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

Terms you need to know

Term Meaning
Appropriate treatment or appropriate medical treatment

This means medical treatment for your mental health problem that is:

  • suitable for you
  • available
  • takes into account the nature and degree of your mental health problem and your individual circumstances.
Approved clinician

A mental health professional who has certain responsibilities related to your healthcare. They are approved to do this by the Department of Health (England) or by the Welsh Ministers (Wales).

Approved clinicians may be:

  • doctors
  • psychologists
  • nurses
  • occupational therapists
  • social workers.

Some decisions under the Mental Health Act, such as deciding on your medication or giving you permission to leave the ward or hospital, can only be taken by approved clinicians.

Approved mental health professional (AMHP)

AMHPs are mental health professionals who have been approved by a local social services authority to carry out certain duties under the Mental Health Act. They are responsible for coordinating your assessment and admission to hospital if you are sectioned.

They may be:

  • social workers
  • nurses
  • occupational therapists
  • psychologists.
Community treatment order (CTO)

If you have been sectioned and treated in hospital under certain sections, your responsible clinician can apply for you to be put 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
  • going somewhere for medical treatment.

See our pages on community treatment orders (CTOs).

Conditional discharge

This is where you are discharged from hospital into the community by a tribunal or the Secretary of State for Justice, but you have to meet certain conditions. If you break these conditions, you can be recalled to hospital by the Secretary of State for Justice.

You will only be put under a conditional discharge if you have been:

  • sectioned by a court under certain sections of the Mental Health Act and have been charged with a crime and you are a restricted patient under a restriction order, or
  • transferred to hospital from prison under the Mental Health Act and you are a restricted patient under a restriction direction.
Detained

A person is detained if they are being kept in hospital under section and are not free to leave.

Equality Act 2010

This is the law that explains:

  • what behaviour counts as unlawful discrimination
  • who has a right to challenge discrimination.
Escorted leave

This is where you are allowed to leave the ward accompanied by a member or members of the hospital staff. Your responsible clinician grants you permission to leave the ward under section 17 of the Mental Health Act.

Guardianship

This is where someone called a ‘guardian’ is appointed to help you live as independently as possible in the community, instead of being sectioned and kept in hospital.

You would be placed under guardianship if your mental health problem meant that it would be difficult for you to avoid danger or people taking advantage of you. Your guardian has the power to make certain decisions about you and to make conditions that you will be asked to keep to.

Find out more about guardianship in our information on community care and aftercare.

Hospital managers (also known as Mental Health Act managers)

An independent team of people in a hospital who make sure that the requirements of the Mental Health Act are properly applied. They have certain important responsibilities and can make decisions related to your detention – for example, they can hear your application to be discharged from your section and decide whether or not to discharge you.

Immediate care or control

This means that you are vulnerable because of your mental health problem and you need a level of care or control that you are not receiving in the public place to keep you safe and healthy.

Independent mental health advocate (IMHA)

An IMHA is an advocate specially trained to help you find out your rights under the Mental Health Act 1983 and help you while you are detained. They can listen to what you want and speak for you.

For more information see our full pages on:

Medical treatment

In the Mental Health Act this means medical treatment that is used to relieve the signs and symptoms of your mental health condition, or to stop it from getting worse. It includes:

  • nursing
  • psychological intervention and specialist mental health habilitation (learning skills)
  • rehabilitation (relearning skills)
  • care.
Mental disorder

When the Mental Health Act talks about someone with mental health problems and whether or not they should be sectioned, it often uses the term “mental disorder”. The Act defines this as “any disorder or disability of mind” (section 1).

Mental disorder can include:

  • any mental health problem normally diagnosed in psychiatry
  • learning disabilities, if the disability makes you act in a way which may seem "abnormally aggressive" or "seriously irresponsible".
Mental 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 illness and need treatment. You can only be kept in hospital if certain conditions are met.

Mental Health Act Code of Practice

This tells health professionals how they should follow the Mental Health Act 1983.

It is not law, so it cannot be enforced by going to court, but health professionals should follow it unless there is a good reason not to.

The Code covers some areas not specifically mentioned in the Mental Health Act 1983, such as visiting rights and the use of seclusion.

If a health professional doesn’t follow the Code, you can make a complaint.

There is both an English and Welsh Code of Practice. They are mostly identical, but have certain differences based on the fact that there are some laws which are different in England and Wales.

Mental Health Tribunal

This is a special court that deals with cases relating to the Mental Health Act 1983. The Tribunal decides whether you can be discharged from your section and can decide about suitable aftercare and make recommendations about matters such as hospital leave, transfer to another hospital, guardianship and community treatment orders.

The court is made of a panel, which normally includes:

  • a legally qualified chairperson
  • a ‘lay person’ who has appropriate experience and qualifications in the area of mental health
  • an independent psychiatrist, who will speak to you and examine you before the tribunal hearing in certain circumstances, and when you request to see them.

Where you see a reference to the Mental Health Tribunal in this guide, it means:

  • First Tier Tribunal (Mental Health), if you live in England, or
  • Mental Health Review Tribunal for Wales, if you live in Wales.
Nearest relative (NR)

This is a family member who has certain responsibilities and powers if you are detained in hospital under the Mental Health Act. These include the right to information and to discharge in some situations.

The law sets out a list to decide who will be the nearest relative. This can sometimes be changed.

See our information on the nearest relative.

Not kept under proper control

This means that you are vulnerable because of your mental health problem, and you need a level of care or control that you are not receiving at the time of the warrant to keep you safe and healthy.

Place of safety

A locally agreed place where the police may take you to be assessed, usually a police station or a hospital. A police station should normally only be used in an emergency.

Registered medical practitioner

A qualified doctor, for example a GP or psychiatrist.

Remand

This means that you will go to prison until you go to court to have your case considered. Sometimes you can be remanded to hospital instead of prison.

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.

Second 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.

To find out more see our information on consent to treatment.

Section

In this guide, 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.

Section 12 approved doctor

A doctor trained and qualified in the use of the Mental Health Act 1983, usually a psychiatrist. They may also be a responsible clinician, if the responsible clinician is a doctor.

Supervised community treatment

You can be under supervised community treatment if you are put under a CTO.

To find out more, see our information on the Mental Health Act.

Voluntary patient (also known as informal patient)

These are people who are staying in a psychiatric hospital but are not detained under the Mental Health Act. They should be able to come and go from the hospital within reason and are able to discharge themselves if they decide to go home. See our Voluntary patients resource for further information.

 


This information was published in September 2017. We will revise it in 2019.


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