Mental Health Act

The Mental Health Act provides a modern legal framework that enables doctors and other professionals to intervene in order to protect people with mental disorders and, if necessary, other people as well.

Sometimes this means that doctors have to use the powers given to them under the Act to insist on a person being detained in hospital and taking medication – this is commonly known as ‘being sectioned’.

These powers to intervene in a person’s life carry a great responsibility and should only be used when it is right to do so; the Act includes a number of safeguards to check that it is being used correctly.

Sectioning a person for assessment

If a person needs to be assessed in hospital and they aren’t willing to be admitted, they can be sectioned for up to 28 days. If two doctors think a full psychiatric assessment is required they will recommend detention for assessment. One of the doctors must be a specialist working with mental disorder. An approved mental health professional may then apply for a person to be detained. Any person who is detained has rights of appeal and the right to an Independent Mental Health Advocate.

Sectioning a person for treatment

If a person, whose mental health condition is known, needs to be treated in hospital and they aren’t willing to be admitted, they can be sectioned for up to six months on the recommendation of two doctors – one of which must be a specialist working with mental disorders – but only if an approved mental health professional applies for them to be detained and the person’s nearest relative does not object. This detention can be extended for another six months if doctors think further treatment is required, and then for a year at a time.

The doctors have to confirm that the treatment a person needs is available in the hospital and is appropriate for their needs; this could be medication, talking treatments, specialist mental health nursing and care.

A person’s rights about medication

For people detained under the Mental Health Act, on the first day of treatment a doctor explains to a person what the medication being offered is for and any possible side effects. If a person does not agree to take the medication or is too ill to give their consent, and the doctor thinks it is needed, the person can be made to take it for up to three months.

After three months treatment can only continue with the consent of the person or a certificate from another doctor. The person’s doctor will again ask them to give their consent. If the person does not want to continue with the medication, or is too ill to give their consent, the doctor tells the Care Quality Commission. The commission arranges for an independent doctor to visit the person and give a second opinion. Until this visit takes place, the person must continue with their medication. If the second doctor agrees that the medication is the best treatment, the person must continue to take it.

In an urgent situation, the rights about consent do not apply. The Mental Health Act allows medication to be given without a person’s consent if it will save their life, reduce serious suffering, stop a condition from becoming much worse, or stop a person from behaving violently towards either themselves or others.

The Mental Health Act and prison sentences

If a person is given a prison sentence and they are assessed as needing treatment for a mental disorder, the Mental Health Act says they can be transferred to hospital from prison on the basis of expert medical evidence. They can be kept in hospital for medical treatment past the term of their prison sentence if doctors think they still require treatment, but subject to safeguards, such as a right to appeal to an independent tribunal.

Leaving hospital

When a person who has been sectioned leaves hospital, the local services have a responsibility to make sure they are looked after and supported for as long as the mental health illness continues. Prior to discharge a care plan will be agreed and a care coordinator identified to ensure follow up in the community.

Supervised Community Treatment

Some people who have had a number of admissions to hospital may be considered for Supervised Community Treatment. While this involves discharge from hospital the person would remain subject to the Mental Health Act and may, under certain circumstances, be recalled to hospital in the future.

Ensuring your rights

A person detained in hospital will have all their rights very carefully explained to them by our staff as well as receiving information in writing, including their right to an Independent Mental Health Advocate. They have a right of appeal to both the Hospital Managers and the First Tier Tribunal and to assist in an appeal are entitled to free legal representation. The Care Quality Commission also regularly visit our wards without telling us first, to meet with patients and staff and make sure that we are fully respecting patients’ rights.