How to get somebody sectioned?

[Freshstarts24]

I don’t want to give too much identifying details but would really appreciate some advice. Adult dd, quite serious undiagnosed mh issues, not had any professional support since discharging as a teen. Now quite heavily reliant on drugs which are causing physical health problems and exasperating mh issues.
Outpatient support at this point is not going to help, she needs to be admitted somewhere but I have no idea how to access this? Where do I start? I know the drugs muddy the waters so I don’t even know what type of support to look at but the root cause is obviously mh.

What she really needs it’s help with the drugs first I think because as people have said, they can’t assess mh accurately with drugs clouding the waters. She also can’t be put on any medication whilst on drugs and she’ll definitely need medication.

NHS psychiatric hospitals are about keeping people who are deemed a risk to themselves or others safe, rather than therapeutic. Detainment (section) is done against someone's will, upon which they lose most of their rights and will be forcibly injected with medicine if they fail to be medically compliant. It's truly awful. So since she wants to go she would be an informal patient if she were admitted.

If she thinks she has a personality disorder then dialectical behavioural therapy is usually recommended for this. It can be done as group work.

In the short term I'm not sure what to suggest since drugs are muddying the waters. I think contacting the crisis team would be a good place to start.

This is not true. If someone presents themselves at their GP appointment with concerns about their own mental health they absolutely can be sectioned voluntarily.
Obviously the GP will make that assessment, but it is possible .

From what you have written an acute impatient admission wouldn't benefit her in anyway I spent years working in acute mental health and it is basically just " Fire fighting there isn't time for any therapeutic work
There are specialized units on the NHS but hey are not easy to access
Honestly the best place co start is her GP but I agree with others the drug issues need to be tackled first

"they absolutely can be sectioned voluntarily."

From the Royal College of Psychiatrists

Why may I be detained?
If you have, or are thought to have:

1. a mental illness which needs assessment or treatment which is sufficiently serious that it is necessary for a. your health or safety, or b. for the protection of other people
2. you need to be in hospital to have the assessment or treatment
3. you are unable or unwilling to agree to admission.

https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/being-sectioned

No they can't a GP can arrange admission and a patient can voluntarily be admitted to hospital but sectioning or detaining somebody under the mental health act is only used when somebody refuses admission and there is immediate concern for their safety or that of others
There are various sections a person can be admitted under .

I think there's a lot of confusion around sectioning.

When you are sectioned, you are effectively (although I would argue an actual) prisoner. You lose the right to liberty. You cannot leave. If you manage to leave you will be brought back by the police. You can be denied permission to make a phonecall. Possessions can be taken from you. You can be locked in a padded room, in solitary confinement. You can be monitored 24/7 by a member of staff, including when you use the toilet and shower.

If you refuse treatment, it will be forced on you. You can be forcibly injected into your buttocks, pinned down by members of staff and/or police, your trousers ripped down, with drugs that cause severe and prolonged side effects that leave people shuffling and drooling. In extreme cases ECT can be forced on you.

You have absolutely no say in your treatment. Psychiatrists decide it for you.

This is not the case for informal (voluntary) patients, aside from the 24/7 monitoring assuming the informal patient isn't trying to leave. There is a world of difference.

We have recently been through this journey with my young adult daughter.very brief outline as It was hell on earth trying to get support and months of heartache You will have to push all the way along. We were referred to crisis via gp. She admitted to smoking weed so that knocked us back as until she had help to stop they wouldn't get passed that being the issue (her illness started about 10 years ago)
We were then pushed back to community mental heath team/GP
Only Crisis team can admit to psychiatric hospital they are hopeless in my area. Empty promises etc etc
So back to crisis team. It took me to beg them to help me or she would die and I would hold each one of them responsible to get her admitted.
It saved her we still have a long battle but the difference is amazing. Even the professionals were shocked to see her well as they had no baseline to how unwell she was.
Just be prepared to be her advocate and push constantly.
Good luck

You also can't smoke,, of course. In 2017 the ward I was in only had decaffienated tea and coffee. The food is now almost inedible. Nothing to do, nothing to read.

Prisoners detained at His Majesty's Pleasure have a better time of it.

Please think about what you post and stop scaring people. Your information is not all correct. Eg police cannot pin someone down in a psych ward so staff can administer meds. If ‘force’ is needed then a team trained in control and restraint will administer the meds. Police won’t get involved.

Things do go wrong and systems are not perfect. But please don’t give a false impression of all mental health care.

And yes, possessions can be removed and people put on enhanced observations if they are a serious risk to themselves. It’s to avoid incidents such as people hanging themselves in their rooms with shoelaces and belts.

Kindness and dignity should be maintained at all times however. And I know that is lacking on some units.

Detaining someone under the mental health act happens if someone has a mental disorder, is a risk to themselves or others and if they need admission but do not or cannot consent to admission.

If you agree to an informal admission and are thought to have capacity to make that decision, you will not be detained but admitted voluntarily instead if needed. That is not a ‘section’.

Most trusts try and avoid admission for personality disorder anyway. It is not thought to be helpful other than managing immediate risk. Care is thought be better served on an outpatient basis, or having crisis house or crisis team input if available.

Services are extremely bad in managing dual diagnosis, ie patients with mental health problems and drug issues. I think it is a false distinction as people with severe substance misuse problems often have mental health problems and how can we separate them?

OP, from what you have said, I do not think your daughter will be detained or admitted. Services will want to see her being proactive to try and address the drug use. Unless she reaches a point where she is actually harming herself or others. Unfortunately, the way things are set up, Services seem to take notice only when somebody is at rock bottom.

Watching this thread because going through something similar with adult DS. Not substance abuse. Currently awaiting a formal planning meeting by safeguarding (social services).

Actually although its rare I have been involved in restraints where police have assisted staff ,this was on admission to a PICU when a patient was acutely psychotic
Having said that restraint is never taken lightly and every endeavour is used to use the leas restrictive measures.

I did think about what I posted, thank you.

Police absolutely can pin someone down in a psych ward in order to assist in restraint/injection of medicine. Whether they're technically allowed to or not is another matter.

I am not giving a false impression; this is the reality of what can happen under section from lived experience.

I have a diagnosis of bipolar disorder and have been sectioned four times, and that's not counting all the times I've been sectioned in quick succession when each section was lifted and I requested to leave hospital.

I'm sorry if that scares you. It scared me as well. It was fucking terrifying actually.

ETA: By the way, if you want to talk about scaring people, you should take a trip to the place my grandfather, also bipolar, was sectioned a few years ago.

Yes when my relative was sectioned the psychiatrist rang and said they would medicate her with or without her consent and they could do it covertly in food etc (once she’d started eating).

I would say a Crisis team was the best option , you can go through your gp to get a referral.
Being sectioned/ informally admitted to a Psychatric ward should be a last resort. They are very hectic places, extremely noisy and tend to just be about getting stabilised with medication, not longer term help.
The person that said there's nothing to read or do Is incorrect however. I work on a psychiatric ward so know what is available.

I know someone who presented themselves at their own GP surgery with concerns about thoughts in their head and they were referred (immediately) to a specialist psychiatric unit where they were assessed as an in-patient.
They have now been under psychiatric care for the past 7 years (although now they have supported living arrangements to help them live as 'normal' life as possible.

But how does sectioning relate to this?

And ?
It doesn't mean they were're detained under the mentsl.health act at the time of admission that could have changed during admission of course
But if a person is willing to be admitted it would be illegal and unnecessary to detain them..

Police involved in a restraint to administer meds? Gosh that sounds unusual. I am glad it doesn’t happen often.

Just to reassure a little, when I have been sectioned the psychs have all worked hard to work with me, not against me. So if I raised specific concerns about treatment then they did listen and try to find a solution. But yes medication can be forced. You are checked on regularly, walked in on whilst showering, have any dangers removed. You cannot have a long phone charger or anything you may use to harm yourself. Food is awful, I refused it and got my husband to bring sandwiches although people did order in takeaways. Smokers were taken outside with nurses. If you ran off, police were called. You cannot get in and out without a member of staff letting you through the doors. So if you go in informally, you still cannot come and go as you please but you have more input into treatment (I have been informal too).

Sorry for delayed reply
Been at work til now

OP your daughter does not need to be 'sectioned'. Do not use that word or you will not be taken seriously

She will not be admitted to a mental health hospital for inpatient treatment straight away especially if the problem is personality disorder and substance misuse. The only people getting an immediate admission are people who are psychotic, manic or severely depressed and unable to keep themselves safe or refusing community treatment

A shortcut to inpatient treatment does not exist. The idea that you get admitted somewhere, taken care of and someone sorts out all of your problems is a bit of an unrealistic fantasy. In reality it's a long hard road to recovery from MH problems and it requires you to turn up to appointments, to tell your story to different people and to make changes in your life. Help is out there but inpatient treatment for the kind of issues your daughter has is very very rarely possible as it would require long term therapy in a specialist unit and would be very expensive
Honestly they don't take a punt spending that kind of money on someone who has not demonstrated any commitment to change by turning up to community appointments

If you want to help her the best thing you can do is sit with her whilst she calls drug and alcohol services and attend the initial appointment with her.

OP, it may help if you say which country you are in. Legislation is different in eg Scotland

Someone close to me is currently a psychiatric inpatient and the comment about there being 'nothing to do or read' is pretty accurate, to be honest. Yes, there are a few books around and we have been able to send some in. There are very few things to do on the ward and in any case the other patients are so ill that the person I know, who has stabilised, feels safer to stay in his room. Each day there is about an hour of something meaningful to do, max two if your lucky, and otherwise it is extremely tedious. A holding cell is a good description.
I honestly don't think the staff appreciate how it feels for the patients, as obviously they are plenty busy. And if the patients try to advocate for themselves to have more to do they are pretty much knocked back at every step - mainly due to lack of resources.