To think sectioning under the mental health act is rarely done

[User4647]

But it’s shown on tv shows like someone has a breakdown and then they are sectioned. The reality is it’s a battle to even get under secondary mental health care never mind sectioned. AIBU to say very few people are sectioned.

I’ve not known anyone to even have any mental health issues worse than depression, definitely don’t know anyone who has been sectioned.

So from my perspective, I’d say it’s rare!

@AwaAnBileYerHeid

CAMHS.

I struggle with watching various soaps/dramas for this reason. It is damaging.

6038 people were sectioned in the year 2018-2019 in Scotland according to the Mental Welfare Commisions report. So not that unusual. There are clinical and legal criteria that need to be met, and it can be detrimental to any therapeutic relationship, so any professional needs to consider the use of detention very carefully.
It is also not just about managing people who are suicidal. It’s about being able to treat people who have become so ill that they have lost the capacity to make medical decisions for themselves ,and whose health safety or welfare is seriously at risk.

@PineappleUpsideDownCake yes it’s really hard, sorry you can relate to my last post. My whole childhood was overshadowed by my mum’s moods/ rages, made all the more difficult by me finding out later that I am autistic. I was a very quiet and well behaved child so my autism didn’t make my mum worse but it did mean that I struggled and didn’t get the help I needed. The only thing my mum picked up on is that I didn’t go to her for cuddles, so she decided she hated me from being a very small child for that reason... she really me for that. Sadly so many things went on that both myself and another sibling don’t have contact with her now. I’m still regarded as nearest relative under the mental Health act though so Get contacted from time to time re her care. Actually had a phone call today as she is currently in under section 2 and they want to extend it to a section 3. She’s spent her birthday in hospital, alone as she has isolated herself from everyone around her. It’s so sad, but too damaging to my own mental health to resume contact. Mental illness is really awful and can tear families apart.

I think it's neither rare or common, depends on what your definition of being 'sectioned' is,.

I really dislike the term 'sectioned' People aren't sectioned, they are detained under one of the sections of the mental health act. The vast majority of people dealt with under the MHA don't end up in hospital long term.

People are detained under S.136 frequently. It's a police power to remove people who appear to be experiencing mental health issues from public spaces temporarily for their own safety or the safety of others. Similarly s.135 is used to remove people from private spaces in the same circumstances. Many custody suites have designated 136/5 rooms set aside for this purpose.

When you take into account their use for people with learning disabilities, autism, dementia etc as well as people with diagnosed mental health conditions it's quite a high rate of use.

All those people though are usually only held for the few hours it takes to get them to an alternative place of safety or some other treatment (a&e etc).

On the other end of the scale it's quite possible to agree to an admission for mental health treatment under s.2 of the act if such services are available. Those that can afford it check into the Priory informally. The rest take their chances with the postcode lottery offered by their CCG. Most will stay at home under community treatment until they get better or get bad enough for admission.

So I suspect the 'carted off under the mental health act' (s.135 or 136) is quite common but remaining detained under the MHA for more than 36 hours after that is less common,

Oh Lioness I am so sorry. It sounds like pur childhoods have an awful lot in common. Ive never met another "me".

I strongly suspect I am not NT (daughter is autistic, my dad almost certainly is...) but I was very very clever and so good at school etc. I do like cuddles but I think my mum too rejected me as I wasnt what she expected, alongside her mental ill health.

Weve had periods where we're too interdependent. Ive found it so detrimental to my MH but also theres been so many times now that without my intervention she would be dead its felt a huge load to bear.

We're not currently close and its really hard knowing she's struggling and not being able to help. But also knowing the extent of the damage living with her has done me 😔.

Anyway complete sidetrack!!

I don't think it's as rare as you'd think but I think it's often not as long as it's appropriate for full assessment or treatment. In court I used to see a lot of s35/36, fewer 37/38 and seldom 41,47,48,49, but they are there for the most serious cases.

Police sections 135/136 are increasingly common in my current area but often only for a very short period of time and issued seen to have no tangible positive outcome.
S2 similar, and of course a S4 emergency is max 72 hours. We don't see as many S3 as you'd expect given the number of people deemed suitable for full assessment and sometimes I wonder what it takes for people to get the help they desperately need.

I have a family member who is regularly detained under section 2 or section 3

At home she self harms most days in quite distressing ways. But they generally wait until she is a danger to others to take her in. Usually by then they have to bring in a special team to transport her straight to a psychiatric hospital. It's really shit that they wait until she is that bad, but there's usually bed shortages and sometimes ends up a couple of hours away from home.

Don't get me wrong, we are glad that she can be at home. But it's also terrifying having her at home with the level of self harm. Her mum dreads going in her room every morning in case she finds her dead

PineappleUpsideDownCake That unfortunately has been my family’s experience. Begging for help for weeks until something utterly awful happens and then there is no choice but to section. My relative was particularly good at faking being well which compounded it and was generally non-violent so was never a public safety thing. I always think it must be quite distressing being a Psychiatrist because they must know they are often sending ill people away who may well harm themselves or others.

Can a psychiatrist section someone at a CPA?

I don’t know about rarity or not. When I voluntarily went into a mental hospital, I asked whether I would be sectioned if I fought to get out. They said yes, so I didn’t.

Thanks @PineappleUpsideDownCake, I’ve never met another ‘me’ either. I’m finding it hard tbh the last few days, dealing with things again. Apparently she has been asking how my sister is (also doesn’t contact her), but has never once asked about me, even though she knows I’m the one that her team are in contact with... Despite being so good and trying to be a nice person, I was not the daughter she wanted and she made that clear every day of my life. Feel so silly that I’m still upset by that even though I’m now in my 40s... anyway, sorry I didn’t mean to go on and derail the thread

There is a national shortage of beds and, in my experience, a tendency to put more responsibility on the patient than they can fulfill. My Mum was very, very ill. I took her to a psych appointment and I was told that 'she needed to go out more' and 'you can take a horse to water but you can't make it drink.' The next day, she was so ill that my Father couldn't even get her dressed and was in complete despair. I was an ITU nurse, so, frustrated with DF, I said I'd come and dress her and to pull himself together. I got there and it took me 45 minutes to get her underwear on. She was so agitated.

I phoned the psych unit and was asked to bring her in at 4.30pm. When I did, they said she might need to be admitted, but it was very late in the day now, so would she be safe at home in the meantime. I pointed out that they'd made a 4.30pm appointment, and unless they were going to give us some sedatives, no, she wouldn't be safe at home at all!!

I obviously said the right things, because as I was driving her home, I got a call to say they'd be visiting that evening. We had to wait 2 hours while they found her a bed, and the only way they could find one was to recommission a room that was decommissioned for bathroom repairs. It was the only bed within 2 hours.

She was on a 5(2), then 2, then 3. After 3 months they let her out because she would only eat if we went there to feed her. She was convinced it was a hotel and that she needed to pay for food.

That was back in 2017. She's been home 3 years but it's still very dependent on us for everything.

If sectioning is rare it's because a lot of voluntary admissions are that in name only. Not really voluntary if the next step is being sectioned and that's explained. You're left sectioning only those who lack the wherewithal to realise there's no choice. It depends how common you think it is.

Years ago but a friend who was seriously ill and a danger to herself tried to get herself sectioned. They refused on the grounds she was too rational. So we tried again a day later, this time with her standing at reception shouting, 'Do NOT section me'. They sectioned her, which was what she wanted.

People are detained under the mental health act, what is rare is that the vast majority of people understand the legal frameworks around this. It is very complex and this is why only certain professionals are able to make this decision. I am a social worker and as a student thought I wanted to work in mental health but somehow ended up in child protection (I had been a nurse before this, working in learning disability and often mental health). I imagine trying to explain to a lay person the complexity and statute regarding detaining someone under the mental health act is the same as explaining family law. There is a legal threshold, quite rightly. So whilst the lay person may consider that a person with mental health or a neglected child should just be locked up/ whipped into care it is far more complex than this. Mainly because a) years of research shows it often does more harm than good and b) people have legal rights and it is expected that there is a robust arguement with evidence to prove this is necessary and there is no alternative

My friends sister has been sectioned today. Young woman, two small children so sad.

@Nomnomarrgh I've been in that situation where I was in as a voluntary patient and decided to leave as I made a plan, this was the end of the 90s I walked out of the unit and said cherrio to one of the Drs on my way to the front doors and walked away to carry out my plan. The ward realised I was missing when they got a phone call from the local ambulance station to see if they were missing anyone. I was treated in the main hospital unit before I was sectioned as I had lost all insight when I left the ward and I was treated medically before being moved back on a section where I was treated until I finally was able to be regraded to voluntary and started to make some major changes in my life some of which stand to this day.

If I am ever admitted again it most likely be on a section, the last time I lost all hope and spent days begging for help, partner was advised to stay with me and as I could talk on the phone I was o.k. apparently, he couldn't stay for various reasons which he outlined to the team still no help, 2 days later another friend found me and I was admitted medically in a coma when I finally regained consciousness, the crisis team were letting me home to literally complete the job, I was clear about it, sw from a different team who was a also mh trained refused to allow me home and psychiatrist advised me what I should have done.. I despair of mh services now

It's not done lightly. I know a fair few people who've been sectioned but that's because of who my family and friends are. In one case the person was, to put it bluntly, raving mad.

That said, sectioning patients who are already in hospital but disagree with the psychiatrist's treatment choices is way too common.

I suspect someone who is severely depressed or suicidal is a lot less likely to be sectioned than someone who is manic.

Yes you're right. I know someone with schizophrenia & bipolar who at different times has been a danger to themselves or a danger to others and everytime it is a battle to get them sectioned for more than a day, even when they've been taken there by the police. It doesn't help that the individual is very good at convincing staff the latest case is a one-off blip & that they are now fine (lost count how many times these 'blips' keep happening ). This helps no one at all, least of all the patient themselves. It is frustrating and exhausting for the family.

If you're a police officer it isn't anywhere near rare.

It's common.

Lots of people refer to someone being "sectioned" when they were only an informal patient though. Too many think any psych admission means the person has been "sectioned" . So I take people's general reporting of how many people they know who've been "sectioned" with a pinch of salt.

I do think people are more likely to end up being detained inappropriately because there are not enough bed places for the people who need them so they only go to those they are legally obliged to find a bed for. Which just brings even more abuse into the system.

Oh, and s136s aren't rare. But that's different and not bed-dependent or a decision made by HCPs.

That said, sectioning patients who are already in hospital but disagree with the psychiatrist's treatment choices is way too common.

YY. Abuse of the law and abuse of the person.