To think sectioning someone because they don’t go hospital informally is wrong

[Okaynow]

Someone if someone is given the choice the go into hospital then it should that a choice. So if they say no they shouldn’t then be sectioned as surely it’s not then voluntary?

Why are you asking?

Usually people are only sectioned when they’re unable to recognise that they need medical help. It’s done for the benefit of the patient when they can’t help themselves.

Sectioning is never voluntary; that's the whole point. It's for people who are a danger to themselves or others and who are refusing to go into hospital.

It really depends if that person needs to go to hospital or not op. I imagine it's always better to let someone make the decision for themselves but it may become appropriate that it's necessary for their own safety to section them if they say no.

I hope you're ok

If there is a risk to then selves or others or they are deemed as not having the capacity to make an informed decision hen then they can be sectioned. Your post is quite limited with info but this is often why people are sectioned as they are not well and not making the best decision for their safety or health and treatment x

Is this you or Simone close to you Okay?

Police can detain someone under MHA if they're harming themselves or others in a public place.

If someone is willing voluntarily to attend hospital (which will hopefully lead to them stopping harming themselves) they don't need to be sectioned.

If someone is harming themselves and refuses to attend hospital they can be sectioned - to prevent them harming themselves.

Why is this bad?

@Okaynow sometimes it’s needed but the person may not see it. Detaining someone under the mental health act is never done easily or as first choice. Do you want to talk?

That’s what sectioning is though. It’s involuntarily detaining someone under the mental health act that is deemed by designated professional to be a danger to themself or to others.

Often they will tell a person they have a choice when they know if the person says no, they will then section them. This is because it is easier to detain and transport a person who is voluntarily going along with going into hospital than having to forcibly detain someone who doesn’t want to go. So they always ask, because if the person verbally agrees to go, that often takes the fight out of the person and de-escalates things.

I think where appropriate, an informal admission is offered as, if someone is agreeable to getting treatment, you don't have to detain them under the MHA. If someone can choose to and consent to care in collaboration with their care team, why would the team not offer this?

Being detained under the MHA also isn't solely for the purpose of getting someone to a mental health ward. It also has implications on the assessment and treatment whilst you're there.

Well it depends whether they have capacity to make the decision to go to hospital or not and understand the consequences of their decision. If very mentally unwell I'm not sure someone is able to make that choice in an informed way.

Hi OP

We're not too sure that AIBU is the right place for this - we're moving it over to the mental health topic now.

Well if they go voluntarily then they don't need to be sectioned.
If they refuse to go voluntarily then it may be decided that they need to be sectioned for their own safety. Or the safety of others.

Its a very necessary tool, but the decision to do so isn't taken lightly.

I know what you mean; it’s not a real choice to say that if you don’t go voluntarily then we’ll make you. I think it’s about the way it’s described; saying to someone that they will be sectioned but also can choose to go voluntarily gives the person a choice over how they go but saying go voluntarily or we’ll section you is more coercive

You have a point in that it means informal patients can be defacto detained if they know if they ask to leave they will be sectioned.

But yes, it's acceptable to detain someone who was admitted informally. Things change.

they are deemed as not having the capacity to make an informed decision hen then they can be sectioned

Sorry this simply isn't true. Lack of capacity to consent to detention under the MHA cannot be a reason to detain someone

You can voluntarily put yourself in, one of my family members did this and stayed in the unit for about 6/8 months which was longer than initially expected.

But yes, it is for the persons safety and those around them.

I think they prefer people to go voluntarily when they need to go, as it’s better for them, so they give the choice, but if they refuse then they will section. As the basis is they do need to go.

@Okaynow

Someone if someone is given the choice the go into hospital then it should that a choice. So if they say no they shouldn’t then be sectioned as surely it’s not then voluntary?

As someone with a parent who has been sectioned, I couldn’t disagree with you more.

Pressed send too soon

Sectioning shouldn’t be inevitable. But in some instances, it is absolutely necessary.

It’s a family member not me. They assumed they had a choice that’s why it’s caused upset. It should really be made clear that they don’t have a choice.

You actually cannot be detained unless you have been offered the option to be admitted informally. You have to be offered the 'least restrictive option'. You can't just not offer.

I see what you are saying that if you agree to go informally at an MHA assessment it might not be a real agreement but you do have to be offered the option legally.
It's not blackmail it's just reality. If it's gone as far as an MHA then not accepting any treatment is unlikely to be an option. Accepting crisis support at home or informal admission are likely to be the only realistic options at that point.

If you are admitted informally then you can leave and you don't have to have special permission to go out and you can't have medication administered against your will so there are advantages to agreeing to informal admission even if really you'd rather not. Thus many patients who've been round the system a few times will agree to informal admission if it's gone as far as MHA as they know they have not got much option at that point.

Correct.

If the threshold is met to detain under the MHA then informal admission was not an appropriate option. If the threshold for the MHA was not met and informal admission was an option then you cannot then detain under the MHA.

Holding "do what we say or we'll detain you" over someone is unlawful. Regardless of the prejudices, opinions and ignorance of MNers.

People on Mumsnet talk a lot of invented shit about the MHA.

It's generally better for the person and those around them if care is voluntary. It might be an illusion really but it can help.

I'm sorry this is happening

It's a high bar to organising an MHA (person is posing risk to their own health, safety or that of others) and requires a lot of time and resources so it's not going to be done for shits and giggles.

Anyone who has been anywhere near the MH system knows that if 2 Drs and a social worker turn up at your door you are almost certainly going to get admitted one way or another so may as well agree.

The choice at that point is get admitted with less restrictions and some more control yourself or with more.

If you 'agree' and then you decide to leave the same day then it's unlikely the concerns that led to the MHA being organised have gone away so yes it's likely you would then still get detained in that circumstance. If you wait a week or so and agree to some treatment and follow up then maybe not.