Mental Health Act

What is the Mental Health Act?

The Mental Health Act is a law in England and Wales that allows people to be assessed or treated for a mental health problem in hospital, even if they do not agree to go. The law applies to adults, children and young people.

Different parts of the law are called "sections". This is why being detained under the Mental Health Act is often known as being "sectioned".

Someone will only be sectioned if it is necessary for their health or safety, or to protect other people.

Most people receiving mental health care are not sectioned. They receive treatment from community services as an outpatient or stay in hospital voluntarily as an informal patient.

What are my rights when sectioned in hospital?

If you're sectioned and detained in hospital, you still have certain legal rights. You'll also gain some new rights related to being sectioned.

While under section, you should have the right to:

  • Be told which section you are under, why you have been detained, and be given information to help you understand your rights. Your views, wishes and preferences should be listened to and respected wherever possible. Including taking account of any Advance Choice Document, or other previously expressed wishes about your care and treatment.

  • Get support from an Independent Mental Health Advocate (IMHA) – see below for more information about IMHAs.

  • Challenge your detention through the Mental Health Tribunal or Hospital Managers – see ‘challenging your detention’ for more information.

  • Have some phone access and visitors in-person. Please speak to your care team about phone access and visiting arrangements, as these may vary depending on the ward.

  • Apply for leave from the ward when agreed by your responsible clinician (the senior healthcare professional responsible for your care).

  •  Vote in local and national elections in most circumstances.

  •  See a copy of your sectioning papers.

  • See a copy of the Mental Health Act Code of Practice .

  • Make a complaint about your care, either by contacting our Patient Advice and Liaison Service (PALS) or the Care Quality Commission

Challenging your detention

If you do not agree with your detention, you have the right to challenge it and ask to be discharged. An IMHA can help you to do this.

You can:

  • ask your responsible clinician to discharge you from your section

  • ask for a hearing with the Associate Hospital Managers*. Associate Hospital Managers are independent of your care team and can review whether your detention should continue. An IMHA can help you arrange this.

  • apply to the Mental Health Tribunal hearing. You can ask for this if you are under certain sections of the Mental Health Act. The tribunal is an independent panel that will consider whether you should continue to be sectioned. Legal aid will always be available for a mental health solicitor to represent you at this hearing, if you have a right to the hearing when you apply.

  • ask your nearest relative, who has the right to apply to take you out of hospital.

*Associate Hospital Managers

If you are detained under the Mental Health Act or are on a Community Treatment Order (CTO), you can ask for your case to be reviewed by Associate Hospital Managers.

Despite their name, they are not managers who run our hospitals. They are independent volunteers who are separate from the Trust and the clinical teams providing your care.

A panel of Associate Hospital Managers will consider information about your care and whether the legal requirements for your detention or CTO are still met. They can decide that you should be discharged if those requirements are no longer met.

We are here to help

Being detained under the Mental Health Act can feel frightening, confusing or overwhelming. If you have questions about your care, treatment or rights, please speak to staff. They can explain your rights, help you contact an IMHA, provide information about mental health solicitors, and answer questions from you, your family or carers where appropriate.

More information

Getting help from an Independent Mental Health Advocate (IMHA)

An Indepedent Mental Health Advocate (IMHA) can help you understand your rights under the Mental Health Act. They can explain information, help you express your views and support you at meetings. They are independent of the services providing your care, and their support is free and confidential.

You may have a right to an IMHA if you are:

  • detained in hospital under the Mental Health Act, sometimes known as being 'sectioned'
  • on a Community Treatment Order (CTO)
  • subject to guardianship
  • an informal patient being considered for certain treatments under the Mental Health Act.


How an IMHA can help

An IMHA can help you understand:

  • your rights under the Mental Health Act, including your rights around discharge
  • your Community Treatment Order and any conditions attached to it
  • the parts of the Mental Health Act that apply to you
  • your treatment and why you are receiving it.

With your agreement, an IMHA can also:

  • meet with you privately
  • look at your health records
  • talk to the people involved in your care
  • speak or write on your behalf
  • come to meetings with you
  • support you if you are eligible to apply to the Mental Health Tribunal.


Contact an IMHA

Refer yourself using the contact details below, or ask a member of staff to help you.

Rethink Advocacy London Hub (for patients at Springfield Hospital)
Telephone: 0300 7900 559
Email: advocacyreferralhub@rethink.org
Rethink Advocacy London Hub

Cambridge House (for patients at Tolworth Hospital)
Telephone: 020 7358 7007
Email: imailbox@ch1889.org
Visit the Cambridge House website

Nearest relative

If you are detained under the Mental Health Act, the law identifies someone as your ‘nearest relative’. They have certain rights, including being given information, being consulted about some decisions and asking for you to be discharged from your section. Your nearest relative may not be the same person as your next of kin.

If you are unsure who your nearest relative is, your local Approved Mental Health Professional (AMHP) service can help.

You can find more information about nearest releatives on the Mind website.

Local Approved Mental Health Professional (AMHP) services

Local AMHP services can support families and carers who are concerned that a relative or someone they care for may need to be assessed under the Mental Health Act. They will listen to your concerns and consider whether an assessment is needed.

Find your local service:

Kingston 

Merton

Richmond and Wandsworth 

Sutton

How detention (being sectioned) happens

Before someone can be detained under the Mental Health Act, professionals must consider whether they can be safely supported without being admitted to hospital.

In most cases, an Approved Mental Health Professional (usually a social worker) and two doctors (usually psychiatrists) must agree that:

  • The person has a mental disorder that requires hospital care or treatment.
  • Detention is necessary for their health or safety, or to protect other people.
  • The care or treatment cannot be provided safely outside hospital.

Types of sections

There are different sections of the Mental Health Act, each with its own rules about care, treatment and how long you may need to stay in hospital. The sections you are most likely to hear about are sections 2 and 3.

What is section 2?

Section 2 allows someone to be detained in hospital for assessment and, if needed, treatment. It can last for up to 28 days and is not usually renewed.

What is section 3?

Section 3 allows someone to be detained in hospital for treatment. It can last for up to six months and may be renewed if needed.

Community Treatment Orders (CTO)

A CTO allows some people to receive treatment in the community instead of staying in hospital. You may need to follow certain conditions, such as attending appointments or living at a particular address. If these conditions are not followed, or your mental health worsens, you may be recalled to hospital.

You can find more information about Mental Health Act sections on the Mind website.

Your rights around treatment

In some situations, the Mental Health Act allows treatment to be given without your consent. The rules depend on the section you are detained under, and staff should explain your rights and treatment options to you.

You can find more information about your rights around treatment on the Care Quality Commission's website.

Advance Choice Documents (ACDs)

An Advance Choice Document (ACD) lets you record your wishes about future care and treatment when you are feeling well. It can help healthcare professionals understand what is important to you if you become unwell in the future.

If you have a valid ACD, healthcare professionals must take it into account when making decisions about your care and treatment while you are detained.

For more information about ACDs, or if you would like to create an ACD in the future when you are well, please speak to a member of staff or an IMHA who can help you.

Section 117 aftercare

If you have been detained in hospital for treatment under certain sections of the Mental Health Act, you may be entitled to free help and support when you leave hospital. This is known as Section 117 aftercare.

Section 117 aftercare is provided jointly by the NHS and local social services. It aims to support needs related to your mental health and help you stay well and reduce the risk of returning to hospital.


Who is entitled to Section 117 aftercare?

You are entitled to Section 117 aftercare if you have been detained for treatment under:

  • Section 3
  • Section 37 (a hospital order made by a court)
  • Section 45A (a hospital direction)
  • Section 47 or 48 (transfer from prison to hospital).

You are also entitled to aftercare if you leave hospital on a Community Treatment Order (CTO).

Your entitlement does not automatically end if you later stay in hospital voluntarily, are readmitted to hospital or your CTO ends.


What can Section 117 aftercare include?

Your aftercare should be based on your individual needs. Depending on your circumstances, it could include:

  • support from community mental health services
  • psychological therapies
  • social care and help with everyday living
  • supported accommodation
  • support with work, education or developing skills
  • support with social, cultural or spiritual needs
  • crisis and contingency planning
  • other support related to your mental health and helping you stay well.

There is no charge for services provided as part of your Section 117 aftercare.


Planning your aftercare

Planning should begin before you leave hospital. You should be involved in deciding what support you need, and you can ask for a family member, carer or advocate to be involved.

Your aftercare plan should explain:

  • what support you will receive
  • who is responsible for providing it
  • what to do and who to contact if your mental health starts to deteriorate.

You should be offered a copy of your care plan.


How long does Section 117 aftercare last?

There is no fixed time limit. Your aftercare should continue for as long as you need services to meet needs arising from or related to your mental health condition.

It should only end when the NHS and social services responsible for your aftercare agree that you no longer need it. You should be involved in this decision.


Getting help with your rights

If you need help understanding your rights or having your views heard, an Independent Mental Health Advocate (IMHA) may be able to support you.

If you have questions or concerns about your Section 117 aftercare, speak to the team involved in your care.

Law centre and welfare benefits

Springfield Advice and Law Centre is an independent charity offering free, independent legal advice for users, their family or carers of our Trust. Staff at the Law Centre are qualified solicitors or experienced legal advisers.

The Law Centre offers:

  • specialist advice
  • casework
  • representation in debt
  • welfare benefits
  • housing and mental health


Welfare benefits

Patients and carers are often entitled to a range of welfare benefits. Specialist advisers in our welfare benefits team can help you with any benefits queries. 

  • Wandsworth residents:

    Contact our Welfare Benefits Team on 020 3513 6469 or email WelfareBenefitsTeam@swlstg.nhs.uk. The drop-in service is held at Springfield Hospital, Monday to Friday, 10am-12.30pm. Scheduled appointments can be made outside these times and must be pre-arranged.

  • Kingston and Richmond residents:

    Contact Richmond AID (RAID) on 020 3393 7011, emailinfo@raid.charity, or visit www.raid.charity

  • Merton and Sutton residents:

    Contact your local Citizens Advice service. Find your nearest branch at www.citizensadvice.org.uk/about-us/contact-us

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