Do people usually get the choice to go into hospital informally before being sectioned

[Confused3393]

Or are some just sectioned straight away?

Depends on the circumstances - it's pretty hard to legally and justifiably put somebody under a mental health section if they are making reasoned and informed judgements on their own care....

If their judgement and decision making or insight are impaired, and particularly if they pose a danger to themselves or others, a section can be used to impose a period of assessment and treatment.

If they have capacity and are willing to be admitted informally but are placed on section there has to be a damn good reason, like the person is a huge risk of violence.

If the person lacks capacity to consent to admission they should be placed under section or Deprivation of Liberty Safeguards.

If someone is felt to need admission and they have lost the capacity to make that decision then a section should be used. It wouldn't be right to expect someone to agree to an admission when they have lost the ability to weight up and make the decision themselves. In practice (I work on an acute mh ward) sometimes people come in informally and it is clear that they do not know what they have agreed to and why they're there.

Least restrictive option should always be explored. Where someone would benefit from being in hospital but has capacity (which they may well do) and consents to admission, it can be done informally. Too often this happens in a coercive way, which should never be the case

I have been in hospital voluntarily. I was asked first, but I think it was under the guise of “well, we’ll let you choose, but ultimately we’ll decide” kind of thing as they made it quite clear I wasn’t allowed to go home. So I imagine I would have been sectioned if I had refused

My best friend has been in and o ut of hospital a lot of times, always voluntarily and always because she was a risk to herself never to others. There was 1 time when she was very high risk and needed 24 hour 1 to 1 observation, and it was made very clear that if she tried to leave she would be sectioned, but it never actually came to that. I think it's something they try to avoid doing unless there's really no other option as it really is a huge deal to take away someone's liberty like that.

Of someone doesn't have capacity to decide about their own care and treatment they should be sectioned even if they are agreeing (as this gives them greater protection).

If you have capacity and are accepting treatment you shouldn't get sectioned.

I'm horrified by the sanctioning by stealth people are describing (where patients are told they will be sectioned if they try to leave). Professionals should not do that, it is against the code of practice. People on a section are subject to a high level of scrutiny of their case to prevent abuses, so if someone doesn't have free choice to leave they should be on a section so they have the highest level of protection.