Abstract The European Convention on Human Rights has exercised an influence on mental health law and mental healthcare for many years, but since the implementation of the Human Rights Act human rights claims before the UK courts have increased. While many have concerned the workings of the tribunal, some recent human rights cases have raised issues of potentially wider significance for mental healthcare. The safeguards applying to the care and treatment of those unresisting but unable to consent, the status of the Code of Practice and the notion of ‘medical necessity’ as a justification for compulsory treatment have all engaged the senior courts in recent years. This contribution considers how the courts have dealt with these issues and the implications arising from them.