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Being detained – What happens next?
Recently, I read a news article about new guidelines regarding disclosure to employers about being detained under the Mental Health Act. This is one of the many potential issues that may affect someone as a consequence of coming into contact with mental health services on a compulsory basis. Often patients and staff alike wonder about some of the wider implications of being ‘sectioned’. Certainly, the Mental Health Act 1983 is the major piece of law concerning the care and treatment of people with a mental disorder with some sweeping powers.
How will being sectioned under the Mental Health Act 1983 affect my life in the future?
First of all, I should say that the Mental Health Act is very wide ranging, so I am focusing on what happens after someone is detained in hospital under Section 2 or 3 of the Act, or taken to a place of safety by the police in order to get an assessment under Section 136. These are the commonest forms of intervention under the Act that someone might experience.
With regards to section 2 and section 3, these sections relate to detention in a hospital regulated for the purposes of undertaking assessment and treatment of people with a mental disorder.
Section 2 allows for someone to be detained in hospital for up to 28 days for assessment (or assessment followed by treatment) and Section 3 allows for someone to be detained in hospital for treatment for up to 6 months, although this time period can be renewed.
Section 136 allows for a police officer to take someone with mental disorder to a place of safety such as a police station or a hospital if they deem it necessary for up to 72 hours, although good practice dictates this should not be for that long. The purpose of this, is for the person to receive an assessment which might result in being offered some care and support at home, or may be detained further under Section 2 or 3.
Being detained under the Mental Health Act
So what are the consequences for the patient? Obviously, these sections allow for the person to be detained against their will, and this is an example of a due process of law which allows for someone to be deprived of their liberty. If the person were to abscond and be absent from hospital without permission, they could be taken into custody by hospital staff or a police officer and returned to hospital.
Sections 2 and 3 (although not section 136) allow for someone to be given medical treatment, even if they do not want it. There are certain safeguards built into this, so that after a period of medication being given against their will, the Mental Health Act requires an independent doctor to give a second opinion as necessity.
So far, I’ve discussed the implications for the patient once they have been detained, however many people are concerned about the longer term implications of having been on a section of the Mental Health Act, such as what will it do for my job prospects, or travelling abroad.
Mental Health Act and employment
Newly issued guidelines issued to police forces in England and Wales, say it would not always be appropriate to disclose the use of Section 136 by the police to potential employers. Police records are consulted as part of Disclosure and Barring (DBS) checks by employers, required for people applying for jobs working with vulnerable people. New Home Office guidance says that unless there was other information held by the police regarding behaviour which might be relevant to someone’s job application, then use of Section 136 should not be disclosed. You can view this guidance here.
Home Office guidance suggests some other questions to be considered before revealing information about someone’s mental disorder. Having looked at these questions, I think these could be a useful way of deciding how any information you hold about someone might be shared.
- Relevant – have you clearly established a clear and current risk to the vulnerable?
- Substantiation – is your information hearsay or confirmed by a qualified party?
- Proportionate – would disclosure be proportionate in this instance?
- Representation – do you need to check or confirm pertinent aspects of the information?
- Ought to – is disclosure necessary? Have you assessed the impact on the applicant?
- Reasonable– are your opinions/conclusions reasonable?
- Final disclosure text – are you disclosing more than is justified? Is it balanced?
Sometimes people say you won’t be able to travel abroad if you’ve been detained in hospital. There is certainly a rigorous process in obtaining a visa to travel to some countries, and the United States and China are countries often cited. Interestingly, the application process to enter these countries does not mention hospital detention records. The USA’s Electronic System for Travel Authorisation application form asks if you have or have had a mental disorder and a history of behaviour associated with the disorder that may pose or has posed a threat to your property, safety or welfare or that of others. China’s visa application form asks if you are experiencing serious mental disorder.
Similarly, if you were applying for travel insurance, companies will ask about any pre-existing conditions such as mental disorder. However, may not use that information in a discriminatory way. The Equality Act 2010 indicates that for people with mental disorder there might be circumstances in which your application for insurance could be treated differently (for example a higher premium) but that must be on the basis of reasonable evidence. MIND, the national mental health charity, produce a very useful guide about insurance cover and mental health that can be downloaded here.
Finally the issue of voting, of which I have written about in a previous blog which you can read here. People who have been detained under Section 2 or 3 of the Mental Health Act are fully entitled to vote in local and national elections.
David Beckingham – QCS Expert Mental Health Contributor