Consent to treatment
Explains your rights around giving consent to or refusing treatment. Find out what consent means, when you could be treated without your consent, and how to make complaints.
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Could I be treated without my consent?
Generally, the law says that you could be treated without your consent in these situations:
- You are detained, also called sectioned, under some sections of the Mental Health Act. For more information, see our pages on sectioning.
- You don't have capacity to decide whether to have treatment, and the treatment is in your best interests. For more information, see our page on capacity.
But the rules on treatment without consent can be slightly different depending on your exact situation.
This page covers your rights to refuse treatment in the following situations:
Living in the community (without restrictions)
You have the right to refuse treatment. You cannot legally be treated without your consent if you're living in the community without any restrictions, for example at home or in a care home. This includes the right to refuse medication prescribed to you.
If you want to refuse treatment, you should discuss your reasons for refusal and other options with your care team. Health professionals cannot threaten to section you to force you to consent to treatment. If they do, you can make a complaint.
An exception to this is if you lack capacity to consent to treatment.
In hospital as a voluntary patient
You have the right to refuse treatment. As a voluntary patient, you cannot legally be treated without your consent. This includes the right to refuse medication prescribed to you.
If you want to refuse treatment, you should discuss your reasons for refusal and other options with your care team. Health professionals cannot threaten to section you to force you to consent to treatment. If they do, you can make a complaint.
An exception to this is if you lack capacity to consent to treatment.
For more information, see our pages on voluntary patients.
On a community treatment order (CTO)
You don't always have the right to refuse treatment. But in general, you cannot legally be treated without your consent if you're on a CTO:
- You can't be given a condition in your CTO that forces you to have treatment.
- You can't be recalled to hospital just because you refuse treatment.
However, if you refuse or stop treatment and there is a risk of relapse, your responsible clinician may have good reasons to recall you to hospital to force you to have treatment. This can happen even if you aren't showing symptoms of relapse yet.
For more information, see our pages on CTOs.
In hospital under section
You don't always have the right to refuse treatment. But in general, you need to give consent before you can lawfully be treated for your mental health problem.
However, the Mental Health Act says you can be treated against your consent in either of these situations:
- You're in hospital under a section 2, 3, 36, 37, 38, 47, 48 or 45A with or without restrictions. For information on what each section number means, see our pages on sectioning.
- You've been recalled to hospital from a CTO.
As well as this, the following types of hospital treatment have special rules on consent. Health professionals have to follow these rules before giving treatment:
You can only be given NMD or hormone implants to reduce male sex drive if both of these requirements are met:
- You consent to the treatment.
- A second opinion appointed doctor (SOAD) agrees to the treatment.
You still might be treated without your consent if the treatment is immediately necessary to:
- Save your life.
- Stop your condition from getting a lot worse.
- Help to improve serious suffering.
- Prevent you from behaving violently or being a danger to yourself or others. As long as the treatment represents the minimum interference necessary.
You can only be given ECT in either of the following situations:
- You consent to the treatment and it is agreed by a SOAD or doctor in charge.
- A SOAD confirms that you lack capacity to consent. They must also confirm that ECT is appropriate to be given as a treatment. If you have an advance decision, a SOAD should take these wishes into consideration, but they do not have to follow them.
You still might be treated without your consent if the treatment is immediately necessary to:
- Save your life.
- Stop your condition from getting a lot worse.
You can only be given medication after an initial 3-month period in either of the following situations:
- You consent to taking the medication.
- A SOAD confirms that you lack capacity.
- You haven't given consent, but a SOAD confirms that this treatment is appropriate to be given.
You still might be treated without your consent if the treatment is immediately necessary to:
- Save your life.
- Stop your condition from getting a lot worse.
- Help to improve serious suffering.
- Prevent you from behaving violently or being a danger to yourself or others. As long as the treatment represents the minimum interference necessary.
Being treated for a physical health problem
You don't always have the right to refuse treatment. If you're being treated for a physical health problem unrelated to your mental health problem, health professionals can't usually treat you without your consent.
You can be treated for a physical health problem without your consent in either of these situations:
- You lack capacity.
- Your physical health problem is a symptom or underlying cause of a mental health problem. In this case, the Mental Health Act says that you can be treated without your consent.
Example: physical health treatment without consent
Toni has a diagnosis of anorexia, a type of eating problem. She is detained under section 3 of the Mental Health Act.
It is lawful for her care team to give her food against her consent through a nasogastric tube (up her nose). This is because it's a physical health treatment related to her mental health problem.
Use of restraint without consent
The law says that, in situations where you can lawfully be given treatment for your mental health problem without your consent, then you can also be lawfully restrained in order to give you that treatment.
Any type of restraint used must comply with the statutory guidance on Mental Health Units (Use of Force) Act 2018. You might also hear this called Seni’s Law. This guidance includes the fact that any force used to restrain you must comply with the Human Rights Act 1998.
For more information about your human rights protection, see our pages on the Human Rights Act.
Responsible clinician (RC)
This is the mental health professional in charge of your care and treatment while you are sectioned under the Mental Health Act.
Certain decisions, such as applying for someone who is sectioned to go onto a community treatment order (CTO), can only be taken by the responsible clinician.
All responsible clinicians must be approved clinicians. They do not have to be a doctor, but in practice many of them are.
Visit our full listing of Legal TermsSecond Opinion Appointed Doctor (SOAD)
This is an independent doctor appointed by the Care Quality Commission in England or by the Healthcare Inspectorate Wales. You need his or her approval to be given or continue to be given certain forms of medical treatment under the Mental Health Act 1983.
See our pages on consent to treatment for more information.
Visit our full listing of Legal TermsConsent
Consent is you agreeing with another person about an action that they’ve proposed.
The law says that consent is only valid if you:
- have capacity to decide
- have enough information to make that decision, and
- give your consent freely.
Section
Being 'sectioned' means that you are kept in hospital under the Mental Health Act. There are different types of sections, each with different rules to keep you in hospital. The length of time that you can be kept in hospital depends on which section you are detained under.
See our pages on sectioning for more information.
Visit our full listing of Legal TermsMental Health Act 1983 (MHA)
This is a law that applies to England and Wales which allows people to be detained in hospital (sectioned) if they have a mental health disorder and need treatment. You can only be kept in hospital if certain conditions are met.
See our pages on the Mental Health Act for more information.
Visit our full listing of Legal TermsCapacity
'Capacity' means the ability to understand information and make decisions about your life. Sometimes it can also mean the ability to communicate decisions about your life.
For example, if you do not understand the information and are unable to make a decision about your treatment, you are said to 'lack capacity' to make decisions about your treatment.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsVoluntary patient
Voluntary patients, also known as 'informal patients', are people who are staying in a psychiatric hospital but are not detained under the Mental Health Act. If you are a voluntary patient, you should be able to come and go from the hospital within reason and discharge yourself if you decide to go home.
See our pages on voluntary patients for more information.
Visit our full listing of Legal TermsCommunity treatment order (CTO)
If you have been sectioned and treated in hospital under certain sections, your responsible clinician can put you on a CTO. This means that you can be discharged from the section and leave hospital, but you might have to meet certain conditions such as living in a certain place, or going somewhere for medical treatment. Sometimes, if you don't follow the conditions or you become unwell, you can be returned to hospital.
See our pages on CTOs for more information.
Visit our full listing of Legal TermsRecalled
This means that you can be returned to hospital. It applies to you if you're on section 17 leave, on a community treatment order (CTO) or have been conditionally discharged from hospital.
- If you're on a CTO, you can be recalled for up to 72 hours if the responsible clinician thinks that:
you need medical treatment in hospital for your mental disorder, and - there would be risk of harm to your health or safety or to others if you are not recalled.
You must meet both criteria.
Visit our full listing of Legal TermsAdvance decision
An advance decision is a statement of instructions about what medical treatment you want to refuse in case you lose the capacity to make these decisions in the future. It is legally binding.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsAdvance statement
An advance statement is a written document that sets out your preferences (apart from refusals of treatment). It is not legally binding. You can ask a professional to follow this document if you ever lose capacity to make these decisions yourself.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsHuman Rights Act 1998 (HRA)
In the UK, our human rights are protected by law. This law is called the Human Rights Act 1998.
See our pages on the Human Rights Act for more information.
Visit our full listing of Legal TermsBest interests
Health professionals must act in your best interests before taking certain steps that affect your care and treatment.
The Mental Capacity Act has a best interests checklist, which outlines what health professionals need to consider before taking an action or decision for you while you lack capacity.
See our pages on the Mental Capacity Act for more information.
Visit our full listing of Legal TermsThis information was published in September 2022. We will revise it in 2025.
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