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What exactly happens when you are sectioned?

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    Well basically what exactly happens when you are sectioned to a Mental Health Facility?

    Who starts the proceedings? How does apprehending , detention and transport work out? Is there some sort of procedure in "sectioning" you and what rights do you have?

    What is then the normal procedure when you arrive at the hospital? Do they strip search you and take away your belongings? What is it like in the hospital..... like a prison with bars etc..? or... as you can imagine.... I don't know much , just curious.


    Thanks guys
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    (Original post by Agent Smirnoff)
    Well basically what exactly happens when you are sectioned to a Mental Health Facility?

    Who starts the proceedings?
    It depends on the circumstances alot of the time. Sometimes someone is just way to ill to see that they need help to reach a place thats stable. My dad has bipolar and when we are worried about him, we have a number people involved with his care that we can call to assess him. Alot of the time the patient/client is able to see that they've past the point of return and they need support. So they'll go onto an acute ward voluntarily.

    (Original post by Agent Smirnoff)
    How does apprehending , detention and transport work out?
    Also depends on the person. If they 'come kicking and screaming' sort of thing, the police can get involved, i presume. If they get violent i presume there wouldnt be any hestiation to provide emergency medication, for example. But when my dad was sectioned, i think the home treatment took him or maybe my mum, cant remember. But he didn't kick up too much fuss.

    (Original post by Agent Smirnoff)
    Is there some sort of procedure in "sectioning" you and what rights do you have?
    I dont know the ins and out of the procedure, in the point view of a nurse, (but i should do considering my placement in a acute ward starts next friday :eek:) but i suspect it different with each trust. Unfortunately a person that has been sectioned doesnt have that many rights. They have the right to an advocate who can help in appealing the decision. Depends what section you have, depends on how long you have to stay in the facility. When the healthcare professionals deciede if you're well enough, i.e. not going to doing and stupid or reckless, you can go home for a weekend or go for a walk or to the supermarket.

    (Original post by Agent Smirnoff)
    What is then the normal procedure when you arrive at the hospital? Do they strip search you and take away your belongings? What is it like in the hospital..... like a prison with bars etc..? or... as you can imagine.... I don't know much , just curious.
    Most 'run of the mill' acute wards are like day centers in the set up. The front door is locked. They are bedrooms- some patients have to share rooms. There is a big open plan day room and separate television room. A garden with benches and a spot for smokers. I suppose some where with more security and forensic (criminal) facilities are different. By all means, gone are the days were you would a setup with straight jackets and padded cells and an image like 'one flew over the cukoos nest' or 'girl interrupted'. I presume patients on the normal ward arent strip searched, probably bags and pockets are searched for meds and razor blades for example.
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    (Original post by Agent Smirnoff)
    Well basically what exactly happens when you are sectioned to a Mental Health Facility?

    Who starts the proceedings? How does apprehending , detention and transport work out? Is there some sort of procedure in "sectioning" you and what rights do you have?

    What is then the normal procedure when you arrive at the hospital? Do they strip search you and take away your belongings? What is it like in the hospital..... like a prison with bars etc..? or... as you can imagine.... I don't know much , just curious.


    Thanks guys
    You could be sectioned under either section 2 or 3 of the MHA. It would depend on the exact circumstances but both of these require at least one psychiatrist, it would normally be two one NHS and one independant and the other would be with the NHS, there would also need to be an Approved Mental Health Practitioner who could be a nurse or social worker etc.

    Apprehending and transport again would depend on circumstances if you go resist you get detained and taken to the MHU by police.

    As rights go, under section 2 you can be held for 28 days and after that that can either extend or dissolve the section. You can't be forced to take meds as its an observation section. To leave the hospital you have to get section 17 leave off your psych and that will say how much time out of the ward you can have.

    Under section 3 they can hold you for up to 6 months and you can be forced to take meds if you don't comply. However if your nearest relative disputes this section they can't take you in unless they remove them as your nearest relative which takes months and they hardly ever do, as they have to prove that they are unfit to be nearest relative.

    Regardless of which section, you can choose to dispute it yourself. When you arrive on the ward they should ask if you want to see a lawyer, and if not you should ask and they have to arrange for one to see you. The lawyer would then take on your case and would look at your notes to see on what grounds you could dispute it. This is all covered by legal aid so is free.

    When I went in I wasn't strip search but I'm not sure if that just because I'd already been searched by the police. They are not like prisions but at the same time you have very little freedom and there is not much to do. You have your bedroom and then there's generally a lounge area with a tv. People tend to spend a lot of time in their rooms or just sitting around.

    Hope that goes some way the satisfying your curiosity
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    (Original post by Agent Smirnoff)
    Well basically what exactly happens when you are sectioned to a Mental Health Facility?

    Who starts the proceedings? How does apprehending , detention and transport work out? Is there some sort of procedure in "sectioning" you and what rights do you have?

    What is then the normal procedure when you arrive at the hospital? Do they strip search you and take away your belongings? What is it like in the hospital..... like a prison with bars etc..? or... as you can imagine.... I don't know much , just curious.


    Thanks guys
    Sectioning can be done by a single psychiatrist who can detain you for assessment for 72 hours. After this, you need to be assessed by a panel of two psychiatrists and a specialist mental health worker, usually a social worker, to extend or revoke the section. Once you're in the hospital, a nurse will usually go through your rights and what is expected of you, and what you'll need to do to get out of the hospital.

    You will be escorted to the hospital by at least one nurse from the facility, usually by ambulance or taxi. If you choose not to accompany them to the ward, the police will be sent after you, no question about it.

    All hospitals are different. There are regular wards and PICU (Psychiatric Intensive Care Unit) wards, with most wards housing around 20 patients, though PICU wards usually only have between 2 to 4 patients at any one time. You will be locked into the ward through the main entrance, and the only way you'll get out is if your section is revoked, if you're granted leave or if you're taken somewhere by staff. In a PICU ward, usually all doors will be locked, including interior ones.

    When admitted, you and your belongings will be searched for restricted items, including drugs, alcohol and anything that you could hurt yourself or others with. You are allowed things such as books, clothing and similar. You won't be strip searched, instead, you remove one piece of clothing at a time and it is checked and handed back to you.

    Some hospitals will have barred or grated windows, but all will only open a very small way. Hospitals will also have electronically locking doors, PICU wards much more so than regular wards. Generally, the only access to the outside world beyond the hospital walls will be through the smoking area, which will always be contained by a very high wall.

    The hospitals themselves are very, very boring. There is literally nothing to do save amuse yourself, speak to other patients or watch television. If you're very, very lucky, the hospital may provide activities which you may or not be able to take part in depending on your observation level. You are woken at set times, you eat at set times, you take medication at set times and you will be checked upon at regular intervals depending on what observation level you have been placed upon. Generally - though not in PICU wards, where access is risk-assessed - you have free roam of the hospital, save the staff areas.

    You get a daily visiting time, although numbers of visitors are restricted. You will have regular one-to-one time with your named nurse, as well as a consultant psychiatrist, and possibly psychologists, therapists and so on.

    I've been on both acute admission wards and PICU wards, and to be honest they are all very similar in set-up and experience, although the possibility of violence towards yourself increases markedly on PICU wards. That said, I have seen violence, sometimes incredibly extreme, towards staff on all wards. Violent patients are always chemically restrained with a 10-2 injection (10mg haloperidol, 2mg lorazepam).

    I'm happy to expand on anything I've said or answer any further questions you might have.
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    (Original post by Misery)
    Sectioning can be done by a single psychiatrist who can detain you for assessment for 72 hours. After this, you need to be assessed by a panel of two psychiatrists and a specialist mental health worker, usually a social worker, to extend or revoke the section. Once you're in the hospital, a nurse will usually go through your rights and what is expected of you, and what you'll need to do to get out of the hospital.

    You will be escorted to the hospital by at least one nurse from the facility, usually by ambulance or taxi. If you choose not to accompany them to the ward, the police will be sent after you, no question about it.

    All hospitals are different. There are regular wards and PICU (Psychiatric Intensive Care Unit) wards, with most wards housing around 20 patients, though PICU wards usually only have between 2 to 4 patients at any one time. You will be locked into the ward through the main entrance, and the only way you'll get out is if your section is revoked, if you're granted leave or if you're taken somewhere by staff. In a PICU ward, usually all doors will be locked, including interior ones.

    When admitted, you and your belongings will be searched for restricted items, including drugs, alcohol and anything that you could hurt yourself or others with. You are allowed things such as books, clothing and similar. You won't be strip searched, instead, you remove one piece of clothing at a time and it is checked and handed back to you.

    Some hospitals will have barred or grated windows, but all will only open a very small way. Hospitals will also have electronically locking doors, PICU wards much more so than regular wards. Generally, the only access to the outside world beyond the hospital walls will be through the smoking area, which will always be contained by a very high wall.

    The hospitals themselves are very, very boring. There is literally nothing to do save amuse yourself, speak to other patients or watch television. If you're very, very lucky, the hospital may provide activities which you may or not be able to take part in depending on your observation level. You are woken at set times, you eat at set times, you take medication at set times and you will be checked upon at regular intervals depending on what observation level you have been placed upon. Generally - though not in PICU wards, where access is risk-assessed - you have free roam of the hospital, save the staff areas.

    You get a daily visiting time, although numbers of visitors are restricted. You will have regular one-to-one time with your named nurse, as well as a consultant psychiatrist, and possibly psychologists, therapists and so on.

    I've been on both acute admission wards and PICU wards, and to be honest they are all very similar in set-up and experience, although the possibility of violence towards yourself increases markedly on PICU wards. That said, I have seen violence, sometimes incredibly extreme, towards staff on all wards. Violent patients are always chemically restrained with a 10-2 injection (10mg haloperidol, 2mg lorazepam).

    I'm happy to expand on anything I've said or answer any further questions you might have.


    Hi. Thanks for that.

    Can you expand greatly on the risk of violence? I would have thought they don't have much of that given that we have drugs n'all. How do they inject you? Restrain you and jab it in? How does the medication take effect?

    Is there abuse (staff-paitent abuse) as cited on Inside Broodmore. (I know we arent talking about broodmore but you know sadly injustices do exist in MHU's')
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    Risk of violence is dependent on the level of secure unit you're in and on the patients. Some patients are more violent because of their illness i.e. they're scared or angry and therefore can lash out. Others even once they're on treatment are still violent.

    The nurses I've worked with are brilliant and usually convince patients to take the treatment without too much fuss. There's usually a rapid response team that you can bleep if a patient is too out of control and needs urgent meds to be administered. In these cases it is usually administered IM for the quickest response.
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    (Original post by Agent Smirnoff)
    Hi. Thanks for that.

    Can you expand greatly on the risk of violence? I would have thought they don't have much of that given that we have drugs n'all. How do they inject you? Restrain you and jab it in? How does the medication take effect?

    Is there abuse (staff-paitent abuse) as cited on Inside Broodmore. (I know we arent talking about broodmore but you know sadly injustices do exist in MHU's')
    No problem.

    The risk of violence is generally relative to the security level of the ward you're on. As I mentioned in my previous post, risk of violence is a lot higher on a PICU ward. Even the most advanced drugs, including anti-psychotics, anti-depressants, sedatives and anxiolytics do not work 100% of the time for 100% of patients. In fact, there are a lot of medication trials to find which drug best suits a certain patient. Furthermore, drugs alone are unlikely to stabilise a volatile patient, unless it is a chemical restraint. The chemical restraint injections are administered by having four or five of the biggest nurses hold you down while you are forcibly injected intramuscularly. The effects are nearly instantaneous, and you pretty much lose all ability to function physically. There is no way you could function to a level where you pose a physical threat to other patients or staff.

    The worst violence I've seen has been on PICU wards, namely Ward 3 in B*** W*** and D*** Ward in C***** K******. On D*** Ward we had one guy escorted in by eight police officers, and as soon as they had left he broke a chair leg off and started randomly attacking patients and staff. He seriously injured two of the nurses before he was restrained. Neither nurse returned to work during my stay, and that particular patient was chemically restrained virtually every day following altercations with staff or other patients. On Ward 3, one of the consultant psychiatrists was maimed by a patient during a review. Since this was behind closed doors we didn't actually see it take place, but we did hear it, and we saw the mess, the blood and the paramedics.

    There is violence on acute admission wards as well, though it isn't as severe or regular. I had a punch-up with a manic patient who attacked some young kid in S* A**'s and while on E*** W****** Ward, which was mixed-sex, I saw a bat**** insane woman **** all over the floor and walls before slinging it at staff and scratching out one of the male nurses eyes.

    Staff-to-patient abuse does exist, though not at a high level. The worst I experienced personally was on E*** W******, where you'd routinely have two of the nurses, one male, one female, abusing the patients verbally and physically. They'd make fun of your paranoia, your symptoms, your behaviour, they'd swear at you, insult you, demean you in front of others, and if you were a handful, physically, you'd better believe they'd give it back as they could. Other than that, generally speaking, there wasn't much abuse of power going on, on the whole, rather one or two isolated incidents with particular members of staff.

    Edit: Maybe I shouldn't give the full names of the hospitals and wards.
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    (Original post by Agent Smirnoff)
    Is there abuse (staff-paitent abuse) as cited on Inside Broodmore. (I know we arent talking about broodmore but you know sadly injustices do exist in MHU's')
    At the ward I was on there was no physical abuse of the patients, but some staff would verbally abuse the more annoying patients, and would tell them they'd never get out or that if they just stopped being 'stupid' they could leave. Stuff like that really.
    No one was chemically restrained while I was there, a couple of people punched walls etc. but because it never went further than that, they didn't need to.
    I think the ward I was on was pretty good but also reasonably standard, in terms of staff practice, for what it was.
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    Bloody hell. Some of the stuff people have mentioned here is so scary. And to think, I was almost (I would have been if my friend had it his way) sectioned a few years ago.

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