Sectioning

Explains the rights that you have if you are sectioned and detained in hospital under the Mental Health Act 1983. Applies to England and Wales.

Your stories

Sectioned sick and bored

Sometimes, boredom is a real problem when you're staying in hospital.

Katy
Posted on 29/07/2014

A first for everything: psychosis, mania, depression and being sectioned

Jamie blogs about her experiences and the importance of her family’s support.

Posted on 03/10/2014

My experience of bipolar disorder and being sectioned

In part one of his blog, Jonny talks about his experience of bipolar disorder and being sectioned.

Posted on 24/03/2016

My rights

What are my rights when I am in hospital?

If you are sectioned and detained in hospital, you have the following rights:

  • Get leaflets with information when you arrive on the ward. If you are not given any leaflets straight away, you can ask the ward manager or a senior member of your care staff, or your independent mental health advocate (IMHA), to get them for you.
  • Appeal against your section to the Mental Health Tribunal.
  • See your sectioning papers. If you are not given a copy, and would like to see them, you should ask the ward staff or your IMHA to help you get them.
  • Get help and support from an IMHA. They can help you understand the effects of your sectioning, or complain about anything that has happened while you are in hospital.
  • See a copy of the Mental Health Act Code of Practice.
  • Ask for a meeting with the hospital managers.
  • Complain to the Care Quality Commission or, if you are in Wales, to the Healthcare Inspectorate.
  • Correspondence from your solicitor and other people and to have visitors.
  • Some telephone access.
  • Vote. You still have the right to vote if you are sectioned (unless you were sent to hospital by a criminal court, or transferred from prison).

    To vote, you must register on the electoral register as living either at your hospital address or at a recent home address. To do this you must apply to your local council. You cannot vote unless you are registered under an address where your local council can send you information about how and where to vote.

    Once you have registered, you can also ask your local council for a postal vote, or you may be able to get permission to leave the hospital to vote, either accompanied by hospital staff or on your own.

    Alternatively, you can have someone you can trust to vote on your behalf, called ‘voting by proxy’.

Asking for information

While you are in hospital, you also have the right to ask for and be told information, such as:

Example 1

Adena came into hospital a few days ago under a section 2. She has never been sectioned before.

Everything happened very quickly and she doesn’t know anything about her rights, or what to expect, or how long she might have to stay in hospital. No one has been to visit her and she has not been able to phone anyone. She thinks she was given some information on the first day, but can’t find it.

She tells the ward staff that she needs some help to find things out about her situation. A nurse says she will try and get an independent mental health advocate (IMHA) to help her. When Adena sees the IMHA, she helps her to:

  • find a telephone to tell her friends what has happened
  • get her the written information about her rights

Example 2

Petra wants to get out of hospital because she thinks she should not have been sectioned. She has read the information she was given when she came into hospital.

She asks to see an IMHA, who explains about Petra’s right to go to a Mental Health Tribunal to have her section lifted. As Petra is on a section 2, she will have to apply within the first 14 days. Petra realises she has the right to a mental health solicitor for the tribunal hearing for free, but she has to find one quickly. Her IMHA helps her to find details of a suitable solicitor, who agrees to come and see her on the ward.

Example 3

Jedi has been in hospital under a section 3 for 2 weeks. He finds out that his family has been to visit him but were told that they could not see him. After a few days some friends rang the ward to see if it was okay to visit him, but were told this wasn’t a good idea at the moment.

Jedi feels very angry that he wasn’t told about this and can’t understand why his friends and family were not allowed to visit him. He wants to complain about it and to find out what is going on.

An IMHA goes through the options for complaining. He decides he would like to have a meeting with the hospital managers, and she helps him arrange this.

Can I find out more information on why I’ve been sectioned?

If you want to find out the reasons why you have been sectioned, you can:

  • Ask your responsible clinician. Your responsible clinician should answer your questions about your mental health and your treatment honestly.

    He or she should also give you information about any medication you are made to take. This includes information about any side effects, why they have decided this treatment is the most suitable treatment for your mental health problem, how long the treatment might take and how long you might have to stay in hospital.

    If they say you have behaved in a way that has posed a risk to yourself or others, or has harmed your health, ask them to be specific about what behaviour they are talking about.
  • Discuss your situation with ward staff. They might be able to explain what is written in your medical notes. You can also ask about anything that happens on the ward, such as ward rounds, how often your responsible clinician will come to see you and whether any other professionals will want to talk to you.

Example 1

Toni is sectioned and is in hospital. She feels that the medication she is on is very strong and has a lot of side effects. It sometimes makes her feel dizzy and sick, and that the world is a bit unreal. She wonders whether anything can be done about it, like reducing the dose she is on.

She asks the ward staff if she can speak to her responsible clinician about it. They tell her when the responsible clinician will be coming, and whether it would be possible to ask her to come the next day.

Example 2

Teri has asked to see her section papers and thinks that they are not correct. They say that before she was sectioned, she was found shouting and screaming in the middle of a busy road. She thinks this is an exaggeration of what actually happened.

She discusses the situation with her IMHA and whether she should complain about it. Her IMHA agrees to get her information about the complaints procedure, and to ask the AMHP who assessed her if she will come and see her. She also offers to help her to see her medical records.

Can I leave the ward?

When you first come into hospital, you will probably not be allowed to leave the ward while you are under section. The Mental Health Act gives the nursing staff and other health professionals the power to keep you on a locked ward.

If you have a good reason for wanting to leave the ward, you can ask your responsible clinician for permission to do this.

  • You can ask them when they come to see you on a ward round or, if it is urgent, you could ask the ward staff to let them know that you need to see them because you need an answer urgently.
  • Section 17 of the Mental Health Act says that they can allow you to leave the ward or the hospital for short periods of time, but they may ask you to keep to certain conditions, such as returning within a certain time.
  • You will need to explain your reasons for wanting leave. If they need you to put any of the details in writing or they need to speak to anyone else about your leave, such as your family, carer or another professional, they should tell you this.

Sometimes you might be able to leave the ward accompanied by a member or members of the hospital staff – this is called escorted leave. But the hospital does not have a legal duty to agree to this. They may refuse you leave if they consider you or someone else would be at risk if you left the ward on your own.

If you are going to be on leave from hospital for more than 7 days, your responsible clinician may need to consider whether to use a community treatment order instead.

Example

Lina’s daughter is going to be eight years old next week. She does not understand why she can’t see Lina on her birthday. Lina asks her responsible clinician if she can have leave from the ward so that she can go home and see her daughter. Her responsible clinician says she can, as long as her partner stays with her all the time, and brings Lina back to the ward in the evening.

If your section is lifted, and you stay in hospital as a voluntary patient, your rights to leave the ward will change: see our information on the Mental Health Act.

Can I refuse treatment?

If you are sectioned under sections 2, 3, 37 and certain other sections of the Mental Health Act, and your treatment is for your mental health problem and prescribed by your responsible clinician, legally it may be given to you without your consent. This may still happen even if you physically resist being given the treatment.

If you are sectioned under sections 4, 5, 35, 135 and 136, or you are under Mental Health Act guardianship or conditional discharge, you have the right to refuse treatment for your mental health problem, but you may be given treatment in an emergency.

See our information on consent to treatment to find out more.

Example

Mick has taken an overdose and is brought into hospital as an emergency admission. When he realises what has happened, he tells the staff in Accident and Emergency he wants to leave. He is then sectioned under section 4 and stopped from leaving.

Mick is given emergency medical treatment for a short time to stop his physical condition from getting worse, but he cannot be given antipsychotic medication for his mental health problem while he is under section 4. But if his section 4 is changed into a section 2, he can be.

What are my rights if I am sectioned under section 4?

Your rights will be different under section 4 compared to your rights under other sections.

Provided the approved mental health professional who has applied to have you admitted under this section has filled in the sectioning papers correctly, this section allows you to be:

  • taken to hospital for emergency assessment
  • kept in hospital for up to 72 hours

You can be put under this section with only one medical recommendation, normally from a doctor who knows you. Normally the approved mental health professional has to get two medical recommendations, but under section 4, they will only need one.

If you are put under a section 4, you will have the following rights:

  • You must be admitted to hospital within 24 hours of the approved mental health professional's application or your medical examination, whichever is the earlier. Otherwise the application cannot go ahead and you cannot be taken to hospital after this time.
  • You will be free to go if your doctor discharges you, or at the end of 72 hours, unless a second medical recommendation says that you should be kept under section for longer – this changes your section 4 into a section 2.
  • Your nearest relative does not have the right to discharge you, because they have to give the hospital managers at least 72 hours’ notice before they can take you out of hospital.
  • You do not have the right to apply to a mental health tribunal, but if your section 4 changes into a section 2, you will have the right to apply.
  • You cannot be treated for your mental health condition without your consent. You can refuse medication and other treatment for your mental health. But you can be assessed and given treatment in an emergency to save your life, stop you from injuring yourself or others, or stop your health from getting seriously worse.

Can I make a complaint about how I’ve been treated in hospital?

Yes, your independent mental health advocate can help you to make a complaint. Ask them to support you in writing a letter or email to the Care Quality Commission (in England) or the Healthcare Inspectorate (in Wales).

You can complain about:

  • the way hospital staff have treated you
  • if procedures have not been followed properly
  • conditions on the ward
  • if other people on the ward have hurt you or behaved badly
  • if your things have been stolen or damaged
  • not getting enough fresh air or exercise
  • not having free access to correspondence or visitors
  • if you or another person have been injured, or a crime has been committed. You can also think about whether to tell the police.

Example

Len came onto the ward a few days ago and another patient, Mike, sometimes tries to punch him on the way to the bathroom. He has also threatened to beat Len up if he gets the chance.

Len feels intimidated and wants to ask if he or Mike can be moved somewhere else so that he doesn’t keep meeting him all the time.

Len’s IMHA helps him to have a word with the ward staff so that they know what has been happening, and will stay with him when he meets his responsible clinician and the hospital managers. The IMHA finds out that another patient, Tom, has been having trouble with Mike. Tom has agreed to speak to the hospital managers, if Len has a meeting with them.

You are unlikely to succeed if you make a complaint only about the fact of being sectioned, even if you think it should never have happened.

  • The complaint would have to be about the way it was done and that the procedures required by the law were not followed properly by the professionals.
  • The same applies to your treatment, if you are sectioned and the treatment is for your mental health problems.

But you may be able to complain about the way the treatment was given to you, for example:

  • if you were restrained and this caused you an injury, or
  • you were left in seclusion for a very long time, without good reasons being given

You cannot usually use a complaint to get compensation, but you may get an apology or you may be able to stop the problem from happening again.

If you want to make a complaint:
  • try to include all the details you can remember, such as names, dates and times
  • try to send a copy of anything that could be used as evidence of your complaint, like letters, documents and photos
  • keep the originals of any letters and documents you use

Example

Jad is under a section 3 and came into hospital after not taking his medication. He refused to accept it when he arrived, so the nurses held him down so that he could be given it. Jad was held face down so that he could not breathe, and this caused him to panic and feel he was about to die. Later he found he had dark bruises on his face and arms.

Jad feels very traumatised by this incident, and believes that what happened to him was wrong. He asks for support from his IMHA to help him complain to the Care Quality Commission.

What are my rights after I leave hospital?

When you are no longer under a section and leave hospital, you have the following rights:

  • The right to vote, as long as you are well enough to decide between candidates, and you are registered on your local council’s electoral register at your home address or another address.
  • The right to travel abroad. You have the right to travel out of the UK, but some countries have restrictions on accepting people with a history of mental health problems. This is because the Equality Act, which protects you from discrimination in the UK, does not apply abroad. 

    Each country will have different rules on this. So you will have to check with the embassy of the country you are planning to visit whether you will have trouble getting a visa and whether they are likely to ask for information about your mental health history.
  • The right to drive. You have the right to drive, but if you are diagnosed with certain severe mental health conditions and taking certain types of medication, your driving licence may be temporarily suspended. For more information, visit the DVLA website and see our information on fitness to drive.

Aftercare services or care plans

  • You should be told before you leave hospital whether you will have the right to aftercare services after you leave hospital, and whether these are likely to be free.
  • Or you will have a care plan which you should be invited to discuss, and you will have the right to the services on the care plan, but you may be means tested and asked to contribute something towards your services: see our information on community care and aftercare.

 


This information was published in January 2015. We will revise it in 2017.


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