Mental Health guide
Your rights as a service user
This is a very brief introduction to your rights as someone who uses mental health services, including those under the Mental Health Act 1983. You should always get detailed advice. 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 Social Services.
You and your medical records
You have a legal right to see your health records made by a GP, hospital staff or other health professionals on or after 1st November 1991 (Health Records Act 1990). Social Services and other agencies also have agreements under which you have access to your records. You may have to pay a fee of up to £10 to see the records, unless they have been added to within the last 40 days. You can have a copy of your records, but you may be charged the cost of copying.
If you believe a record is incorrect, you can have an amendment attached, though 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.
Community Care Assessment
If you contact Social Services for help you are entitled to an assessment, which can lead to an agreement between you, your carer (if appropriate), and Social Services, about the help you need.
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
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 s/he follows
- whether they receive regular supervision from a qualified supervisor
Treatment without consent
Treatment can be given against your will in these 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 chose to go into hospital
You are an 'informal patient'. You are free to leave the ward or the hospital as you choose. (See also Preventing you from Leaving Hospital below) You have the right to refuse any treatment.
If you were 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
- have a say in your care plan to make sure it meets your needs
- 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.
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.
Preventing you from leaving hospital
If you are an informal patient, and you decide to leave hospital, 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.
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, and
- 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 (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 the request.
- 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.
Information
If you are a formal patient the Hospital Managers have a duty to give you information on:
- the section under which you are detained
- your right to apply to a Mental Health Review Tribunal and/or appeal to the hospital managers
- your right to be discharged
- consent to treatment rules
- correspondence rules
- the duties of The Mental Health Act Commission