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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.

  • This information applies to England and Wales.
  • This information applies to adults. It doesn't apply to children unless specifically stated.

​Could I be treated without my consent?

Generally, the law says that you could be treated without your consent in these situations:

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.

If you're thinking of coming off your medication, remember that it's best to come off gradually, not suddenly. Try to get support from people you trust – ideally a health professional.

For more information on stopping medication safely, see our pages on coming off psychiatric drugs.​

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.

Can I refuse to be on a CTO?

You can be put on a CTO even if you don't want to be. But you should still be involved in decisions about your treatment.

To find out more, see our information about when a CTO can be made.

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 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.

If you have an advance decision or an advance statement, health professionals should take these into consideration when treating you – even though they don't always have to follow them.

For more information, see our page on planning ahead.

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.

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This information was published in September 2022. We will revise it in 2025.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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