a mental breakdown is voluntary resignation. Sectioning is rare. Most mental health patients enter hospital voluntarily and remain at their choice. Sectioning is only when the patient has not been able to get early support and whose mental health has deteriorated to the point that they are a danger to themselves. The Prime Minister is surrounded by supporters, advisors and aides. She would be much more likely to receive timely support, and the chance of a situation developing in which she was removed against her will is very unlikely to occur.

  • This is a great answer. If I can nitpick two things in the 2nd paragraph: (1) Under normal circumstances, the PM is appointed on the recommendation of the outgoing PM, not the Cabinet. However, under abnormal circumstances, it's certainly feasible that the Cabinet would have to step in to perform this role (and indeed, the Labour Party constitution specifies that if the PM becomes "permanently unavailable", "the Cabinet shall, in consultation with the NEC, appoint one of its members to serve as Party leader [and hence PM] until a ballot under these rules can be carried out.") Mar 23, 2019 at 19:03
  • (2) The PM is appointed is appointed personally by the Queen, not by the Crown, which has a distinct, if vague, meaning. Mar 23, 2019 at 19:04

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