Do people genuinely believe 'you should get her/him sectioned' as some sort of option?

[likelysuspect]

I see this sort of comment quite a lot on here and its cropped up in another thread.

'you should consider getting her sectioned'

And the OP is thanking the poster for the useful advice!!

The issue around sectioning has also come up a lot in the threads about the Southport killer and on threads about children with that sort of presentation

It astounds me that in this day and age people still think that you can 'get someone sectioned' as if you just phone someone and the black Maria comes and gets them.

But that’s part of the point of this thread? There’s a lot of ignorance and misinterpretation of what “sectioning” is, what it does and who needs that level of treatment. The term is thrown around flippantly and it (and other bad use of mh language) imo adds to the stigma of SMI.

I do wholeheartedly agree that getting someone help when they are unwell is the most important thing. But it’s as important for people to not throw around the “needs sectioning” term flippantly.

It’s actually difficult to section someone. quite rightly so too
I have some insight because I discussed this with a psychiatrist involved in the care of a family member.

I agree completely. Nearest relative should always be consulted during a MHA for their subjective opinion and history on their loved one’s condition. Sometimes it’s not taken for the weight it should have. Sometimes it’s more valuable than the patients own insight.

I guess I just come from the perspective of having a paranoid schizophrenic family member and trying to get them help over the years. There's just no doubt to anybody who knows him when he's in need of sectioning but I suppose some people do use it flippantly. And yes it was incredibly difficult for him to be sectioned the last time (very different to when he was originally diagnosed).

I can't say what he did to trigger the process as it could be a bit outing but without a certain encounter happening with a professional who finally saw the behaviour for themselves (and was scared for their own safety apparently) nothing still would've been done. He certainly got the ball rolling after that and he was sectioned within a couple days. But we knew it's what he needed months before.

This!! Being sectioned can make things even worse. My daughter has been sectioned twice over past couple of years..once as a child and once as an adult since turning 18. New habits and ways of harming are learnt from fellow patients, and if you think you get any therapy/ support whilst under a S2 you are wrong. Even with suicidal thoughts, she is much safer at home ( CMHT are beyond useless too!) with family and support than being anywhere near a MH hospital. If you think people go in to get better, you’re very wrong and really most people have no idea exceptionally poorly you have to be to be sectioned.

It is and it isn’t imo.

It’s very hard to get someone sectioned in their house. But in public it’s actually much easier. That’s how I ended up being sectioned. Driven from the house because my mother was driving me insane on the phone to 999 continuously and holding my house hostage. I left. I then became a missing person potentially ill, and by the time the police picked me up I had been flagged enough times they basically were like this must be escalating so let’s section for assessment.

Basically if ARs parents had been on the phone continuously to 999 saying he’s buying weapons, he’s getting worse, he’s saying he wants to kill people, he needs sectioning… and then he went off to that bus with a knife and told police he wanted to kill people then he would have been sectioned. 100%

That didn’t happen because the parents. ARs father in particular kept minimising his behaviour. So much so that a psychiatrist passed his case on because he was being aggressive and misogynistic towards her.

De no one read the second part of my post where I said “it’s not easy and takes two doctors”?

When I, or anyone else, says “I got someone sectioned” we don’t mean that we signed the order. We mean we got the outcome we hoped for, which was for someone to receive mental health care against their will, in a healthcare facility.

I get (in the sense of understand) that this is some sort of pet peeve for the OP but it’s fairly common parlance for having achieved something. “I got married” “I got my friends together” “I got Bryan to stop talking about bicycles.”

Occasion 1: I was 19 and my girlfriend tried to kill herself. I was “part of the process” (the phrasing OP prefers) by calling 999 and later showing the doctors the suicide note that convinced them to section her. (She was okay , not clear how serious the attempt was.)

Occasion 2: I was 46, three years ago. Tried desperately to get my friend sectioned because she was having psychotic delusions. Couldn’t convince doctors to hold her after I got her to the mental health hospital. Sectioning happened a week later when she attacked her partner and police were called to the scene. I was interviewed again by doctors and “part of the process” to “get her sectioned” (does phrasing really matter that much?) She killed herself a month later.

Occasion 3: Mid 20s. I was tangentially involved. I was not part of the process in any way but a group of my friends had to get another friend sectioned after she had a psychotic break and became a danger to herself and others. She lived but cut contact with the friend group.

I’m not claiming to be a doctor. I never said it was easy to get someone sectioned. But it is possible. And I think it’s not unreasonable to use the expression “I got someone sectioned” or “can you get X sectioned” when talking about this process. I desperately wanted those people to be sectioned, I initiated the process for them to be sectioned, I achieved the result I wanted which was for them to be sectioned. Is nitpicking the language used really important?

As I said before, it’s not easy, But it can be done. Whether or not it works is another issue.

The threshold for getting sectioned was much lower 30 years ago so it was more likely then that flagging up concerns would lead to someone being sectioned. That is less likely these days to have much influence because of lack of beds

'I think my mum is very unwell and needs an assessment'

or wtte

Its the very concept of 'I think she needs to be sectioned' that needs to be challenged in my view.

Yes and thats if you get as far as the MHA, I think, as you have set out, a lot of people dont understand there needs to be an agreement by medics to even agree to carry out the MHA assessment in the first place. They dont always agree and therefore the needs are unassessed.

Then even if its agreed an assessment will take place it may not, due to lack of beds, they dont want to find someone needs detainment but no where to put them. A+E cant always hold them, or refuse to sometimes.

Additionally, there are a lot of services designed to prevent detention, its not always good for the patient and can be actively harmful, those with ND are considered to be harmed by detention the DSR/CETR services are designed to prevent this for children at least. That isnt always considered in their best interest and there is considerable professional disagreement at times about that.

That must all be really hard for you to deal with as a family. I hope you are ok and get your own support. But yes, in your situation it sounds like you have been on this train for a while and know the drill, know your brother’s illness well enough to know when he needs to be in hospital. My best wishes to you.

Frankly it should be easier. I’ve known people have very very unwell family members with schizophrenia who are throwing their own excrement around and refusing to eat food because it’s poisoned and they’re just left to cope with it.

There needs to be some kind of intervention.

I’m pretty sure you can do this as we did it successfully with my brother. He was very unwell so very easily met a criteria. They came to our house and took him away. Is this unusual? It’s the only time I have seen this process in action and it’s very sad and traumatic

Yes. S2 is containment for safety and meds adjustment until you are stable enough to continue your care in the community. Getting therapy while on a s2 is just not something that happens. There’s no point anyway, if you are poorly enough to warrant treatment under section then you won’t be in the right place for any sort of therapy. Ward rounds with a dr are only once a week for a check and meds adjustment and risk assessment. In the meantime you will be monitored and supported by the clinical nurses who will report everything back to the drs.

As for the learning negative behaviour from other patients, this is unfortunately true. Patients feed off each other’s moods too. If there’s an incident on the ward it will have a knock on effect to the rest of the patients, sadly.

I’d argue that you will get support on the ward, but it’s hit and miss. Some staff/wards really do care a lot, but some are harder to engage. I’m one of those who care and are 100% engaged while on the ward. I really do give my all to my patients.

ETA: I’m sorry to hear about your daughter’s struggles. As I’ve said to others I hope you are also getting support (I do care about family and loved ones too, it’s underestimated how so difficult it is supporting people you care about with SMI)

I think she was trying to mislead people into thinking she had something to do with the assessment process! Or there wasn't one and it was just her say so 🤷

To add, even if a MHA happens and it’s agreed a patient needs to go into hospital under section, legally the section doesn’t start until a bed is found and they are admitted to the ward.

So someone can be sectioned in a&e and have to wait a week for a bed (this is sadly the norm, not the exception to wait that long), but they can still leave if they want to. They should be under 1-1 obs from the psych liaison team (the team in a&e who deal with all psyc patients in the hospital), though and be challenged or restrained by security if they try to leave. But they can leave if they want to.

@RhiWrites it’s not nitpicking language, it’s making sure the language around SMI is correct and raising awareness. Please read my pp if you’d like to know why I feel that way.

To answer the original question, I think older people still think that it's as easy as it used to be thirty years ago. My mother used to work with people who had all sorts of mental illnesses, and genuinely several of them were sectioned in the local 'mental hospital' as it was called then just for being severely depressed. So to this day she still says things like "well he/she should be sectioned!" if I mention someone who is depressed and needs help etc.

People posting things that indicate a belief that they can 'get someone sectioned' on the basis of some minimal thing (as minimal as, say, explaining a person's problems to a GP and signing a form) seems rare-to-non-existent to me. I think that what people generally have in mind if they talk of 'getting someone sectioned' is simply initiating some process of concern that might activate the whole formal process.

A much more frequent error concerns the sheer availability of inpatient care: posters are quite likely to advise people in distress to seek admission for problems that wouldn't give them the slightest chance of admission.

The same posters are very likely to wildly over-estimate the therapeutic value of admission, which, on acute wards at least, is close to zero -- as another poster upthread says, the reality is warehousing plus meds.

I have experience myself of speaking to my GP about a relative, and eventually contacting social services in despair, to try and find ways of getting the relative to access help. I don't think I explicitly thought in terms of 'getting them sectioned', just more generally in terms of trying to arrange the help that they were failing to seek.

The person was in fact sectioned, and probably my input was of some relevance, though I think that a lot was already happening (slowly) when I began seeking support for them.

It's pathetic really how ignorant people can be. I've been sectioned and it's horrible.

There's an episode of Peep Show where mark and Jez start trying to get eachother sectioned. It's really funny. But that's not how it works.

As if a member of the public would be able to just brand someone incapable of making their own decisions and they would be detained?! It's bad enough when it's three MH professionals. Never mind some complete random with no skills or training in psychiatry whatsoever.

You can say you think someone's a danger to themselves or others due to MH crisis but you can't 'get someone sectioned'. Even people who desperately need help sometimes don't meet the threshold for it.

The language is important to those of us that have been detained under section and live our lives with that possibility.

It's a huge thing as the only situation where someone loses human rights without committing or being under suspicion of committing a crime.

Like with a lot of disabilities, language is important. We also no longer say 'deaf & dumb' 'handicapped' or 'committed suicide'

This is a police section (136), which is just for assessment, not a section (2 or 3) for actually being admitted to hospital/enforced treatment. Which is usually what people mean by "getting sectioned".

A 136 is a lot easier to achieve than a 2 or 3!

You are right that a 136 should have happened though.

The police took me to a place of safety for assessment. As I had already been seen by the MH team in my home (due to my mothers badgering) that met the bar for the two assessments within 5 days. I was then sectioned for assessment for 30 days on section 2. With no diagnosis, not a risk to myself or others.

It was deemed in the best interests for my health.

Thats the easiest way to get someone sectioned. The bar is actually quite low and I will paste the legislation here for others to see for themselves. All it takes is 2 people to agree it’s in best interests.

Admission
Two doctors must make the recommendations, and the application is then made by an Approved Mental Health Professional (AMHP) (or in theory, but extremely rarely in practice, by the nearest relative).
In relation to the medical recommendations:

• One doctor must be approved (under s12) as a mental health specialist and, if practicable, one doctor should have previous acquaintance with the patient.
• The recommendations can be on a joint form or two individual forms.
• The patient must be conveyed to hospital within 14 days beginning with the date on which the patient was last examined by a registered medical practitioner before giving a medical recommendation (s6(1)(a)).
• There must be no more than five clear days between the two medical examinations (s12(1)), i.e. if the first were on a Sunday the second must be no later than Saturday.

In relation to the application:

• An AMHP must interview the patient in a suitable manner and satisfy himself that detention in a hospital is in all the circumstances of the case the most appropriate way of providing the care and medical treatment of which the patient stands in need (s13(2)).
• The applicant (usually AMHP, but could in theory be NR) must have personally seen the patient within the period of 14 days ending with the date of the application (s11(5)).
• Where the application is made by an AMHP, he must, before or within a reasonable time after the application, take such steps as are practicable to inform the person (if any) appearing to be the nearest relative of the patient of (i) the application and (ii) the NR's discharge powers (s11(3)).

The criteria for admission under s2 are:
(a) he is suffering from mental disorder of a nature or degree which warrants the detention of the patient in a hospital for assessment (or for assessment followed by medical treatment) for at least a limited period; and
(b) he ought to be so detained in the interests of his own health or safety or with a view to the protection of other persons.
(Note that the 'learning disability exclusion' does not apply to s2.

It’s actually very loose, very flexible and it’s as it should be imo.

My uncle was schizophrenic and frequently violent. My grandparents used to beg for him to be sectioned. They called the police on him so many times. He was convinced his mum was trying to poison him, his dad had been replaced with an alien lookalike.. He never once got held under section and eventually took his own life.

I have been in a psychiatric hospital myself and my psychiatrist told me that she only ever used it as a last resort when absolutely necessary.

On here, everyone else’s problems are always so easy to fix:
Child with disabilities/ ND: Get respite or put them in residential care
Older relatives difficult to look after: put them in a home
Marital/ relationship problems: LTB
Health problems: Go to GP or A&E (now!)
Mental health problems/ trauma: Have you had therapy/ tried counselling?

TBF I’ve given oversimplified advice on here too. It’s just how it works really. People comment without knowledge or proper insight. It’s good to inform posters but I don’t know how effective it will be.

136 can't be used in a private property. It would be unlawful for police to detain someone under s136 in their own home.

In that scenario it would be a s135 which requires a warrant & an AMHP.

Virtually no one is voluntarily admitted to hospital these days. The pressure on beds is too great & there's people waiting on sections to be admitted. Some people remain voluntarily after discharge from section but that's usually only to prepare for discharge.

It used to be a last resort & voluntary admission considered first but not any more.