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Email this pageBeing sectioned means being admitted to hospital whether or not you agree to it. The legal authority for your admission to hospital comes from the Mental Health Act rather than from your consent.
This is usually because you are unable or unwilling to consent.
This leaflet provides information, not advice.
The content in this leaflet is provided for general information only. It is not intended to, and does not, mount to advice which you should rely on. It is not in any way an alternative to specific advice.
You must therefore obtain the relevant professional or specialist advice before taking, or refraining from, any action based on the information in this leaflet.
If you have questions about any medical matter, you should consult your doctor or other professional healthcare provider without delay.
If you think you are experiencing any medical condition you should seek immediate medical attention from a doctor or other professional healthcare provider.
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If you have, or are thought to have:
If you are on a section 3, that is for treatment, then the treatment you need must be available at the hospital in which you’re detained.
The process usually starts because your GP, a family member, a police officer or psychiatrist is worried about your mental health.
The decision is usually made (other than in an emergency) by two doctors and an Approved Mental Health Professional (AMHP).
One of the doctors must be specially certified as having particular experience in the assessment or treatment of mental illness.
If possible, one of the doctors will already know you. The AMHP is usually a social worker, but could be a mental health nurse, psychologist or occupational therapist.
In an emergency, things are slightly different - it depends on where you are.
One member of your family is known as your ‘Nearest Relative’. Who fulfils this role is decided from a list in the Mental Health Act.
It is not the necessarily the same as your next-of-kin. Your husband/wife/civil partner is the first choice. If you don’t have one then, in order, it is the oldest of your children, or parents, or brothers or sisters and so on.
The person who acts as your nearest relative can only be changed by that person themselves or by a court. You can apply to the court to change your nearest relative if you don’t think the person at the top of the list is suitable.
Your nearest relative has a number of powers, including stopping you being placed on a section 3 and applying for your discharge from detention.
Under certain circumstances, the powers of your nearest relative can be overridden.
Yes. You would normally be taken to hospital by ambulance, although the police will be asked to help if necessary.
You will meet members of the clinical team, particularly the nursing and medical staff, who are responsible for your care and treatment.
Most of your care will be the same as you would expect if you had agreed to admission. But, in addition, you will have your rights as a detained patient explained to you and be given a copy of these rights to keep.
You should also be offered the assistance of an Independent Mental Health Advocate.
You will be placed under the care of a person who is called your Responsible Clinician. This is usually a consultant psychiatrist, although it could be a senior nurse, psychologist, occupational therapist or social worker.
You can be held in the hospital, including being kept on a locked ward if necessary (because, for example, you keep trying to run away or behave in a way which suggests you need more staff to keep you, and other people, safe).
You can also be required to take medication for your mental illness.
Yes. The choice of medication should be discussed with you, unless you are unable or unwilling to discuss it. But you can be forced to take it if your Responsible Clinician thinks it is necessary.
If, after 3 months, you are still detained and don’t want the medication, or are too ill to consent to it but your responsible clinician still thinks it’s necessary, then you will see an independent consultant psychiatrist sent by the Care Quality Commission.
You can then only be forced to take the medication agreed to by the independent psychiatrist (called a Second Opinion Appointed Doctor or SOAD).
No, you can't be forced to have Electroconvulsive Therapy (ECT) (unless it is an emergency to save your life or prevent a serious deterioration in your health).
You can have ECT if you consent. If you are too ill to be able to make a decision, then you can have ECT if it is agreed by a SOAD.
Yes, but only with the permission of your Responsible Clinician.
Conditions may be put on your leave, such as how long you can be away for, where you can go and whether or not you are accompanied.
The first thing to do is to discuss it with your responsible clinician or other members of the team looking after you. It is important to remember that they would like to be able to discharge you home as much as you wish to go home.
The moment your Responsible Clinician thinks it is safe to do so, they will discharge you. However, if your Responsible Clinician thinks you still need to be detained, but you disagree you can seek discharge in three other ways:
At the hearing, the Tribunal will listen to the staff and to you. You will be asked questions by the Tribunal members. The staff will also be asked questions by the Tribunal members. The staff can also be asked questions by your solicitor. It is for the staff to ‘prove’ you need to be detained, not for you to prove you don’t.
They are sections of the Mental Health Act which mean you can leave the hospital, but with certain conditions.
You can be put on a CTO if you are detained on a section 3 (but not if you are on a section 2). The decision is made by your Responsible Clinician and an AMHP.
It is initially for 6 months but can be renewed. You have the same rights of appeal as when you were detained. You can be recalled to the hospital if your Responsible Clinician thinks it necessary.
All patients on a CTO must agree to see their Responsible Clinician and, if required, a SOAD. Other conditions will be decided by your Responsible Clinician and AMHP. The most common is that you agree to take your medication.
Other conditions may include such things as places you mustn’t go or things you mustn’t do. The conditions must be necessary for your health or safety, or to protect other people or to ensure you receive the treatment you need.
You will normally only be placed on a CTO if you agree to the conditions.
Generally no, not while you are in the community. The only time you can be forced to take medication is if you lack the capacity to decide whether or not to take the medication, and it is an emergency.
If your Responsible Clinician wishes to insist you take medication which you refuse, then they must recall you to hospital.
Your Responsible Clinician may recall you to hospital to discuss the difficulties. If your Responsible Clinician and an AMHP think it necessary, your CTO may be revoked and you will again be a detained patient.
The staff, particularly your Responsible Clinician, should be able to help with most questions. In addition, you are entitled to legal advice from a solicitor and assistance from an Independent Mental Health Advocate.
You can also request to see a Mental Health Act Commissioner from the Care Quality Commission (an independent healthcare regulator).
In Scotland:
In England, Wales and Northern Ireland:
Expert review: Dr Tony Zigmond.
Series Editor: Dr Philip Timms
User and Carer input: members of the RCPsych Service User Recovery Forum and Carers Forum.
Published: Aug 2015
Review due: Aug 2018
© Royal College of Psychiatrists
