Most people are treated in hospital for mental disorders under a voluntary basis. However some are in hospital because it has been considered they need to be detained under a formal basis and then the Mental Health Act 1983 applies. This is the law which sets out when you can be admitted, detained and treated in hospital against your wishes. This is only done if you are putting your own safety or someone else’s at risk and you have a mental disorder. The Mental Health Act covers what rights you have, how you can leave hospital and what aftercare you can expect to receive.
The Act describes the term ’mental disorder’ as ‘any disorder or disability of mind’. It includes mental health conditions such as schizophrenia, depression, bipolar disorder, anxiety disorder, obsessive-compulsive disorder (OCD), eating disorders, personality disorders and also includes other conditions such as dementia, changes in behaviour due to brain injury, mental disorders due to drug use and autistic spectrum disorders. The detention is known as being “sectioned” as you detained under a section of the Act.
Who decides to section you
When you are sectioned, three people must usually agree that you need to be detained in hospital. Normally, the three people would be:
- an Approved Mental Health Professional (AMHP) who can be a Social Worker or Nurse; or your nearest relative
- a doctor who has been given special training (known as a section 12 approved doctor)
- a registered medical practitioner (another doctor).
Normally they will make this decision by interviewing you. During the interview you may be asked about a number of things, including how you feel and what thoughts you are having.
The two doctors must agree that you have a mental disorder and that you need to be detained in hospital for assessment or treatment. They must also agree that it is in the interests of your own health, your own safety or to protect the safety of other people. If possible, one of the doctors should already know you.
You may find it useful to get support from an Independent Mental Health Advocate (IMHA). The aim of an IMHA is to help you make decisions about your care and treatment. They can also help you find out what your rights are. You can ask about seeing an IMHA when you are in hospital. The hospital staff should give you details of the service.
The nearest relative can be the person who can admit you to hospital or in some circumstances request your discharge. It can include your spouse, unless separated, children, parents, siblings and the person who was caring for you before you went to hospital.
If you are sectioned you have the right to appeal this by asking for a Tribunal. The procedure varies depending on the type of section. You can also be released with an order that you have treatment in the community.
However, you can be released from section in a number of ways:
- The professional responsible for your care in hospital (Responsible Clinician (RC))
- The Mental Health Act managers
- Your nearest relative (although this can be overruled by the Responsible Clinician)
- The Tribunal
Further information is available at Rethink.org and Mind.org.uk