Hello, it's Dr Beth Colby from Talk Mental Health. The Mental Health Act was an act of Parliament in
1983, and it was revised in 2007. it gives the legal authority for people to be detained in
hospital against their wishes. Today I'm going to be talking about Section 2, which is a 28-day
Assessment Section, and Section 3, a six-month Treatment Section. So what's the process for
somebody getting sectioned? By the way, it's called sectioning because the Mental Health
Act has got lots of different sections in, and they're numbered, so that's why we use that term.
Well, somebody has to be suffering from a mental disorder. The mental disorder has
to be of a nature or degree - this implies the seriousness of the disorder - to warrant
somebody being detained in hospital against their wishes; and it's either for their own health,
their own safety or for the safety of others; and this is for people who are either not agreeing
to go into hospital or people who have not got the capacity to consent to going into hospital.
So then, what's the process for somebody getting into hospital under a Section of the Mental
Health Act? Okay, so somebody's very unwell, may need to go into hospital, psychiatric hospital,
and somebody raises the concern about them. So it could be their GP, psychiatrist, a member
of their family, it could be the police; and then a Mental Health Act assessment is arranged.
The three people who take part in assessing whether somebody is liable to be detained in
hospital are as follows: one is the Approved Mental Health Practitioner or AMHP - this is
usually a social worker, but it could be a psychologist, an occupational therapist
or a senior nurse; one is a doctor that hopefully the patient may have met before,
which is usually a GP; and the third one is somebody who's been certified in expertise in
the assessment or treatment of mental disorders, and that's usually a psychiatrist, but it could be
a Forensic Medical Examiner or a GP. Now the assessment may take place on more than one day,
because the three people don't necessarily have to be together. The assessment more usually takes
place in somebody's house, but it could be at a hospital. If they're in a public place,
the police have the powers under Section 136 to take somebody from a public place
to a place of safety for them to be assessed under the Mental Health Act. What if the person refuses
to let people in so that they can be assessed? Does that mean they won't need to go into hospital?
Well, no. If somebody's not allowing people to come in, a warrant can be obtained from
the court to allow entry into the person's premises, so if they don't answer the door,
then this warrant will allow entry even if they do not wish their property to be entered. Do families
get involved in Sections, what goes on there? The Mental Health Act describes the 'nearest relative,'
which is written down in law - it's not a usual term that we'd use as next of kin, it's actually defined.
So the first person who would be somebody's nearest relative is their husband or wife or civil
partner, if they have one; otherwise it will be - the the next level down will be their oldest child; if
they haven't got children, it'll be their oldest parent; if no parents their oldest sibling; and
if no siblings - you know there's a whole list that goes on. Now, so the nearest relatives have certain
rights within the Mental Health Act. One is to stop somebody being detained under a Section 3;
one is to apply for somebody, a patient, to be discharged off their Section 2. Okay, so
somebody's ill, they've been seen by the AMPH, the GP and the psychiatrist or Section 12 Approved Doctor,
who feel that they need to go into hospital. What happens then? Well if they've never been into
hospital before, then they're likely to be admitted under a Section 2, which is an Assessment Section.
If somebody has been in and out of hospital over the years, quite a few times for lengthy periods,
then they would already have a diagnosis, and they would go into hospital on a Section
3, which is the treatment section. As I said, the patient's being detained under the
Mental Health Act because they don't want to go, so can they be forced to go in? Well, yes they can.
People are usually taken in by ambulance, but the police could be asked to be involved if
necessary to escort them to hospital. And then once in hospital, what happens then? Well,
people are treated the same as if they weren't on a Section, although they have certain rights.
So they've got a right to a Mental Health Review Tribunal, so for a Section 2 they can apply for
that within the first 14 days of their Section; they've got the right to get an Independent
Mental Health Advocate, and they've also got a right to apply for a Managers' Hearing, which is
appealing against Sectio,n and also they've got a right for free legal support for them for
their Managers' and Mental Health Review Tribunal hearings. When they-re prescribed medication, then this
can be given without their consent. Do they have to stay in hospital all the time - can people leave?
Well, if people are under a Section, they're not allowed to leave the hospital ward unless a form
is written. It's called Section 17 leave and it may stipulate certain things like for how
long, for who with. So this can happen once people's mental health has settled down sufficiently enough
for them to be well enough to go out of hospital for a while. The senior clinician whose care they are
under is called the Responsible Clinician, and this is usually a psychiatrist, and they will regularly
see the patient and review their care. If they've been admitted under a Section 2, as soon as it's
felt that they no longer meet the requirements for being under a Section 2, the
patient can be taken off the Section and discharged from hospital, or become an informal patient - that's
somebody who's there voluntarily, or agreeing to be in hospital. If it's clear from the start that
the patient's going to need a longer time in hospital than the 28 days, this Section could be
converted from a Section 2 to a Section 3, which is the treatment section. Section 3s last up to
6 months, and they can be continued , so after one Section 3 you could have another
Section 3 for six months, and then they can be continued annually for as long as necessary.
If when somebody's on Section 3 they're not consenting to medication, after the first 3
months of being sectioned under Section 3, a Second Opinion Appointed Doctor will come to see
the patient to assess their capacity to consent and whether they are consenting to the medication,
the medication plan that has been written by the Responsible Clinician. So that's a safeguard
for the patient that if they haven't got the capacity to consent that they're being given
medication that's going to be helpful for them, and in somebody who's not consenting that it's
another somebody to see, yes this treatment will be really good for them to help get them better.
So we've talked about a Section 2 for up to 28 days that's not renewable; Section 3 treatment
section up to six months which is renewable; we've mentioned getting a warrant from the court
to allow entry into a person's home to assess them and section 136 which the police can use to
take somebody from a public place to a place of safety. I hope that's been useful for you 'Bye then.