Consent to treatment

Explains your rights to consent to (or refuse) treatment, including what 'consent' means, when you can be treated without your consent, and how to make a complaint. Applies to England and Wales.

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​Could I ever be treated against my wishes?

The rules on this are slightly different depending on your situation. This page covers your rights to refuse treatment in the following circumstances:

Broadly, the law says that you can be treated without your consent in these situations:

  • If you are detained (sectioned) under some sections of the Mental Health Act.
  • If you don't have capacity to decide whether to have treatment.
  • If it's emergency life-saving treatment.

What if I'm living in the community (not subject to any restrictions)?

You cannot legally be treated without your consent if you're living in the community (e.g. at home or in a care home) and are not subject to any restrictions – you have the right to refuse treatment. This includes refusing medication that might be prescribed to you. (An exception to this is if you lack capacity to consent to treatment.)

If you want to refuse treatment, you should discuss your reasons for refusing and what other options you have with your care team. Health professionals can’t threaten to section you to make you agree to treatment. If they do, you can make a complaint about it.

If you're thinking of coming off your medication, remember that it's best to come off gradually (not stop suddenly), and get support from people you trust – ideally a healthcare professional. For more information on stopping your medication safely, see our pages on coming off psychiatric drugs.​

What if I'm in hospital as a voluntary patient?

You cannot legally be treated without your consent as a voluntary patient – you have the right to refuse treatment. This includes refusing medication that might be prescribed to you. (An exception to this is if you lack capacity to consent to treatment.)

If you want to refuse treatment, you should discuss your reasons for refusing and what other options you have with your care team. Health professionals can’t threaten to section you to make you agree to treatment. If they do, you can make a complaint about it.

See our legal pages on voluntary patients for more information.

What if I'm on a community treatment order (CTO)?​

In general you cannot legally be treated without your consent if you're on a CTO:

  • You can't be given a condition 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 – even if you aren’t showing symptoms yet – your responsible clinician may have good reasons to recall you to hospital to force you to have treatment. For more information, see our legal pages on CTOs.

Can I refuse to be on a CTO?

You can be given a CTO even if you don't want one, but you should still be involved in decisions about your treatment. To find out more, see our page on CTOs.

What if I'm in hospital under section?

Although you generally need to give consent before you can lawfully be given treatment for your mental health problem, the Mental Health Act says you can be treated against your wishes if:

  • you're on a section 2, 3, 36, 37, 38, 47, 48 or 45A (with or without restrictions – see our legal pages on sectioning for more on this), or
  • you've been recalled from a CTO.

However, the following types of treatment have special rules on consent that health professionals have to follow before you can be treated:

Type of treatment

Who needs to agree to treatment

Exceptions

Neurosurgery (NMD) or hormone implants to reduce male sex drive

You can only be given this treatment if:

You still might be treated without your consent if the treatment is immediately necessary to:

  • save your life
  • prevent a serious deterioration
  • alleviate 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).

Electro-convulsive therapy (ECT)

You can only be given this treatment if:

  • you consent, and it is confirmed by a SOAD or doctor in charge, or
  • a SOAD confirms that you lack capacity to consent, and that treatment is appropriate and it wouldn’t conflict with an advance decision or a Court of Protection decision.

You still might be treated without your consent if the treatment is immediately necessary to:

  • save your life, or
  • prevent a serious deterioration.

Medication after an initial 3 month period

You can only be given this treatment if:

  • you consent, or
  • a SOAD confirms that you lack capacity, or
  • you haven’t consented but the SOAD confirms that treatment is appropriate.

You still might be treated without your consent if the treatment is immediately necessary to:

  • save your life
  • prevent a serious deterioration
  • alleviate serious suffering, or
  • 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 if they don't have to follow them. (For more information, see our page on planning ahead.)​

What if I'm being treated for a physical health problem?

If you're being treated for a physical health problem unrelated to your mental health problem, the health professionals can't treat you without your consent.

You can only be treated for a physical health problem without your consent if:

  • you lack capacity, or
  • 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 given treatment against your wishes.

Example

Toni has anorexia nervosa (an eating problem) and is detained on section 3 of the Mental Health Act. 

It is lawful for her care team to give her food against her wishes via a naso-gastric tube as it is physical health treatment related to her mental health problem.

Is it lawful to restrain me in order to treat me?​

The law says that, in circumstances when 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.

However, any force used to restrain you would have to comply with the Human Rights Act 1998 – this is the law that protects your human rights in the UK. (See our legal pages on the Human Rights Act for more general information about how your human rights are protected.)

Mind is campaigning on restraint

We've been campaigning on the use of restraint and restrictive practices. Read our guides on restraint in mental health services, and visit our campaigns page to find out more about what we're doing, and how you can get involved in helping us bring about change.

 


This information was published in March 2018. We will revise it in 2020.


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