Mental Health Act

Mental Health Act

If two doctors and an approved mental health professional believe that a person needs medical treatment because of a mental disorder, there are certain situations where that person may be detained in hospital against their will in order to receive appropriate care and treatment.

This is known as being sectioned. Doctors and approved mental health professionals would do this if a person’s health is at risk or if their behaviour puts them or others at risk of being harmed.

Sectioning a person for assessment (Section 2)

If a person needs to be assessed in hospital and they aren’t willing to be admitted, they can be sectioned for up to 28 days. If two doctors think a full psychiatric assessment is required they will recommend detention for assessment. One of the doctors must be a specialist working with mental disorder. An approved mental health professional then has to decide whether they agree with the doctors or not, and if they do they apply to a hospital to accept the person as a detained patient. Any person who is detained has rights of appeal and the right to an Independent Mental Health Advocate to help them appeal.

Sectioning a person for treatment (section 3)

If a person, whose treatment plan for their mental disorder is known, needs to be treated in hospital and they aren’t willing to be admitted, they can be sectioned for up to six months. The process for this is the same as described above- i.e. two doctors have to agree that detention in hospital is necessary, and an approved mental health professional has to agree with the doctors. This section can be extended initially for another six months if the doctor in charge of the person’s treatment thinks further treatment is required, and then can be renewed annually.

The doctors who carry out the assessment have to confirm that the treatment a person needs is available in the hospital. This could be medication, talking treatments, specialist mental health nursing and care.

A person’s rights about medication

On the first day of treatment, the approved clinician in charge of the person’s treatment (usually a doctor) explains to the person what the treatment being offered is for and, if the treatment is medication, any possible side effects. The person may understand the explanation and consent to the treatment. The person may understand the explanation and not agree to consent to the treatment. The person may not be able to understand the treatment, so is unable to consent or refuse the treatment. In any of these cases the treatment may be given to the person on the authority of the approved clinician in charge of treatment for up to three months. After three months the approved clinician can continue to authorise the treatment for a person who understands the treatment and consents to it. A person who refuses the treatment, or who is unable to understand it, must be seen by a Second Opinion Appointed Doctor (from the Care Quality Commission) who decides whether or not to authorise continued treatment.

In an urgent situation, the rights about consent do not apply. The Mental Health Act allows medication to be given without a person’s consent if it will save their life, reduce serious suffering, stop a condition from becoming much worse, or stop a person from behaving violently towards either themselves or others.

The Mental Health Act and the Courts

If a person suffering from a mental disorder has committed an offence which could be punished by imprisonment, the court can decide (using evidence from two doctors) that the person should be assessed or treated in hospital for their mental disorder, instead of sending them to prison. It is also possible for a sentenced or remanded prisoner to be transferred to hospital if they require treatment for a mental disorder. They can be kept in hospital for medical treatment past the term of their prison sentence if doctors think they still require treatment but subject to safeguards such as a right to appeal to an independent tribunal.

Leaving hospital

When a person who has been sectioned for treatment leaves hospital, the local Primary Care Trust and social services authority has a responsibility to make sure they are looked after and supported for as long as they have needs directly related to their mental disorder.

Some people who have been detained for treatment may be discharged from hospital on a Community Treatment Order. This is a section designed to help a person to stay out of hospital by asking them to abide by conditions which they and their responsible clinician agree will keep them well in the community.

Ensuring your rights

There are a number of other sections in the Mental Health Act which cover situations such as someone being arrested by the police, attending court or when they are already in hospital on a voluntary basis.

A person detained in the Somerset Partnership NHS Foundation Trust will have all their rights very carefully explained to them by our staff as well as receiving information in writing including their right to an Independent Mental Health Advocate. The Care Quality Commission also regularly visit our wards without telling us first, to meet with patients and staff and make sure that we are fully respecting patients’ rights.