If a person with a mental illness isn’t able or willing to be involved in decisions about treatment because of their condition, doctors at the WLMHT will make decisions in their best interest.
Sometimes, this means doctors have to use the powers given to them under the Mental Health Act to insist on medication or a stay in hospital. This is known as being sectioned. Doctors would do this if a person’s behaviour puts them or others at risk of being harmed.
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 then has to ask for a person to be sectioned. Any person who is detained has rights of appeal and the right to an Independent Mental Health Advocate to help them appeal.
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 evidence of two doctors, one of which must be a specialist working with mental disorder but only if an approved mental health professional asks for them to be sectioned. This 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. This could be medication, talking treatments, specialist mental health nursing and care.
A person’s rights about medication
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 must take it for up to three months.
After three months, a doctor again asks the person 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.
When a person who has been sectioned leaves hospital, the local council has a responsibility to make sure they are looked after and supported for as long as the mental health illness continues.
Ensuring your rights
There are a number of other sections in the Mental Health Act which cover situations such as someone being arrested by the police, attending court or when they are already in hospital on a voluntary basis.
For a few people who have had a lot of admissions to hospital, supervised community treatment is also a possibility. A person detained in WLMHT 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. 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.