Introduction

In most cases, when you are treated in hospital or another mental health facility, you have agreed or volunteered to be there. You may be referred to as a “voluntary patient”.

However, there are cases when you can be detained (also known as sectioned) under the Mental Health Act (1983) and treated without your agreement. The Mental Health Act (1983) is the main piece of legislation that covers the assessment, treatment and rights of people with a mental health disorder.

A person can be detained under the Mental Health Act need urgent treatment for a mental health disorder and are at risk of harm to themselves or others.

Section 2

A person can be detained if:

  • they have a mental disorder
  • they need to be detained for a short time for assessment and possibly medical treatment, and
  • it is necessary for their own health or safety or for the protection of other people

How long a person can be kept under section

Up to 28 days.  The section can’t normally be extended or renewed, but they may be assessed before the end of the 28 days to see if sectioning under section 3 is needed.

Section 3

You can be detained if:

  • you have a mental disorder
  • you need to be detained for your own health or safety or for the protection of other people, and
  • treatment can’t be given unless you are detained in hospital

You cannot be sectioned under this section unless the doctors also agree that appropriate treatment is available for you

How long you can be kept under section

Up to 6 months.  The section can be renewed or extended by your responsible clinician:

  • for 6 months, the first time
  • then for 6 months, the second time
  • after that, for 12 month periods. There is no limit to the number of times the responsible clinician can renew the section 3.

Your responsible clinician can also discharge you from your section before it comes to an end. If this happens, you are free to go home.

If your mental health gets worse again in the future, you could be sectioned and taken to hospital again on a new section.

Section 4

You need to be detained if:

  • you have a mental disorder
  • it is urgently necessary for you to be admitted to hospital and detained, and
  • waiting for a second doctor to confirm that you need to be admitted to hospital on a section 2 would cause “undesirable delay”

You can be sectioned by one doctor only (together with the approved mental health professional) and you can be taken to hospital in an emergency and assessed there.

Your rights are different compared to your rights under other sections. For example, you cannot be treated without your consent.

How long you can be kept under section

Up to 72 hours.

Section 5 (2)

Applies to you if you are a voluntary patient or inpatient (including inpatients being treated for a physical problem).

A doctor or other approved clinician in charge of your treatment needs to report to the hospital managers that an application to keep you in a hospital (a detention section) ‘ought to be made’.

How long you can be kept under section

Up to 72 hours.

Section 5 (4)

Applies if you are a voluntary patient receiving treatment for a mental disorder. A nurse specially qualified and trained to work with mental health problems or learning disabilities can detain you if they think that your mental health problem is so serious that:

  • you need to be kept in hospital immediately for your health or safety or for the protection of others, and
  • it is so urgent that it is not practicable to get a practitioner or clinician to provide a report to the hospital managers.

How long you can be kept under section

Up to 6 hours, or until a doctor or clinician with authority to detain you arrives, whichever is earlier.

Section 17 Leave

Applies if you are already detained under the Mental Health Act. This section gives the responsible clinician power to grant you leave for a specified period of time from the ward and the hospital.

You are likely to be asked to keep to certain conditions, such as returning on a certain day or at a certain time, or staying at a particular place or in the care of a particular person.

Section 35

Applies if you are a person accused of a crime in criminal proceedings. The Crown Court or Magistrates’ Court can remand you to hospital if one doctor has evidence that:

  • there is reason to suspect that you have a mental disorder, and
  • it would be impracticable for a report on your mental condition to be made if you were remanded on bail.

How long you can be kept under section

Up to 28 days, renewable for further periods of 28 days to a maximum of 12 weeks in total.

Section 37

Under this section, you can be sent to hospital for treatment.

The Crown Court can make a hospital order before or after you have been convicted of a crime. The Magistrates’ Court can only make a hospital order when you have been convicted of an offence that could be punished with a prison sentence.

The court makes a hospital order on evidence from two doctors that:

  • you have a mental disorder of a nature or degree that makes detention for medical treatment appropriate
  • appropriate medical treatment is available for you, and
  • a hospital order is the most suitable option for you, after taking into account all the relevant circumstances (including your past history and character and other methods of dealing with your mental health problem that might be available to the court).

How long you can be kept under section

Up to 6 months, and then can be renewed for a further 6 months, and then for 1 year at a time.

Section 41

If the Crown Court has made a hospital order under section 37, it can also impose a ‘restriction order’. This means that you can only be discharged, transferred or given section 17 leave with permission from the Ministry of Justice.

The Court will make a restriction order if it thinks it is necessary to protect the public from serious harm.

How long you can be kept under section

No fixed time limit.  It changes the time limit of section 37

Section 37/41

If you are under a Section 37/41 it means that the Crown Court has decided that (on the advice of two doctors) instead of going to prison, you would benefit from going to a hospital to receive treatment for a serious mental health problem. The judge will have decided that, because of concerns about public safety, you need to be both Section 37 and also Section 41. Section 37 deals with treatment of your mental health problem.

The Section 41 (often called a Restriction Order) means the Secretary of State decides when you can be given leave and when you can leave hospital. If it is agreed that you can leave hospital, conditions will be attached to your discharge. This is called a conditional discharge and means that you could be brought back to hospital if you do not comply with these conditions.

How long you can be kept under section

No time limit.

Section 47

The Ministry of Justice can order you to be transferred from prison to hospital for treatment of your mental health problems.

How long you can be kept under section

Up to 6 months, renewable for a second 6 months, and then 1 year at a time.

Section 48

If you are under a Section 48 it means that you are a prisoner waiting to be sentenced. On the advice of two doctors, the Secretary of State decided that you needed to spend time in hospital to have treatment for a serious mental health problem. In most cases you will return to court for final sentencing. Most people under Section 48 are also under section 49

If you were admitted under this section, a nurse will have given you a leaflet explaining the Section you are under and any rights of appeal you have.

Section 49

If the Ministry of Justice has ordered you to be transferred from prison to hospital under section 47, at the same time it can also impose a ‘restriction direction’ on you under section 49. This means that you can only be discharged, transferred and given leave from hospital with permission from the Secretary of State for Justice.

How long you can be kept under section

Until the end of the section 47 or the date when you should be released from prison.

Section 117 Aftercare

Health authorities and local social services have a legal duty to provide free aftercare for people who have been discharged under Mental Health Act sections 3, 37, 45A, 47 or 48. The duty to provide aftercare also applies if you are given s17 leaven or are under a community treatment order.

Aftercare services in the aftercare plan should be provided free of charge. The services will meet a need relating to your mental health problem and prevent you from returning to hospital.

Section 135

You can be placed under this section if there is reasonable cause to suspect that you have a mental disorder and you are:

  • being ill-treated or neglected or not kept under proper control, or
  • unable to care for yourself and live alone.

A magistrate can issue a warrant authorising a police officer (with a doctor and an approved mental health professional) to enter any premises where you are believed to be and take you to (or keep you at) a place of safety.

How long you can be kept under section

Up to 24 hours.

Section 136

If it appears to a police officer that you have a mental disorder and are “in need of immediate care or control”, they can take you to (or keep you at) a place of safety. You will be kept in the place of safety you were taken to so that you can be examined by a doctor and interviewed by an approved mental health professional, and any necessary arrangements can be made for your treatment or care.

How long you can be kept under section

Up to 24 hours.

CTO (Community Treatment Order)

You may be placed on a Community Treatment Order (CTO) and put under supervised community treatment when discharged from certain sections of the Mental Health Act.

You can be discharged under a CTO if:

  • you have been detained under section 3 of the Act or
  • you have been diverted to hospital from the criminal justice system under certain sections of the Mental Health Act.
  • You can’t be placed under a CTO if you have been detained under section 2 or you are a voluntary patient.

A CTO means that you must meet certain conditions to stay in the community. You may be taken back to hospital if you don’t meet the conditions of the CTO.

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