Sectioned but no beds available

[Helpless25]

Anyone know what happens now? Been ten days since the assessment.

It's just a waiting game unfortunately.

Where are you at the moment?

If you're in a general hospital or a&e you will remain there until a bed is found. If you're in a 136 suite/police custody they may move you to a&e or other health based place of safety.

They will be looking at out of area beds & private providers.

Even if you don't want to appeal your section it's worth getting a solicitor (completely free & non means tested) as they can ensure you are being detained legally - it was solicitor that got me moved from 136 suite when no beds were available.

Also ask to speak to a mental health act advocate

You can contact Rethink for advice.

I think they’ll be questions if someone can stay safe for ten days out of hospital then what treatment needs to be done in hospital? If it’s a titration or similar that’s different. I would think they would redo the MH assessment too.

It’s not me. Person is at home while they wait. Have had the two dr assessment and seen an advanced mental health nurse.

I guess if there’s no beds there’s no beds and they can’t magic one up but just feels so wrong to leave someone at home in this situation.
They are seen daily by the crisis team and there’s 24 hour telephone support but even so….

If there are no beds then there are no beds. Not unusual these days. You may find that when a bed comes up it’s private out of area many miles away. If they are mitigating the situation with the crisis team then that’s all they can do. Is the person refusing treatment? Because otherwise if they are engaging with the crisis team usually that would mean they don’t get detained.

Are you sure they’ve been detained on section, if so which one? People aren’t always detained after a mental Health act. If the person has agreed to an informal admission then they can feasibly wait at home with crisis team support. I’ve been doing this sort of work for over 20 years and never seen a detained patient left at home waiting for a psychiatric bed. I’ve seen it in general hospital plenty of times, but that’s because they were detained there

Yes. Are you quite sure that they were actually detained following the MHA assessment because if someone agrees to work with the crisis team this will be deemed a less restrictive option and usually would mean they don’t get detained?
In this day and age in certain parts of the country I have known people who are detained to be waiting at home for a bed although there would be the obvious risk of absconding. Usually the AMHP in our area refuses to do an assessment without a bed because of just this situation.

Yes I’m 100% certain they are detained on a section 2. No beds available for admission.

That's not legally possible.

You may have misunderstood.

It's more likely that they had the MHA assessment (2 psych & AMHP) but they agreed to try home treatment voluntarily or agreed to a voluntary admission when a bed became available, rather than section. You should always be offered the least intrusive option eg home rather than hospital, voluntary admission rather than section.

Section 2 is admission to hospital for assessment. They would have had to admit them somewhere & that could mean going anywhere in the country to a private provider.

If they genuinely don't understand what's going on they need to discuss with home treatment team.

Sounds a bit crazy when I was sectioned a very long time ago now first one was section 5(2) which is emergency 72 hours and then section 2 28 days and section 3 for 6 months.so 10 days in and they have to review at the end of the 28 days,it's highly unusual to leave someone at home and concerning that they are nearly half way into the section without any support

I am aware (admittedly through word of mouth from a relative who works within mental health services) of this happening on several ocassions. My understanding through what was shared with me is that once a bed is found depending on how much time has passed a reassessment may need to be done to see if it would still be in their best interests to be sectioned.

I hope a bed is found for them soon and they are able to access the support they meed

You cannot in law be detained without a bed. You need to be detained to a named place. You can have medical recommendations made for detention which last for up to 14 days but the AMHP cannot make the application without a bed to detain you to. They person therefore cannot possibly be actually detained on s2 currently. If you think about it that’s obvious. One of the main purposes of detention is to stop you leaving the hospital which can’t apply if you are not actually in a hospital. You need to ask CRHTT to clarify the position.

The named place is at home. Two people have been named to be with that person at all times. They can’t go out on their own or be left on their own. This is in place until a bed can be found. It might not be usual or the correct way but this is what has been done.

Tbh they might be better off at home. Forty something relative spent weeks on a dementia ward before being sent home because no bed became available. It did more harm than good.

I really am not sure that is legal. You cannot legally he detained to your own home. I’m a S12 approved Dr so not talking out of my arse on this. Keeping someone at home against their will isn’t legal even if they lack capacity. It requires a community DOLs order from a judge. The person could sue the trust for unlawful detention. You really need to make a complaint about this. The AMHP (usually a social worker) who came with the 2 Drs for the MHA assessment is the person responsible who should clear this up. Where are the detention papers? Have you had sight of them? The papers are submitted to the ward where the person is detained and not until they are accepted by the nurse in charge is the person detained

For a section 2 - you need a section 12 qualified doctor to recommend detention under the act is needed + another doctor - usually GP and then the AMHP (usually a social worker) to agree and make the application. The application has to be to a hospital intended for the assessment of mental health disorders (MHA Section 2(1) ). So the AMHP can't do the application until a bed has been identified.

I think the AMHP has up to 2 weeks from the person being seen by the section 12 doctor to make the application or you have to start over.

Home wouldn't meet the section 2(1) criteria. So normally in this situation things get put on a sort of pause, crisis team help cover, family often support, bed managers try and look for a bed and as soon as one is found the AMHP completes the section 2 paperwork. Until that point the person isn't on a section.

The only way I can think you might prevent someone from leaving their own home and insisting they have people with them would be having the court of protection make an order under the mental capacity act? But it's been a while since it's been my area of practice so I might be missing something.

Reassuring (for me) cross post with ThePure there. Glad I haven't forgotten everything about the MHA!

Is this an elderly person with dementia & additional needs?

I think that's the only scenario where that could happen.

If so, I think you are better off trying to support them at home rather than push for bed. Assessment/police 136 suite/a&e or even an out of area bed 100 miles away would likely make their condition worse.

If this is the case they should be reviewing it daily & updating the nearest relative.

Are you the nearest relative OP?

No this isn’t an elderly person.

I honestly don’t know what’s going on then. The whole situation feels very wrong to be honest. Will see what tomorrow brings.

My dd was put under some sort of order for two weeks but at home with twice daily visits and we couldn’t leave her. They do this if they think it can work

This happened to me. They have to keep you in whichever hospital setting you're currently in, with an RMN monitoring you 1:1 24/7.
Then as soon as bed becomes available they can moved you there. If it doesn't become available in the 28 days and you're getting better then they must release you home.
If you're not getting better then they can move to section 3, whereby your urgency for a bed might be bumped up or they just still keep you where you are with RMN.
I hope you feel better soon.
Mine was for anorexia. So it may be a bit different for other types of critical MH.

What's your involvement in this? Are you the nearest relative under the act?

It might be that they just don't want to discuss the details with you.

A relative of mine with ongoing mental health problems has been sent to hospitals out of the area on a number of occasions. They've never been left at home.

Spoke to the AMHP today who did the assessment and he said they have two weeks from sectioning to admitting into hospital.

yes but they will reassess if no bed is found and then they have another 14 days to find a bed