The Mental Health Act is the law which sets out when you can be admitted, detained and treated in hospital against your wishes. It is also known as being ‘sectioned’. For this to happen, certain people must agree that you have a mental disorder that requires a stay in hospital. There you will have an assessment and be given treatment if needed.
- This is only done when you are putting your own safety or someone else’s at risk.
- You can sometimes be given treatment even if you don’t want it.
- You have certain rights under the Mental Health Act, including the right to appeal and the right to get help from an advocate.
There are different sections of the Mental Health Act that have different aims
Section 2 allows compulsory admission for assessment or assessment followed by treatment. It can last up to 28 days. It is the most common way for people to be detained,
Under a section 2 (S2), you are detained in hospital for assessment of your mental health and to get any treatment you might need. An assessment will normally look at:
- whether you suffer from a mental disorder,
- which type of mental disorder you have,
- whether you need any treatment and how you might respond.
You will be placed under a S2 if you have not been assessed in hospital before or if you have not been assessed in hospital for a long time.
What are my rights on a Section 2?
- You have the following rights when you are detained under a section 2:
- You have the right to appeal against your detention to a Mental Health Tribunal during the first 14 days that you are detained.
- You have the right to appeal to the Associate Hospital Managers.
- You can ask for the help of an Independent Mental Health Advocate who can help you to raise any issues you have with your care and treatment.
You will be given a Patient Rights Leaflet (which tells you about your legal rights) by a member of the hospital staff, who will explain in person what your rights are.
Can I be treated against my will?
Under Section 2, you can’t refuse treatment. However some treatments can’t be given to you without your consent unless certain criteria are met. These treatments include electro-convulsive therapy (ECT). If you are unhappy about your treatment, you should talk to your named nurse or psychiatrist. An Independent Mental Health Advocate may be able to help you put your case forward.
Who can discharge me?
You can be discharged from a S2 by:
- The professional responsible for your care in hospital (known as the Responsible Clinician). This is usually your Consultant Psychiatrist
- A Mental Health Tribunal
- The Associate Hospital Managers
- Your nearest relative (although this can be overruled by the Responsible Clinician)
Section 3 allows compulsory admission for treatment. It can be for up to 6 months, and may be renewed for a further 6 months, and after that 12 monthly.
Section 136 allows a police constable to remove an apparently mentally disordered person from a public place to a place of safety for up to 72 hours for the specified purposes. The place of safety could be a police station or hospital (often a special s136 suite).
Section 5(2) is doctor’s holding power. It can only be used to detain in hospital a person who has consented to admission on an informal basis (i.e. not detained under the Act) but then changed their mind and wishes to leave. It can be implemented following a (usually brief) assessment by the RC or his deputy, which, in effect, means any hospital doctor, including psychiatrists but also those based on medical or surgical wards. It lasts up to 72 hours, during which time a further assessment may result in either discharge from the section or detention under section 2 for assessment or section 3 for treatment.
Section 4 allows admission in an emergency and lasts up to 72 hours. It can be converted to another section (usually section 2) if circumstances require.
Section 37 is a hospital order made by a court.
Section 38 an interim hospital order
Section 41 indicates additional restrictions which require Ministry of Justice permissions.
Section 47 and Section 48 refer to transfers from prison to hospital.
Section 117 - Health authorities and local social services have a legal duty to provide free aftercare for people who have been discharged under Mental Health Act sections 3, 37, 45A, 47 or 48. The duty to provide aftercare also applies if you are given s17 leaven or are under a community treatment order.
You should not be charged for the services provided to you under Section 117 as aftercare if they meet a need relating to your mental health problem and prevent you from returning to hospital.
Community Treatment Order When a person has been detained under certain sections of the Mental Health Act 1983 and options for discharge back into the community are being considered, one option is to discharge subject to ‘supervised community treatment’, known as a Community Treatment Order. The Responsible Clinician (RC) makes an application for supervised community treatment and it must be accompanied by a recommendation from an Approved Mental Health Professional (AMHP). A Community Treatment Order can include conditions on where a person will live or where they will go to receive treatment.
What sort of aftercare can I expect? For many people the time after you have been discharged is a difficult period. This is because returning to your home and community can be stressful, particularly if you have been in hospital for a long time. Before you are discharged, a care plan should be made under the Care Programme Approach (CPA) which will look at how your needs will be met. Many hospitals also agree to contact you within 7-14 days of discharge to see how you are getting on.