Mental Health guide

Your rights as a service user

This is a brief introduction to your rights as a mental health service user. It includes details of your rights under the Mental Health Act 1983 - some of these rights will be amended by the Mental Health Act 2007 (see separate section). Detailed advice is available from a number of organisations - see the section on Advocacy, Rights and the Legal System in the listings. The best way to try to ensure you get your full rights is to get the help of an advocate.

You and your GP

You have the right to:

  • be registered with a GP
  • an interpreter, if you need one, when you visit your GP
  • take a friend, relative or an advocate with you
  • a clear explanation of any treatment proposed, including risks and possible side effects, and any available alternatives
  • to be referred by your GP to a specialist (such as a psychiatrist) where necessary, as judged by the GP
  • have a second opinion from another specialist, if you are uncertain about agreeing to the treatment proposed, provided your doctor agrees
  • advice and help from your GP in applying for help from Adult Social Care

Your medical records

You have a legal right under the Data Protection Act (1998) to see your health records whether these are made by a GP, hospital staff or other health professionals. Under the Act you also have a right to see records about you held by Adult Social Care and other agencies. You may have to pay a fee of £10 to see computerised records or £50 for manual records. You can have a copy of your records, but you may be charged for the cost of copying.

If you believe a record about you is incorrect, you can have an amendment attached, although you cannot insist that the record itself is changed. Parts of your records may be withheld (without you being told) on the grounds that seeing them would damage your physical or mental health. Information about third parties may also be withheld.

Care Programme Approach

See separate section.

 

Community Care Assessment

If you contact Adult Social Care for help you are entitled to an assessment, which can lead to an agreement between you, your carer (if appropriate), and Adult Social Care, about the help you need.

Direct Payments

Direct payments are local council payments for people who have been assessed as needing help from Adult Social Care, and who would like to arrange and pay for their own care and support services instead of receiving them directly from the local council.

You must be able to give your consent to receiving direct payments and be able to manage them. The money is paid directly to you so that you can choose and pay for services which best meet your needs.

For example, you could choose to employ your own care worker or personal assistant, or buy special equipment to help you live independently. Or you might organize respite care if you are caring for a disabled child.

Direct payments can’t be used to buy services from the council.

You can also choose to have a combination of council-provided social care services and direct payments to pay for services that you choose yourself.

ASIST who are the Leeds direct payments support service for advice on arranging direct payments can help you manage your direct payments and associated responsibilities. For example you will be required to keep records of everything you pay for and also follow employment regulations. You can contact ASIST on 0113 214 3654.

Treatment

Consent to treatment

You must give consent before you are given any treatment (except in the circumstances described below under Treatment Without Consent).

If you are over 18 and have the mental capacity to make decisions for yourself nobody else can give consent on your behalf.

Information about treatment

You have the right to be given, and to understand, all necessary information about the proposed treatment:

  • what it is for, and what it is likely to achieve
  • what the treatment consists of
  • what is likely to happen if you don’t have the treatment
  • any risks or possible side effects
  • any alternative treatments

For talking treatments like counselling and psychotherapy you have a right to know:

  • what the treatment will consist of, and how long it is likely to last
  • what qualifications the counsellor/therapist has
  • what code of professional ethics they follow
  • whether they receive regular supervision from a qualified supervisor

Treatment without consent

Treatment can be given against your will in the following circumstances:

  • in an emergency: if you are acting in a way which is causing serious immediate danger to yourself or others you can be given limited treatment to alleviate the immediate situation
  • loss of capacity - if you do not have the mental capacity to make decisions for yourself
  • compulsory detention/ treatment under the Mental Health Act (see below)

Your rights if you go into hospital

If you choose to go into hospital … you are an ‘informal patient’. You have the right to refuse any treatment. You are free to leave the ward or the hospital as you choose, except in the following circumstances:

You can be kept against your will…

  • for up to 6 hours by a nurse in order to be assessed by a doctor
  • for up to 72 hours by a doctor while an application for detention under another section of the Mental Health Act is made

If you are taken into hospital against your will … you are a ‘formal patient’. You can only leave when you are discharged (see below). In some circumstances you can be given treatment against your will

Care and Treatment in Hospital

You are entitled to:

  • ask for a relative, friend or advocate to be told that you have been admitted to hospital
  • be allocated a named (key)nurse whose job it is to make sure that your needs are met
  • be given information about independent advocacy
  • be involved in the development and ongoing review of your care plan
  • have a relative, friend or advocate present at ward round or care programme meetings
  • ask to see the consultant alone (or with a relative, friend or advocate) if the ward round or care programme meetings are too large or public
  • to complain if you are unhappy with the service you receive. If your complaint cannot be handled informally you can take steps to make a formal complaint

You have a general right to dignity, respect, choice of diet, choice of a single-sex environment, access to religious or spiritual advisers, security of possessions, and meaningful or therapeutic activities

The Mental Health Act 1983

The Mental Health Act and the Code of Practice give safeguards and procedures which must be followed by psychiatrists and other staff.

Compulsory Admission

You can be detained against your will (often known as ‘being sectioned’) if:

  • your condition is deemed to pose a threat to your health or safety, or that of others, andkeynotes
  • if you are suffering from a ‘mental disorder’

You can then be detained for:

  • up to 28 days, for Assessment (Section 2 of the Act)
  • up to 6 months (renewable), for Treatment (Section 3)
  • up to 72 hours, for Emergency Assessment (Section 4):
  • up to 72 hours, if a police constable removes you from a place to which the public have access to a place of safety such as a police station or hospital (Section 136)

Discharge

For Sections 2 and 3 you can be discharged by:

  • your ‘nearest relative’ who must give 72 hours notice to the Hospital Managers, who may overrule your relatives request to discharge you
  • the Responsible Medical Officer, or the Hospital Managers

Appeal

You have a right to appeal to the Mental Health Review Tribunal:

  • within 14 days of detention under Section 2 or
  • once within a 6 month period under Section 3

You can also appeal to the Hospital Managers at any time and they will consider holding a review. If you have a Hospital Managers Hearing, they will only hold a further hearing if your circumstances have changed.

Information

If you are a formally detained patient the Hospital Managers have a duty (under section 132 of the Act) to give you information about:

  • the section under which you are detained and the effects of this section
  • your right to apply to a Mental Health Review Tribunal and/or appeal to the hospital managers for a review of your detention
  • your right to be discharged and who can discharge you
  • consent to treatment rules
  • correspondence rules
  • the duties of The Mental Health Act Commission
  • Managers Appeals

You should also be given information on the following:

  • the Care Programme Approach
  • how to make complaints or give compliments
  • the PALS service (Patients Advice and Liaison Service)
  • advocacy
  • aftercare

The Mental Health Act Commission monitor the use of the Act and keep under review all aspects of the care of patients detained under the Act. They are contactable via their website www.mhac.org.uk or on 0115 943 7100.

It is important to note that this Commission will merge along with CSCI and the Healthcare commission by 2009 to form one new public monitoring body, details of which are not yet available.

Human Rights Act 1998

This Act provides a way of challenging unfair treatment and disregard for proper procedures. The following articles under the Act are particularly relevant to mental health issues:

Article 3: “No one shall be subjected to torture or to inhuman or degrading punishment or treatment.”

Article 5: “Everyone has the right to liberty and security of person.”

Article 6: “…everyone is entitled to a fair…hearing, within a reasonable time by an independent and impartial tribunal established by law.”

Article 8: “Everyone has the right to respect for his private and family life, his home and his correspondence.”

This Act applies to public authorities including NHS Trusts and local councils.

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