Sectioning – Mental Health Act 1983
This legislation is about the safety of the person involved and their immediate surroundings, including the people in those surroundings.
People can be sectioned under s.2 of the MHA if they are suffering from a mental disorder and are at serious risk to themselves or others and that the situation warrants detention in a hospital for assessment and possibly treatment. This means that two medical professionals will have considered the situation and thought that keeping this person in a specialist mental health unit will be the best thing for them in the circumstances.
The “mental disorder”, could just be temporary, I have previously had a client who was going through a stressful divorce and at that time was having difficulty getting contact with their child, the pressure of which became too much and they attempted to take their own life. They were detained for a few weeks and as time passed and once the divorce was resolved and family relations settled, they became much happier and were unlikely to take that actions again.
The mental disorder can also be cyclical, I have had a different client who is schizophrenic, they heard voices in their head. At times they can live with support in the community, even though they feel compelled to follow what the voices have said, they are not necessarily causing serious harm to themselves or others. That status is not always sustainable and from time to time, something will trigger an episode where the stability of the preceding months is broken and they are at risk, often to themselves, but can also be to others.
The elderly with dementia can be detained if their behaviour becomes aggressive towards others or damaging to themselves, such are refusing to eat. Aggressive outbursts tends to be more common than issues to do with self-harming, however in the process of being aggressive towards others, these usually very frail elderly people can get hurt themselves.
The period that they can be detained for under s.2 is not more than 28 days, so if the healthcare professionals looking after them still think that they need to stay in the specialist mental health unit, then they can either informally detain them, if they think that they would be willing to stay, or section them under s.3. The requirements for this are similar to s.2, in that the person needs to be suffering from a mental disorder, but that they need more than assessment, that they need treatment and that it is necessary for their protection or the protection of others that they receive treatment. Again, this must be supported by two medical practitioners. It is also relevant that this measure in proportionate, that other forms of treatment have been considered not to be appropriate.
Health care professionals consider carefully whether they will section someone under s.3, as there is funding for care afterwards, which can become very expensive! The aftercare funding that follows will be in place as long as the person requires “aftercare”. So if the condition that they suffer from is completely resolved, then the funding might cease. Often for people with dementia, as the dementia is both deteriorating and non-curable, the funding remains in place for life.
When people are detained under either s.2 or s.3, the healthcare professionals caring for them might consider that an acute hospital is not the best place for them to remain and can discharge them from the hospital to be admitted into a specialist care home, as this might be a calmer and or more homely environment. This can be done under s.17 of the MHA, whilst they still remain sectioned under either s.2 or s.3 and would continue to be supervised by clinicians.
If you have need any help or support dealing with a loved one, who has been sectioned, please contact me.