Questioning on Sectioning

As a few of you may know, in July of last year I was sectioned. It was under Section 2 of the Mental Health Act which means I could be held in hospital, against my will, for 28 days. I have decided to write a blog post on the subject because last week I was having a conversation with one of my close friends about my experience last year. She didn’t know much about sectioning, which isn’t surprising if you’ve been lucky enough to bypass it. Before I got ill, I was unaware that you could be detained for healthcare reasons, so I thought it would be useful and insightful to summarise a bit about the process and hopefully teach others.

What is the Mental Health Act?

The Mental Health Act is a law that states you can be held in hospital and treated against your will if you have a mental disorder that puts yourself or others at risk. When you are sectioned you are detained.

Last summer when I was sectioned, I had only just turned 18 so they didn’t use handcuffs on me, although they could have. They had to escort me out of the John Radcliffe though, holding my wrists, and I was put in a secure transport vehicle, a bit like the vans you see prisoners travelling in.

What counts as a mental disorder?

You can only be detained under the Mental Health Act if you have a mental disorder. This means you can’t be sectioned if you have have, for example, delusions caused by a drug or alcohol addiction. However, the actual legislation doesn’t state what is classed as a mental disorder so it’s up to the health care professionals to decide whether or not you meet the definition.

Who sections you?

To be sectioned, usually 3 people have to agree that it is necessary. If it’s an emergency though, sometimes only 1 person is needed. When it is 3 people, they are usually 2 doctors, one that you know (could be a GP or in my case it was my psychiatrist) and an approved mental health care professional. One of the 3 can be a close relative, too.

Once all 3 agree that you need to go to hospital, the mental health professional will apply for a bed in a local hospital.

What rights do my nearest relatives have?

The nearest relative can speak to the doctors and professionals who are deciding whether or not to section the patient and can help them make a decision. In my case, they were originally going to section me under a Section 3 but my mum spoke to them about my history in inpatient units and they decided it probably wasn’t the best thing for me.

Where does it happen?

Sectioning can pretty much happen anywhere. It could be your home, hospital or a police station. For me, I had been admitted to A and E then sent to general hospital where they assessed me.

If they are coming to your house and you refuse to let them in, they can get a warrant.

How is it deemed necessary for someone to be detained?

During the assessment you are asked a series of questions by the health care professionals, to see whether you are putting anyone in danger and to see how you feel. It’s important to remember that by being sectioned, you are refusing treatment so it is against your will. This is because the person is deemed so mentally unwell that they lack capacity to know that they need help or want help.

What types of section are there?

There are 4 sections that apply to people with mental health disorders. These are known as section 2, 3, 4 and 5. A section 2 is the most common and means you can be detained for up to 28 days. A section 3 differs from a Section 2 in that no other treatment can be given to you unless you’re at hospital and it can be up to 6 months. A section 4 is used for emergencies where only 1 doctor is available at short notice. A section 4 can last up to 72 hours to give the hospital time to arrange a proper assessment. This type of section would only happen if it seemed too high risk to wait for other doctors to join in the assessment. A section 5 can be applied to either voluntary or involuntary patients who want to leave but aren’t deemed healthy enough yet. It can last up to 72 hours.

What rights do you have when under a Section 2?

When you are under a section 2 your rights include: the ability to appeal to a tribunal within the first 14 days of your section; the right to appeal to the managers of the hospital and the right to see a Mental Health Advocate who can advise you on how to voice your concerns and rights.

What rights do you have when under a Section 3?

When detained by section 3 of the MHA you can appeal to a tribunal within the first 6 months; appeal if your section is renewed; ask the hospital managers to discharge you; ask for a Mental Health Advocate to help you to understand your rights and to get your voice heard.

Can you appeal your section?

Yes. If you are under either a section 2 or 3 you have the right to ask the manger of the hospital to discharge you. You can also apply for a tribunal to appeal your section, get free representation from a mental health solicitor and get help from a MHA.

Can your section be extended or renewed?

For a section 3, it can be renewed after 6 months then after that every 12 months but a section 2 cannot be extended. If needs be and you need to be in hospital for longer than 28 days, you will then be sectioned under section 3.

Can you get leave if you’re on a section?

When you first arrive on the ward, you’ll probably not be allowed to leave. The Mental Health Act gives the staff the power to keep you on a locked ward. After a while if you wish to get leave you can ask on the ward round and leave could be given under section 17 of the Mental Health Act. This states that they can allow you to leave the ward for short periods of time. The case is usually under some conditions though, like a specific time to return. You also need to explain your reasonings for wanting to leave the ward and often it’s not granted.

Escorted ground leave is also available usually when you first arrive on the ward. This is when a nurse walks with you around the hospital on the grounds. After a little while, this could turn into unescorted ground leave and the amount of time this can happen for increases when you build your trust up with the staff.

Can they give you medication you don’t want to take?

Yes, they can force you to take medication when you are under a section. This would be the case if the professionals believe you lack the mental capacity to make a rational decision about treatment or the treatment is in your best interest, whether you agree or not.

What are the consequences of being sectioned?

Often when travelling to countries such as China and the US, you have to say whether you have been detained due to mental health reasons. It may put you at a disadvantage when obtaining a Visa or certain jobs but technically, they are not allowed to discriminate.

I hope this has helped a few people understand a bit more about being sectioned and what it entails. It’s a terrifying process and I have never felt so trapped and alone as to when I was sectioned so I hope and pray that this post has helped people to know what it’s really like and to possibly spread the word and help others too. That’s all for now xxx