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?

I've gone through this with a family member (not in the UK). They deemed the person was not safe, said the psychiatrist is recommending hospitalisation. I said "if I say no, this will happen anyway, right?" and they said yes. So I agreed. Not sure if the conversation would have been any easier if they said to us "we are deeming this person unsafe and sending them to hospital and neither of you have any say at all".

It is tough, OP. I hope you all get through this.

@Okaynow

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.

They want the person to engage and to know that they can engage. Ultimately though when someone is sectioned it is because it’s required and that’s the key thing to remember.

When the person refuses then it’s clear they don’t understand how ill they are. Because if they did, they would agree.

Family member sectioned for 72 hours . They knew after 6 suicide attempts that they needed help.
Discharge after ward round and now has actually good community care, even during covid.
If this hadn't happened they would of probably been dead and this isn't an exaggeration.

OP I think you need to give some more details for anyone to help. I understand that it is distressing when our free choice is taken away from us. As we are so used to having freedom.

A section can be appealed. However I used to work in mental health services and its really hard to get in patient care. So if professionals think it was needed that should be taken seriously.

My understanding is that being sectioned has long-term implications afterwards - has to be declared when applying for an American visa, for example, and I think for some types of insurance, whereas a voluntary admission doesn't. This is one reason to prefer a voluntary admission. As others have said a voluntary admission allows the person more say in the treatment offered once inside (although it can change from a voluntary admission to a section inside the hospital if the person refuses vital treatment).

I just feel if someone is given a choice it should be respected as one.

@Okaynow

I just feel if someone is given a choice it should be respected as one.

That only works if they are in a state of mind to make choices. We tried to have a relative sectioned when they were doing incredibly dangerous things that they would never normally do, and it was almost impossible. It's hard to get, especially for the first time.

If you or someone close to you is being sectioned, I guarantee it is a last resort.

It was phased to them as sometimes a few days on the ward is helpful. They disagreed due to what the ward is like and unfortunately it’s proven to be true what they said.

@Okaynow

It was phased to them as sometimes a few days on the ward is helpful. They disagreed due to what the ward is like and unfortunately it’s proven to be true what they said.

I don’t think you’re fully understanding what mental state your relative must have been in to have been sectioned. This absolutely would not have been done lightly.

I used to work sectioned patients. None of them thought they should have been sectioned. I can absolutely guarantee that all of them needed to be.

Completely depends on the situation.

If someone is a danger to themselves or others, or if they're judged as not having capacity to make an informed decision then yes, they can be sectioned against their will.

Hmm. As the parent of a young person who had MH problems I am not convinced that the majority of HCPs always deal with these sorts of issues as transparently as they should. Assumptions are made al9ng with allegations to swiftly deal with a&e protocols. It is not always helpful or in the best interests of the patient.

I was quite shocked that A&E nurses were allowed to make decisions and referrals to MASH prior to the involvement of Drs and that this created an unnecessary escalation and that a&e staff were unaware that the option of a review by the MH Liaison service available between 8am and 2am was an option rather than an admission for a camhs review for 16-18 year old was available. It was all rather ghastly and decisions were made before the parent was involved and prior to full information being shared such as the young person had already been refused by camhs and as a result the the young person was safety netted by a consultant paediatric consultant psychiatrist and afforded better care than available on the NHS. They just weren't capable of thinking and analysing that some parents cared and would put in place care when the NHS refused.

Yes @epsom&sthelier I am looking at you.

OP I have a lot of experience of the mental health system and I assure you that the threshold for sectioning an adult is very high (as it should be). Mental health services don't have enough resources for half the people who need them and for an adult to be sectioned the situation must be absolutely critical. I've been on a unit before and not allowed to leave when my anorexia was critical. The treatment was extremely poor and the ward was very chaotic, but it kept me alive and I may well be dead otherwise.

I don't really understand the scenario

So they were offered informal admission as 'sometimes a few days on the ward is helpful'

If this was just a normal visit form the care co and the person turns down the offer then that is the end of it. The care co on their own has no power to compel. If they are seriously concerned that the person is at risk they might go away and arrange an MHA but they would tell the person they are seriously concerned. If they really just thought a few days in hospital might help then they are not going to organise an MHA on that basis. There has to be risk by law for someone to be detained.

An MHA assessment is not a casual matter and that would be obvious to anyone. If 3 senior professionals turn up to your house uninvited they will not be making a casual offer that you can take or leave. At the start of an MHA the possible outcomes are explained including detention. If you are unable to understand that then it does rather suggest you might not be thinking clearly perhaps because you have a mental illness?

If you feel your relative has been wrongfully detained then they have a right to appeal their detention. If you are the nearest relative under the Act ie their spouse or their parent if no spouse then you also have a right of appeal.

My sister has been in this position many time unfortunately. They like to get you to agree as it shows willingness to recover and obviously legally is a lot less complicated.

Op here is some information on advantages and disadvantages of voluntary treatment from Mimd website and on sections

www.mind.org.uk/information-support/legal-rights/sectioning/overview/

www.mind.org.uk/information-support/legal-rights/voluntary-patients/about-voluntary-patients/#WhatAreTheAdvantagesAndDisadvantagesOfBeingAVoluntaryPatient