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.

Same people who think you can "press charges". They've seen it on TV and think it's a real thing.

I was friends with a couple. Man developed bipolar and went manic and tried to kill woman and their children.
He needed to be sectioned and his mother basically accused friend of ‘arranging it’ as she was after his money (he’d lost his job and she was a much bigger earner).
Eventually sectioned 3 times before he was under control and has lived with mum for 30 years now.

100%

If you want someone sectioned the easiest way is to start the process and then get them picked up by the police. It’s really difficult if they are at home. And nearly impossible if the nearest relative is shielding them.

"I got someone sectioned ".

I can't tell you how offensive this is. God knows there is a power imbalance when you have an SMI, let alone someone airily (and incorrectly) saying this.

And calling it the posters "pet peeve" is downright rude. Language is the greatest power you have to define your world.

Walk a mile in our shoes.

Or a mental health nurse ,or SHO under section 5/4 or 5/2 but these are just in patient holding powers untill a patient can be aaaesed for a section 2 or 3.

Yep and patients were often kept in hospital far longer then they should have been depending on how risk averse the consultant psychiatrist was.

As someone who themselves have been sectioned I am not offended.

We need greater awareness of the help available and how to access it. That is the most important thing to me and I am not offended by this plain English. Everyone knows what it means. And if they don’t it’s because we have an education problem. Not an English language problem.

I have bipolar disorder and have been very unwell in the past (suicidal, delusions). I've only ever been referred for "outpatient" treatment which took around 8-12 weeks to get an appointment, and even then is just fortnightly catch ups where they run through the same set of generic questions each time. The only thing that's helped me is getting prescribed quetiapine because it numbs me so much.

Even while I was in active psychosis being "held" was never something that came up - even when my family were suggesting to my GP I should be sectioned.

You can’t just ‘get someone sectioned’ anyway. It doesn’t work like that. Thankfully.

Exactly this. In my own personal (and sadly extensive) experience of trying to get a close relative who is clearly extremely mentally unwell / very psychotic some help (reasons as per thread of why ' getting them sectioned' not necessarily the right terminology), I've only had success with either them being in a public place and very obviously being a serious risk to themselves or the public, or (and this obviously only works with a degree of cooperation from the person) taking them to A&E.

The police (rightly) will not come out to someone's home unless there's a crime in progress or very likely to be committed, and being mentally unwell is not a crime. 111 and Crisis team pretty much won't do anything for a patient who's 'safe' at home (even if person well known to them and has extensive history including previous in patient stays under section) unless the person themselves consents and asks for their help, and since with psychotic and manic illnesses very often the person has no insight that they are unwell and/or they're deeply suspicious of medical staff or authority, (perhaps with cause based on previous experience) that's unlikely to happen. So hence the horrible dilemma of they're not sick enough in any state short of immediate serious self-harm or smashing up the house or something, but too sick for the GP or other services short of tertiary mental health to help - there are no magic words you can say as a relative that fix this, just saying you think they need an assessment or think they need help or think they are psychotic or indeed, think they need sectioning, don't usually work at all. The only way usually as I said to force services to act (and force the person to accept the help) is for police or an ambulance to pick them up outside the home or if you can get them physically to a hospital...

Things have gone steeply downhill since I was last in hospital. It was quite a while ago. Although it was also in ROI so maybe things aren’t quite as bad here.
I know that they prioritise patients with severe illness/ symptoms for any type of treatment in the public services nowadays and push everything back onto GPs.
It surprises me that that would transpire to mean that hardly any patients are voluntary though.
I have known many people to be seriously ill and admitted voluntarily in the past.
I was on minimum security but knew a lot of patients on higher security wards and hardly any of them were under section.

Actually, you are wrong.
According to the according to the Health Research Board (HRB). While the vast majority of patients are voluntary, involuntary rates have fluctuated, often hovering between 12% and 18% in recent years.

2023: 16% of all admissions were involuntary (down from 17% in 2022).

Yes in my experience also a lot of admissions are voluntary - but again voluntary doesn't mean what you think it means in normal speak. You can't just pitch up feeling a bit down/anxious and have a lovely few days being fed nourishing meals and doing group therapy or however you imagine a modern mental health hospital would be before you experience the crashing reality.

To be admitted as a voluntary patient you do need to be really seriously unwell - tbh in my entirely unqualified opinion to comment (not a professional just a relative), most voluntary patients are not in fact well enough to understand or consent to their voluntary admission and probably would qualify for a section if they weren't compliant enough to say they'll stay voluntarily. My relative has been admitted under voluntary several times when he's been repeatedly and loudly attempting to leave and had to be locked in - what part of that is voluntary I don't know. I've also definitely and frequently heard staff use sectioning as a threat, i.e. if you don't agree to stay voluntarily we'll put you on a section which I'm sure is not quite right either. I wouldn't challenge it as him being kept in and made to have treatment 💯 is the right thing for him and I guess whatever boxes the staff have to or want to tick to make that happen is a secondary consideration but I'm sure in a functioning and well resourced system we wouldn't have these weird quirks...

That's really interesting. Mt recent admissions there's never been anyone admitted informally. That's acute & PICU.
I guess the figures include things like rehab & PD wards where people have to be informal.
In my area people wait at home after being assessed as needing admission & the AMHP has to wait until a bed becomes available before doing the paperwork, meanwhile people are waiting in a&e & 136 suite for days waiting for a bed. A voluntary admission would never make it to the top of the list as there would always be emergency admissions needing beds

They would have to be on a section to be on PICU, MSU or high secure.
You can't have someone informal on those wards as they are locked & it would be a breach of human rights.

A MH professional may well feel that this can be managed in the community though, its not likely someone would be force fed on a ward so the eating wouldnt change necessarily. Believe it or not, while under section, hospitals dont always want to force medication/food, they'll avoid that if they can.

If someone is at risk of organ damage from not eating, a detainment could be made due to extreme risk, but someone has to go a long time not eating to get to that point.

Staff shouldnt be using it aa threat but if a voluntary patient was to leave and something happened to them
the stsff would be held accountable
Often when peoole are so unwell they dont have the insight to understand why they need to be in hospital.

I categorically agree with people saying "I sectioned my family member" being uneducated.

However, by saying this, people listen (or read) the terminology. They are more likely to think you CAN section a family member of they have heard that than sit back and explore the implications and nuances

Language is SO important and I hate lazy and ignorant wording. Being slapdash doesn't cut it in this context.

Exactly this!
Getting the language correct (and that's not just about whether it offends the majority/minority) is a really important way of reducing stigma & increasing understanding.

Thank you. Things are good for now. Of course it's a lifelong illness so never know if/when he'll have a relapse. Just so so relieved it didn't end in tragedy last time because it so easily could've (I don't think he'd have intentionally hurt anyone but it's not for me to assess the risk. But I was more worried he'd end up killing himself or someone else as his behaviour was so reckless) there was like zero support the entire time for us and his case worker was useless! Wouldn't wish this illness on anyone.

But why beat around the bush? Saying you think someone is very unwell is so vague as to cover practically any mental health illness. Mentioning sectioning is only really going to cover things like psychosis. I understand you not wanting people to use the term flippantly, and I agree they shouldn't. But if someone is genuinely worried about their family member experiencing an extreme break from reality, why would you criticise the language they use?

I think you have an important point here. I accept that there's insufficient capacity within the NHS for MH issues, and that for all our safety it should be increased. But can you put numbers on how much MORE money is needed, and HOW MANY more therapists are required? Even more important, can they deliver? It is quite easy to write, my team are under pressure, we need more xxxxx. But if you don't or can't suggest a better solution, maybe because there really isn't a better or faster fix, then what do you propose?

The regular ordinary tax payer like you, me and your NDN who work every day are already paying massively rising tax bills. I am only moderately sympathetic to people telling me they need more help. A bit too anxious to join a new workplace? Too depressed? At some point, someone needs to point out, in a very loud voice, that sometimes we all have to do shit we don't like or want to do.

Someone being in psychosis does not necessarily mean they need detainment

Similarly someone can be lucid and need detainment.

Basically, someones health and functioning is declining and they are becoming more unwell, it might need a change in meds, a different approach, monitoring within a community safety plan, who knows. Detainment is not a 'treatment', and not always appropriate or necessary. Its not always helpful.

Thats why Im being pernickity about the descriptors. Its like me rocking up to the doctor every time I have something wrong which is getting worse and saying I need surgery or to go to hospital (and in fact I see that on threads all the time too) when in fact what Im asking for is to be seen again for a different intervention. I might need to go to hospital, I might not.

@likelysuspect and what if they DO need detainment? You don't seem to be distinguishing between the cases you mention and those that are actually very seriously unwell. It'll be family who are blamed for not doing enough if it ends in tragedy.

Yeah it’s very much the last resort. You have to very unwell and a genuine risk to yourself or others.