FAQs for siblings

Compulsory admission (compulsion) to a psychiatric hospital is admission of someone with mental ill health, against their will. The Mental Health Act 1983 covers compulsory admission, the rights of people while detained, discharge from hospital and aftercare. The Act applies in England and Wales.

The Mental Health Act 1983 is divided into Sections. When someone is admitted to hospital under compulsion this is commonly known as "being sectioned". You can be sectioned under a number of different parts of the Act for the purpose of being assessed or to receive treatment for a mental disorder.

Section 1

Under section 1 of the Mental Health Act, mental disorder is defined as 'mental illness, arrested or incomplete development of mind, psychopathic disorder or any disorder or disability of mind'.

For someone to be sectioned, three people must agree that they need to be detained. (There are exceptions in urgent situations). Usually, they would be an Approved Social Worker (ASW) or nearest relative as specified by the Act, a doctor who has received special training, and a registered medical practitioner. If possible, one of the doctors should already know the person being sectioned. In practice this may well be the psychiatrist rather than their GP.

Section 2

Section 2 allows a person to be admitted to hospital for an assessment of their mental health and any necessary treatment. Assessment can cover whether they suffer from a mental disorder; which type of mental disorder they have; or how they might respond to treatment. A section 2 is usually used when the person has not been assessed in hospital before or when they have not been assessed in hospital for a considerable period of time.

How long can my sister be detained for?

She can be detained for up to 28 days but this does not necessarily mean she will be. Section 2 cannot be renewed but she may be transferred onto a section 3.

What are her rights on a section 2?

Your sister should be given a leaflet 6 by a member of the hospital staff which explains her legal rights. She has the right to appeal against detention to a Mental Health Review Tribunal during the first 14 days that she is detained. She also has the right to appeal to the Hospital Managers.

Section 3

Section 3 allows a person to be admitted to hospital for treatment. It must be "necessary for your health and safety or for the protection of other peoples that you receive such treatment and it cannot be provided unless you are detained under this section". In addition, you must be suffering from one of four specific categories of mental disorder:

• mental illness
• severe mental impairment
• psychopathic disorder
• mental impairment

In addition the mental disorder must be of a nature or a degree that requires treatment in hospital. In the case of psychopathic disorder and mental impairment the proposed treatment should be "likely to alleviate or prevent a deterioration" of the condition.

She can be detained under a section 3 if she is well known to the psychiatric services and there is little need for assessment, or following a section 2.

What are her rights on a section 3?

Your sister should be given a leaflet 7 by a member of the hospital staff which explains her legal rights. She has the right to appeal against detention to a Mental Health Review Tribunal once during the first six months of detention, once during the second six months and then once during each period of one year. She also has the right to apply for discharge to the Hospital Managers at any time whilst she is detained.

Section 4

Section 4 is used in emergency situations where, were it not an emergency, a section 2 would be used. Section 4 allows a person to be admitted to hospital for an assessment of their mental health. Your sister can be detained under a section 4 if:

• she is suffering from a mental disorder of a nature or degree which warrants her detention in a hospital for assessment or assessment followed by medical treatment; and
• she needs to be detained in the interests of her own health and safety or with a view to the protection of other people; and
• it is of urgent necessity that she is admitted and detained under section 2; and
• that compliance with the usual section 2 requirements would involve an "undesirable delay".

How long can she be detained for?

She can be detained for up to 72 hours but that does not necessarily mean she will be. An appropriate second doctor should assess her as soon as possible after she is detained and decide whether the section should be converted into a section 2.

What are her rights on a section 4?

She should be given a leaflet 4 by a member of the hospital staff which explains her legal rights. She has the right to appeal against detention to a Mental Health Review Tribunal. She also has the right to appeal to the Hospital Managers.

Further information

A mental health advocate should be able to give you information about the different sections of the Mental Health Act and help you out with your concerns. A member of the medical or nursing staff should be able to tell you if there is a mental health advocacy service that covers the hospital she is in. Alternatively, you can find out about a mental health advocate through the Patient Advice and Liaison Service (PALS) in the hospital or the Rethink Advice and Information Service.

The Rethink National Advice Service provides advice and information on all aspects of mental illness including being detained under the Mental Health Act. They can let you know about your sister's rights, and deal with queries and problems you have.

They can be contacted at:
Rethink Advice and Information Service
89 Albert Embankment
London SE1 7TP

Tel: 0300 5000 927 Mon - Fri 10am-1pm.

Email: advice@rethink.org