The Mental Health Act is a UK law that tells people with a mental health disorder what their rights are, and how they can be treated.
In 2017, the government asked for an independent review of the Mental Health Act 1983, and for suggestions to improve it. The final report for the MHA review stated that the Mental Health Act did not always “work as well as it should for patients, their families and their carers”.
Changes are being proposed by the government this year, to change elements of the Mental Health Act to better work for patients. This includes ways to allow patients to have more say in their treatment, ensure that the most severe elements of the act are used in the least restrictive way, to ensure that patients get a full recovery and can be discharged, and ensure that patients are see as, and treated as, individuals. You can find out more about the consultation here: Reforming the Mental Health Act.
The following information is based on the Mental Health Act as it stands today.
The Mental Health Act is a UK law that tells people with a mental health disorder what their rights are, and how they can be treated. The term “mental health disorder” is used to describe people who have:
- a mental illness
- a learning disability
- a personality disorder
Being detained (also known as being sectioned, because the law has different sections) under the Mental Health Act is when you’re made to stay in hospital for assessment or treatment – you can be detained if medical professionals think that your mental health puts you or others at risk. If you are detained in hospital, NHS staff may be able to give you treatment, even if you don’t want it.
You should only be detained under the Mental Health Act if there are no other ways to keep you or others safe.
When you are detained, NHS staff may be able to give you treatmen, even if you don’t want it. It’s important that you know what happens to you when you’re detained, what your rights are, and where you can seek help.
What are the sections of the Mental Health Act in relation to detention?
Your situation and mental disorder determine which sections of the act apply. These are the main sections in relation to detention.
- Section 135
- This means the police and healthcare professionals have the power to enter your home, by force if necessary, if they think you are at serious risk of harming yourself or someone else. They must have a a warrant to do so.
- Section 136
- This means the police can take you somewhere safe, if you are in a public place, or keep you somewhere safe if you are already in a safe place. You can be kept safe for up to 24 hours, during which time you should be assessed (section 2).
- Section 2 – Assessment
- During assessment you can be detained up to 28 days, which can’t normally be extended beyond that. Assessment before the end of 28 days can determine whether you need to be sectioned under section 3.
- Section 3 – Treatment
- Under section 3 you can be held for up to 6 months. It can be renewed or extended beyond 6 months and there is no limit on the number of renewals. You can be discharged at any time, if the mental health professionals feel you are well enough to go home.
- Section 4 – Emergencies
- In an emergency, where professionals agree you must be admitted to hospital and detained urgently, you can be admitted for up to 72 hours for assesment – however, you cannot be treated without your consent during this time.
- Section 5 – Holding powers
- If you are in hospital and a doctor or nurse feels you have a mental health problem, and that you are not well enough to leave, you can be kept in hospital for up to 6 hours. If a doctor does not see you in this time for assessment, you are free to leave. You cannot be given treatment without your consent during this time.
You can find out more about the Mental Health Act sections on the NHS website here.
What is classed as a mental disorder?
You can only be detained if you have a mental disorder, as mentioned above. The Mental Health Act doesn’t define what is classed as a mental disorder, and so health professionals will decide if your mental health meets this definition. You can’t be detained for substance abuse, but you can be detained if the abuse has caused mental health problems such as delusions.
Who decides if I am to be detained?
Unless it’s an emergency or urgent situation, there usually has to be 3 people in agreement that you need to be detained. These are usually an approved mental health professional (AMHP), a doctor who specialised in mental disorders, and another doctor. (An AMHP is a mental health professional, and may be a nurse, social worker, or psychologist. They cannot be a doctor.)
It’s usually preferred if one of the doctors knows you. The doctors must have seen you together or within 5 days of each other and the AMHP within the last 14 days.
The professionals will discuss with you how you feel, if you are planning to hurt yourself or others, whether you use drugs or alcohol, and about your daily life, lifestyle and living conditions.
If all three agree to detain you for your safety, the AMHP will make arrangements with a local hospital.
A relative can apply for you to be detained but this is in very rare cases.
Where will I be assessed?
This depends on the situation – you may be at home, in a public place (in which case you might be taken by the police to somewhere safe under ‘section 136’) or in a hospital. If you are at home and refuse assessment, the AMHP can ask the court for a warrant if they feel it is necessary.
Where will I be detained?
If you are not in hospital when you are assessed, the AMHP will arrange for you to go to hospital as soon as possible. Staff there will explain why you are being detained, which section of the law applies, and what your rights are. They may give you documentation about the Mental Health Act. If there is something you don’t understand, let them know and they will explain it.
In most cases, you will be taken to a specialist ward for people who have mental health problems, usually called a ‘psychiatric ward’. In most hospitals, the door to the ward will be locked.
Can I avoid being detained?
People are often detained because their mental health is putting themselves or others at risk. Looking after your mental health, taking medication and accepting treatment can reduce the chances of you being detained.
During your assessment you can discuss if there are alternatives to being detained, which might include local mental health services.
What support is available to me?
Your friends and family will be able to visit you, during visiting hours, if you want them to. There may be situations where the doctors would restrict visiting – they need to show this is necessary for safety reasons and they should explain this to you. If a doctor restricts visiting without reason it could be a breach of your rights.
While in hospital, you should have access to a way of keeping in touch with your family via telephone or email.
If you are under sections 2 or 3 of the Mental Health Act, you can ask for help from an Independent Mental Health Advocate (IMHA). They are there to help you tell staff about any concerns, and find out what your rights are, as well as helping you understand your treatments. IMHAs are independent of the hospital staff. Staff should explain to you about IMHAs when you are admitted.
You can seek legal advice if you are detained under sections 2 or 3, and feel you should not have been detained. You can ask for a solicitor who can help you appeal to a tribunal.
It is important that you know your rights when being detained in hospital, and that you ask questions if you don’t understand something or need further advice.