AIBU to be concerned about an informal admission

[Rebecca496]

Hi all,

I am at the A and E at hospital in London and will be transferred to my local hospital in the Midlands on Monday when in patient bed (mental health) becomes available.

I have never experienced this before so do not understand what the process is about - e.g. what will happen as an informal patient.

I did ask to go outside earlier to the shops across the road but was told this was not possible.

How long will I need to stay as an informal patient for and what does this mean?

Will I be allowed to go outside of the hospital?

Will I have my own room? They did mention about a crisis house, but thought that I would need to see a doctor more often than once every three days. Does this mean I will need to stay longer than three days?

What is a voluntary patient versus being sectioned (I do not want this)?

AIBU to be worried? How much of a stigma is this? I feel like such a failure really. How did I get like this at 28? :(

Informal means voluntary - you're not being admitted forcibly under a section of the Mental Health Act.

If you're an informal patient in theory you should be free to come and go and to decline medication, but there are various sections they could use to intervene either for a very short period of time or to formalise your admission for a longer period.

If they are stopping you from going to the shops without putting you under any type of section then they are legally on thin ice (it gets into false imprisonment territory). In some ways a formal admission is "better" because your rights are clearer and you can appeal restrictions, however informal means you retain freedoms and some control.

Do you have anyone to advocate for you?

A hospital admission of any variety is not a failing, so please put that thought out of your head.

Rethink has information pages about this that might cover your questions:

https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/going-into-hospital-for-mental-health-treatment/

They also have an advice and information helpline:

https://www.rethink.org/aboutus/what-we-do/advice-and-information-service/

Hi @Rebecca496, I work on acute mental health wards like the one you are waiting for.
I’ll try and answer your questions.

I have never experienced this before so do not understand what the process is about - e.g. what will happen as an informal patient.

• Being an informal patient means that they deem you in need of mental health support as an inpatient, but means you are going there voluntarily rather than being forced through a section. Generally informal patients are on the ward for far less time than sectioned patients. They will be looking to support you on the ward, and come up with a treatment and discharge plan to support your mental health going forward.

I did ask to go outside earlier to the shops across the road but was told this was not possible.

• On the mental health wards I have worked on, being an informal patient means you can come and go as you please - although they will want you there at certain times of the day, like when the doctors are doing their ward rounds. The ward would just need to do some paperwork each time you go out, and have a timescale and know where you’re going, just to keep you safe.

How long will I need to stay as an informal patient for and what does this mean?

• There isn’t a specified time - until your mental health is good enough for you to be safe outside of the ward.

Will I be allowed to go outside of the hospital?

• yes

Will I have my own room? They did mention about a crisis house, but thought that I would need to see a doctor more often than once every three days. Does this mean I will need to stay longer than three days?

• all of the mental health wards I have worked on patients have had their own bedrooms. It’s hard to say how long you will need to stay, but you will discuss all of this when you’re admitted

What is a voluntary patient versus being sectioned (I do not want this)?

• sectioning happens when someone is deemed to not have capacity to consent to their mental health treatment, is a risk to themselves or others etc - in my experience I haven’t seen an informal patient be sectioned, so I’m not sure how common it is.

Just a disclaimer that my answers are based on my experience working on mental health wards, and they all vary so it might not apply to the ward you are on. But the staff will be happy to discuss everything with you.

sectioning happens when someone is deemed to not have capacity to consent to their mental health treatment

This is wrong, although it is a complex area. People are detained under the MHA for safety reasons, but they may still have capacity.

The Mental Capacity Act deals with capacity. It is distinct from decisions about MHA detention.

Thanks all - especially @Lemonade197 , really helpful.

I am in the A and E at the moment in the Crisis Assessment Unit at St Thomas Hospital. Maybe that's why I can't go outside, or someone has to come with me to the M and S at the front?

i.e. - I haven't actually been admitted yet.

Is there someone there you can ask?

I did but they just said it "wasn't possible"/"hospital protocol". They did allow me to order food to the reception through Just Eat.

Why have you started another thread?

I just want to say that you absolutely aren't a failure, and I don't think there's any stigma in being a voluntary patient. (There shouldn't be a stigma in being sectioned.)

I would think as something has happened that has brought you there tonight, the hospital wouldn't be keen on you going across the road to the shops, also it may be as much to do with staffing levels as anything else.
For what it's worth this is the same for me as a disabled person who lands up in hospital easily - no running around to shops or takeaways on admission or while stuck in a+e waiting for a bed.

I'm sorry you're having a difficult and scary time right now, YANBU to find it frightening or overwhelming, but this too will pass.

I wanted to ask about the specifics of an Informal Admission - not about location.

I think you should continue on your previous thread which had been moved to the mental health section.

I think more people will see it here and I am unsure about the legalities etc. of being an informal patient to a more formal admission (section). Does being sectioned show up on a DBS and/or will employers see it? Does being sectioned stop the ability to travel to the USA?

If you are there as an informal patient it would be very foolish to do anything that causes staff to feel the only way to make sure you're safe, is to section you.

I am not intending to...

Sensible 🙂

https://www.mind.org.uk/information-support/legal-rights/informal-patients/about-informal-patients/#:~:text=You%27re%20more%20likely%20to,limited%20evidence%20of%20this%20happening. This is really helpful

I sort of feel that I am not free to leave right now, but am content with that as I know I need treatment.

I suspect if I got up right now and said I am going to the shops outside/for a walk they would then intervene.

It is like I am "informally sectioned"?

If they have someone sitting with you all the time it is to keep you safe, you don't need to go outside, it's cold, damp, you will get 3 meals a day and can order food in. Try and just let them look after you, they will arrange the bed, the transport and the staff for Monday, you don't need to worry.

Just a question - would someone actually have to TELL ME if I have been sectioned? Reading about it, at the moment it sort of feels like I have been but no one has said that I have been. I guess I just feel like that as I am under 1-1 constant supervision and also wouldn't be able to go anywhere on my own.

I think you are correct that they would intervene. Your situation is informal, and it would be wise to keep it that way. Yes you would be told if it became formal.

I'd advise accepting the situation and co-operating, because right now they are trying to keep you safe without sectioning you.

Yes, that is exactly what it feels like.

I know for a fact if I said I wanted to go outside then they would object.

What does being sectioned mean? Would this show up on my medical record and are there adverse impacts in the future (e.g. jobs, insurance, travel etc.).

I will be staying put, but just need to know what COULD happen if they make it formal.

Informal is good. It means you are willing to engage with treatment and have a lot more choices.

Believe me, being sectioned is horrible. You have your liberty removed, and treatment can be forced on you.

If you get sectioned, you will have a load of paperwork thrown your way. It is a legal thing, at the end of the day.

Either way, informal or sectioned, you clearly need some help with your MH, and there is NO shame in that at all. No one would shy away from talking about an admission to hospital for something like a stroke, or and injury. MH is no different.

1-1 is not unusual when you have just been admitted, sectioned or not. The staff are observing and learning more about you.

I hope you find the time in hospital useful, and that you feel more like yourself soon

Can the Mental Health team give me an MRI Scan to see if there is a chemical imbalance in a certain part of my brain which has been causing me to feel so low in the last few months? Maybe then I can see what medicine would be better for me?

MRI wont show up anything. MH conditions do not show up on any tests like MRI. There are no scans for MH.

All they can do, is look at your symptoms and work through various treatments.

Have you been going through anything tough in your life?