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According to mental health act section 3, Jonathan can not refuse treament, however he can not received certain treatment without his consent unless specific criteria are fulfilled. NMC 4.1 and 4.3 underpin the patient interest at the center of all decision making, and also NMC 6.1 draws attention to evidence based information and advice. Jonathan can be advice on alternatives option for his treatment such as the use of antibiotics for his treatment and also advising him that delaying his treatment can lead to a burst appendix that can result in infection and even dealth, so it will be of his best interest to accept treatment with medication or appendectomy.

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According to mental health act section 3, Jonathan can not refuse treament, however he can not received certain treatment without his consent unless specific criteria are fulfilled. NMC 4.1 and 4.3 underpin the patient interest at the center of all decision making, and also NMC 6.1 draws attention to evidence based information and advice. Jonathan can be advice on alternatives option for his treatment such as the use of antibiotics for his treatment and also advising him that delaying his treatment can lead to a burst appendix that can result in infection and even dealth, so it will be of his best interest to accept treatment with medication or appendectomy.

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How ethically correct is it to perform a medical procedure on a patient who, at that present time, does not consent to doing so? Regardless of that person's capacity, is it ever appropriate to transcend their beliefs? These are questions we must ask ourselves. When assessing a persons' capacity it is paramount that the solution medical professionals reach is correct as if not, the results can be highly unethical.

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Found in Epidemics, Book I, of the Hippocratic school: "Practice two things in your dealings with disease: either help or do not harm the patient". By refusing to act on Johnathan’s behalf, we are allowing harm. This could be argued as a form of euthanasia, which is not of our concern in the UK. Hippocrates stated “make a habit of two things; to help, or at least do no harm.”

(Amber) ETHICS

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Johnathan is suffering from depression, which could greatly affect the decisions that he chooses to make. He is refusing treatment for his appendicitis, which will lead to fatality if left untreated. Depression, although severe, is not a form of psychosis. It could be argued that depression does not alter a patient’s competency to a big enough extent for a patient to be treated when they are unwilling. However, Rudnick* argues that although depression may not impair choice, understanding, logic or a patient’s understanding of personal relevance, it can be agreed that it may cause a drastic change in a patient. “Such change may be evaluated by comparing the treatment preferences of the individual during the depression to his or her treatment preferences during normal periods.” If Johnathan has made previous compliant medical decisions in periods of time when he was less depressed or not suffering from depression, the best ethical decision for Johnathan may be to act in the best interests of his former self. This would mean that the operation should go ahead, with or without Johnathan’s permission. Johnathan is being detained currently, which demonstrates that his illness is so severe that his mental capacity to live accordingly to his previous self is currently non feasible. Johnathan’s autonomy must always be regarded and respected, however, in a life-threatening circumstance we cannot allow Johnathan to die, especially at the age of 34.
* *Dr A Rudnick, Department of Behavioral Sciences, Tel Aviv University School of Medicine: Depression and competence to refuse psychiatric treatment 2001

(Amber) ETHICS

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Nursing ethical values and definitions: A literature review
-Nursing ethical values and definitions: A literature review - M Shahriari
(2013)

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Nursing ethical values and definitions: A literature review
-Nursing ethical values and definitions: A literature review - M Shahriari
(2013)

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Shahriari states the key themes involved with ethical decision making in nursing. These are human dignity, social justice, altruism, autonomy, accurate care, responsibility, human relationship, competency, sympathy and trust. Johnathan has been detained under the mental health act for 6 months, which has given his healthcare providers a firm basis for assessment on these grounds. This amount of time has hopefully given staff an insight into his life and his personal values. This insight can be used to determine whether Johnathan has the mental capacity to make decisions for himself that are in his own best interests. Selinger* describes that consent is a principle that was valued by the likes of Plato and Hippocrates. “The ethical principle of justice needs to be applied when deciding what treatments are offered to or withheld from patients.”
(Amber) ETHICS

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The Mental Capacity Act of 2005, principle 4, states that “Anything done for or on behalf of a person who lacks mental capacity must be done in their best interests.” This means that it is our job to assess a patient for long enough to understand them and what their best interests truly are. This excludes the best interests of their family and friends, the healthcare provider and any staff involved. It is purely patient-based. If a patient is not presently able to make decisions for themselves that are in their personal best interests, it is our job as healthcare provider to work with the patient to become an extension of the patient and their mental capacity.
(Amber) ETHICS

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Professional
Values - Cassie       Professional and collective values inform nursing philosophy;
therefore, nurses should take these values into consideration in this
situation. An example of a professional value would be the beneficence which
involves balancing the treatment against the risks involved. (Alzheimer’s-europe.org,
2009). Appendicitis can be life threatening and this needs to be explained to
Johnathan to help him make his decision on whether to have the operation or
not. If Johnathan has the operation then this would prevent his suffering,
which is also a professional nursing value. On the other hand, nurses should
promote autonomy and freedom of choice in practice. Nurses should let patients
be informed, free and independent to decide on their treatment (Shahrialri et
at, 2013) however in this case, Johnathan may be forced to have the operation
as it is in his best interest and this could go against some of the nurse’s
values. Professional values can be found in The Code of Conduct which is
produced by the Nursing and Midwifery Council. 

# data[].attributes.subject
Professional
Values - Cassie       Professional and collective values inform nursing philosophy;
therefore, nurses should take these values into consideration in this
situation. An example of a professional value would be the beneficence which
involves balancing the treatment against the risks involved. (Alzheimer’s-europe.org,
2009). Appendicitis can be life threatening and this needs to be explained to
Johnathan to help him make his decision on whether to have the operation or
not. If Johnathan has the operation then this would prevent his suffering,
which is also a professional nursing value. On the other hand, nurses should
promote autonomy and freedom of choice in practice. Nurses should let patients
be informed, free and independent to decide on their treatment (Shahrialri et
at, 2013) however in this case, Johnathan may be forced to have the operation
as it is in his best interest and this could go against some of the nurse’s
values. Professional values can be found in The Code of Conduct which is
produced by the Nursing and Midwifery Council. 

# data[].attributes.body
Principle 1: “A person must be assumed to have capacity unless it is established that he lacks capacity.” [Section 3(2) Mental Capacity Act] The assumption is that a person has capacity to make a decision for himself unless there is proof that it is more likely than not that he lacks capacity to make the decision at the time it needs to be made.

This assumption applies to persons 21 years of age or older.  In this circumstance, Jonathan has capacity – though if it was suspected if this may not be the case, two psychiatrists could be requested to make an assessment. However, excepting this (and it does not seem there has been any history of such lack of capacity, or that depression would cause such temporary incapacity), then Jonathan can indeed refuse treatment. (Owens, 2014)

The General Medical Council web site advises:

“You must respect a competent patient’s decision to refuse an investigation or treatment, even if you think their decision is wrong or irrational.* You may advise the patient of your clinical opinion, but you must not put pressure on them to accept your advice.† You must be careful that your words and actions do not imply judgement of the patient or their beliefs and values.” (Council, 2013)

Principle 3: “A person is not to be treated as unable to make a decision merely because he makes an unwise decision.” [section 3(4) Mental Capacity Act] 3.5.1, therefore Jonathan’s decision should be respected to avoid breach of his human rights (absolute human rights not being capable of removal under Article 6 of the Human Rights Act 1998. (Chancellor, 2007)

A person is free to make his own decisions even if those decisions are unwise in the view of others, for example, relatives, care staff and doctors. This is a very important principle in autonomy (freedom) which recognises the right of a person to make his own choices.

Just because a decision is unwise does not mean that the person has lost mental capacity. 3.5.2 However, there is a difference between a person making an unwise decision (which the person who decides may make) and his making a decision when he lacks the ability to understand, remember or use the information necessary to make the decision (see paragraph 4.6). 3.5.3 If a person makes several decisions which are unusual bearing in mind his usual behaviour or makes decisions which make it easy for him to be exploited or harmed, then further investigation into that person’s capacity should be conducted. (Basant K. Puri, 2005)

The definition of “lack of capacity” provides a two-stage test for mental capacity [section 4(1) Mental Capacity Act]: STEP 1: Is the person suffering from an impairment of, or disturbance in the functioning of the mind or brain? STEP 2: If yes, does the impairment or disturbance cause the person to be unable to make a decision when he needs to? (Health, 2015)

Unless Jonathan has been deemed to lack capacity as appraised two doctors, then his decision must be respected and upheld, though information, and support should be offered e.g. offer of pain killers or carer support. (Basant K. Puri, 2005)

It is also clear from MHA guidance on their Code of Practice in relation to the Mental Health Act, that the provisions of the Act should not be used to a greater extent than is necessary i.e. proportionality, to preserve the rights and independence of the patient so far as possible, though if capacity is diminished, to overrule / assist decisions to the most limited possible degree in their interests.  (Dimond, 2016)

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States what factors to consider while considering the best interests, in refusal of consent. http://www.legislation.gov.uk/ukpga/2005/9/section/4

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The NMC has 4 main principles (Sophie) - 

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The NMC has 4 main principles (Sophie) - 

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1. Make the care of people your first concern, treating them as individuals and respecting their dignity.
2. Work with others to protect and promote health and well being of those in your care, their families and the wider community.
3. Provide a high standard or practice and care at all times.
4. Be honest and open, act with integrity and uphold the reputation of your profession.

# data[].attributes.headline
The professional values of a nurse can be found in the NMC Code of Conduct. (Sophie) 

# data[].attributes.subject
The professional values of a nurse can be found in the NMC Code of Conduct. (Sophie) 

# data[].attributes.body
The Value "Gives clear instructions and explanation and checks that a person understands the use of medicines and treatment options" could be used in the scenario to make Jonathan aware of exactly what his options may be and what could potentially happen if he keeps refusing treatment.

# data[].attributes.body
This link explains why the patient has been detained under section 3 of the mental health act, what the patients rights are,  how section 3 is carried out, whether or not the patient can refuse treatment and also what aftercare is provided for the patient. (Sophie)

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The Mental Health Act 1983

If you have severe mental illness, you might be held under the Mental Health Act. This is sometimes called 'sectioning'. We explain why you may be detained, and what rights you have.
***** New emergency coronavirus legislation has been introduced. It means that there are some temporary changes to some of the information included below. You can read about the changes by clicking here. *****

Overview

The Mental Health Act says when you can be detained in hospital and treated against your wishes.

You can be detained if professionals think your mental health puts you or others at risk, and you need to be in hospital.

If you are detained, NHS staff may be able to give you treatment, even if you don't want it.

There are different sections of the Mental Health Act. These are used for different reasons.

When you are detained, you have the right to appeal, and the right to get help from an independent advocate.

About the Mental Health Act

The Mental Health Act says when you can be taken to hospital, kept there, and treated against your wishes. This can only happen if you have a mental disorder that puts you, or others, at risk.

You should only be detained under the Mental Health Act if there are no other ways to keep you, or others, safe.

Being detained under the Mental Health Act is sometimes called being 'sectioned', because the law has different sections.

Your rights under the Mental Health Act depend on which section you are detained under.

This page does not cover criminal law sections. Click the links below to find our more about each section:

What is a mental disorder?

You can only be detained if you have a 'mental disorder'. The Mental Health Act does not say exactly what can be classed as a 'mental disorder'. So, when they're using the Mental Health Act, health professionals will decide if someone's mental health meets this definition.

You cannot be detained for drug or alcohol addiction. But you can be detained if alcohol or drugs cause mental health problems. For example, if you have delusions because of using cannabis.

Find out more information about 'Drugs, alcohol and mental health' here.

How can I be detained?

Who decides if I should be detained?

Usually, 3 people have to agree that you need to be detained. But this may not be the case if the situation is urgent.

The 3 people are normally:

If possible, at least one of the doctors should have met you before.

The AHMP can only agree this if they have seen you in the past 14 days.

The doctors must either have seen you at the same time, or within five days of each other.

If all 3 people agree that you need to be detained, the AMHP will apply to a local hospital for a bed.

Your nearest relative can also apply for you to be detained, but this is rare. There is more information about your nearest relative below.

What is an AMHP?

AMHPs are mental health professionals who carry out certain duties under the Mental Health Act. They are given specialist training to do this.

An AMHP might be a:

social worker,

nurse,

occupational therapist, or

psychologist.

A doctor cannot be an AMHP.

Where am I assessed?

This depends on where you are. The assessment might take place at your home, in a public place, or in hospital.

If you are at home, the AMHP should introduce themselves, and the doctors, to you. They should explain why they have come to see you.

The AMHP can apply to court for a warrant if you refuse to let them in, or if they think it's necessary for another reason. A warrant lets the police enter your home to take you somewhere safe. This is called a 'section 135'. If your home can be made a safe place, you may be kept there while an assessment is arranged.

If you are away from home in a public place, the police can take you to a safe place under 'section 136'. A safe place might be:

The links below can tell you more about each type of section:

How do they assess me?

When you are safe, the professionals will decide if you need to be detained. They will ask you questions, and think about all of your circumstances. They may ask you:

how you are feeling,

if you have plans to harm yourself or others,

about your lifestyle, daily routine, and living conditions,

if you have been taking your medication, and

if you have been using drugs or alcohol.

What happens if I am detained?

If you are not already in hospital, the AMHP will arrange for you to go there as soon as possible. In some cases the police will go with you.

Staff should tell you which section you are detained under, and what your rights are. They should also give you a 'Patient Information Leaflet' about your rights. If you find it hard to understand, let them know.

It is likely that you will be taken to a specialist ward for people with mental health problems. They may call this an 'acute ward' or a 'psychiatric ward'. In most hospitals, the door to the ward will be locked.

Sometimes the hospital might be a long way from home. But guidance says that the AMHP should try to find you a hospital bed as close as is 'reasonably possible' to where you would like to be.

In hospital, you will be introduced to your 'responsible clinician'. This is the person who is in charge of your care and treatment. They are usually a psychiatrist, but they can be other professionals too.

What is a nearest relative?

The 'nearest relative' is a legal term used in the Mental Health Act. It is not the same as your next of kin.

Your nearest relative has certain rights if:

Find out more about your 'nearest relative' here. {{needs link}}

Can I avoid being detained?

People often get detained because their mental health is putting them or others at risk, and they won't accept treatment. Taking steps to improve your mental health can reduce the chance of being detained.

If it is likely you will be assessed soon, think about the possibility of accepting treatment, and reducing risky behaviour. During the assessment, you may want to explain how things are at home, and what support you already have.

If the professionals think you are at risk, talk to them about other options for reducing these risks.

The professionals should listen to what you have to say, and consider all alternatives to detaining you. These alternatives might be treatment from local mental health services, or you agreeing to go to hospital.

If you want a friend or family member with you during a Mental Health Act assessment, let the approved mental health professional (AMHP) know.

What support can I get?

Being taken to hospital against your will can be stressful and upsetting and you may feel that you need a lot of support.

Friends, family, and carers

Your friends and family can visit you in hospital if you want. There may be set visiting times.

There may be situations when doctors can stop someone visiting you. But they would need to show that this is necessary for safety or security reasons and they should explain these reasons to you. If a doctor stops someone visiting you, when it's not necessary, it could be a breach of your rights.

While you're in hospital, you should be able to keep in touch with your family by telephone, email, or social media.

Emotional support lines

You may want to talk to someone about the way you feel. Ask the ward staff if you can use a phone to call a listening service, like Samaritans (telephone: 116 123).

Independent Mental Health Advocate (IMHA)

You can get help from an IMHA if you are under sections 2 or 3 of the Mental Health Act.

IMHAs help you to tell staff about your concerns, and find out what your rights are. They can also help you to understand your treatment. They are independent of the hospital staff.

Staff should tell you about help from an IMHA as soon as possible after you are detained.

If you think you would find it helpful to speak to an IMHA, ask staff about how to get in touch with one. You may have to ring a number to make an appointment. IMHAs can meet with you in private, if you would like them to.

You can't get help from an IMHA if you are:

under an emergency section (Section 4),

under holding powers of the Mental Health Act (Section 5), or

in a place of safety under police powers (Section 135 or 136).

Solicitor

If you are under sections 2 or 3, and you think you should not have been detained, you can appeal to a tribunal. A solicitor can help you do this. This help should be free under legal aid.

Civil Legal Advice can tell you more about legal aid, and help you to find a solicitor. Their number is in the 'Useful Contacts' section of this page.

There may also be a list of solicitors on the ward.

Use the links below to find more information about:

Going into hospital {{needs link}}

Going into hospital- for carers, friends, and relatives {{needs link}}

Sections 2, 3, 4 & 5

Section 2 - Assessment

Under section 2, you can be kept in hospital for up to 28 days. This section gives doctors time to decide:

An approved mental health professional (AMHP) is more likely to use section 2 than section 3 if:

you have never been assessed in hospital before, or

you have not been assessed for a long time.

A psychiatrist may offer you treatment. If you refuse treatment, the staff may be able to give it to you without your permission.

When can I be detained?

You can be detained if:

How will I be detained?

An approved mental health professional (AMHP) needs to apply to hospital. Your nearest relative can also do this, but this is rare.

An AMHP can only apply if they have seen you in the last 14 days. They also need recommendations from 2 doctors. One of these doctors must have seen you in the last 14 days. And the doctors must not have seen you more than 5 days apart.

How long can I be kept in hospital?

Up to 28 days. But this doesn't mean you will be in hospital for that long. Your doctor should discharge you from section 2 if you no longer meet the criteria for detention.

Hospital staff cannot extend a section 2. If you need treatment in hospital for longer, you will need to go on to a section 3.

You can stay on a section 2 longer than 28 days if the county court is thinking about changing your nearest relative.

What are my rights on a section 2?

You have the following rights when you are under section 2.

You can find more information about 'Discharge from the Mental Health Act'here.

Can they give me treatment I don't want?

Yes. But the staff should ask you to accept treatment first. If you are unhappy about your treatment, talk to the person in charge of your care (your responsible clinician). An Independent Mental Health Advocate (IMHA) may be able to help.

Staff can only give you some treatments, like electro-convulsive therapy (ECT), if certain criteria are met.

Who can discharge me?

You can be discharged by:

your responsible clinician,

the hospital managers,

your nearest relative, and

the tribunal.

What happens next?

If your doctor thinks you should stay in hospital longer than 28 days, and you won't agree to this, they may put you on a section 3.

Section 3 - Treatment

Under section 3, you can be detained in hospital for treatment for up to 6 months. But it can be extended for longer.

When can I be detained?

You can be detained if:

* you have a mental disorder,
* you are unwell enough to be in hospital,
* professionals think you should be in hospital for your own health or safety, or to protect other people,
* appropriate treatment is available for you, and
* you will not get this treatment unless you are detained.

How is a section 3 carried out?

An approved mental health professional (AMHP) needs to apply to hospital. Your nearest relative can also do this, but this is rare.

How long will I be in hospital for?

To start with, you can be detained for up to 6 months. But your doctor can discharge you earlier, if they think you are well enough.

If your doctor thinks you need to stay in hospital at the end of the first 6 months, they can renew your section for another 6 months. After that, they can renew it for 1 year at a time.

If your responsible clinician thinks your section should be renewed, they have to assess you in the 2 months before it ends. They will then write a report for the hospital managers.

What are my rights?

You have the following rights when you're under section 3.

* You can appeal to a tribunal once in the first 6 months.
* If your section is renewed, you can appeal once every time it is renewed.
* You can ask the hospital managers to discharge you.
* You can ask for the help of an Independent Mental Health Advocate (IMHA). They can help you to understand your rights, and to get your voice heard.

Can I be treated against my will?

You can be treated against your will for 3 months. After 3 months, staff can only treat you without your consent if a 'second opinion approved doctor' (SOAD) approves the treatment.

If you are unhappy about your treatment, you should talk to your responsible clinician. An Independent Mental Health Advocate (IMHA) may be able to help.

Staff can only give you some treatments, like electro-convulsive therapy (ECT), if certain criteria are met.

Who can discharge me?

You can be discharged by:

* the professional in charge of your care (known as your 'responsible clinician'),
* the hospital managers,
* your nearest relative, and
* the tribunal.

What happens next?

When you leave hospital, you will get free aftercare. This is known as section 117 aftercare. It is likely that mental health services will plan your care under the 'Care Programme Approach'.

You can find more information about:

* Section 117 aftercare here
* Care Programme Approach (CPA) here
* Electroconvulsive therapy (ECT) here
* Discharge from the Mental Health Act here

Section 4 - Emergencies

Section 4 is used in emergencies, where only 1 doctor is available at short notice. Unlike a section 2 or 3, you can be detained with a recommendation from only 1 doctor. You can be kept for up to 72 hours. This gives the hospital time to arrange a full assessment.

When can I be detained?

You can be detained under section 4 if:

* you have a mental disorder,
* you are unwell enough to be in hospital,
* professionals think you should be in hospital for your own health or safety, or to protect other people,
* it is urgent and necessary for you to be in hospital, and
* finding another doctor would cause an "undesirable delay".

How is section 4 carried out?

An approved mental health professional (AMHP) needs to apply to hospital. Your nearest relative can also do this, but this is rare.

You must have been seen by a doctor in the last 24 hours. The doctor will write a report that says you should be detained.

How long can I be detained for?

You can be detained for up to 72 hours. But this does not mean that you will be kept for this long. A second doctor should assess you as soon as possible. They will decide if the section 4 should be changed to a section 2. The AMHP does not need to make another application to change the section 4 to a section 2.

Can I be treated against my will?

You can refuse treatment. Staff can only treat you without your consent if:

* you do not have the mental capacity to make a decision about treatment, and
* the treatment is in your best interests.

Who can discharge me?

You can be discharged by the professional in charge of your care in hospital. They are called your responsible clinician.

You can find out more about Mental capacity and mental illness by clicking here.

Section 5 - Holding powers

Section 5 allows a doctor or nurse to stop you from leaving hospital. They may do this if you are in hospital voluntarily, and you want to leave. But they think you are too unwell to leave.

If you are in hospital voluntarily, and you are on a locked ward, staff either have to:

* let you leave when you want to, or
* use their section 5 powers.

If they stop you from leaving without using section 5, this is against the law.

Staff should only use section 5 when it is not possible or safe to use sections 2, 3, or 4.

Doctor's holding power - section 5(2)

A doctor can hold you in hospital for up to 72 hours, if they write a report explaining why you need to be detained, and send this to the hospital managers. A doctor can do this in any hospital.

Nurse's holding power - section 5(4)

A mental health or learning disability nurse can keep you in hospital for up to 6 hours if:

* they need to immediately stop you leaving hospital, for your own health or safety, or for the protection of others, and
* it is not possible to find a doctor who can section you under section 5(2).

How long can I be detained for?

Under section 5(2)

You can be held for up to 72 hours. The doctor cannot renew or extend it. An approved mental health professional (AMHP) and doctors must assess you as soon as possible to see if you should be detained under section 2 or 3.

Under section 5(4)

A nurse can keep you in hospital for up to 6 hours. This is not renewable. The holding power ends as soon as a doctor arrives.

The doctor may transfer you onto a section 2, 3, or 5(2). Or you may continue as a voluntary patient.

Can I be treated against my will?

You can refuse treatment. Staff can only treat you without your consent if:

* you do not have the mental capacity to make a decision about treatment, and
* the treatment is in your best interests.

If you have the capacity to make your own decisions, staff cannot treat you without your consent, unless they move you to a section 2 or 3.

When does the section end?

Section 5 ends when:

* the time runs out, or
* you are detained under a different section.

If the time runs out, and the staff have not detained you under another section, you should be able to leave.

You can find out more about Mental capacity and mental illness by clicking here.

What happens next?

What happens next?

Discharge

You must be discharged from the Mental Health Act when you don't meet the criteria to be detained anymore. For example, if you are in hospital because your health puts you at risk, you can be discharged when this risk is low enough.

You can choose to stay in hospital, if hospital staff agree that you need to be there.

Most people will not have completely recovered from their illness when they leave hospital. If staff think you are ready to leave, they should plan what will happen next. This is called 'discharge planning'.

Your doctors should start planning your discharge as soon as possible, and you should be involved.Discharge planning should be part of your care plan. Your care plan depends on what staff think will be best for you, and what you want. It might say:

where you will live,

what medication will help you,

what social support you will have, and

which mental health services can help.

You can find more information about 'Discharge from the Mental Health Act' by clicking here.

Aftercare

When you leave hospital, professionals should plan your care under the 'Care Programme Approach' (CPA), if there's a high risk that your mental health will get worse without ongoing care.

If you have been in hospital under section 3, you are entitled to free aftercare under section 117.

You can find more information about:

Care Programme Approach (CPA) by clicking here.

Section 117 aftercare by clicking here.

Community Treatment Order (CTO)

A CTO means that you can leave hospital, but you stay under the Mental Health Act. You have to meet conditions to stay in the community. You may be taken back to hospital if you don't meet the conditions in the CTO, or you become unwell. This is sometimes called 'supervised community treatment'.

You may go on a CTO if you are discharged from section 3. You can't go on a CTO if you are under section 2, or if you are not detained.

You can find more information about 'Community Treatment Order' by clicking here.

Useful contacts

Samaritans
This is a national helpline that gives confidential emotional support for people who are distressed. Local branches offer telephone support and, sometimes, face-to-face support.

Telephone: 116 123. Open 24 hours per day, 7 days a week.
Email: jo@samaritans.org
Website: www.samaritans.org

Civil Legal Advice
Civil Legal Advice can help you to find a solicitor who works under legal aid.

Telephone: 0345 345 4 345. Open Monday-Friday 9am-8pm, and Saturday 9am-12.30pm.
Website: www.find-legal-advice.justice.gov.uk

Further reading

Mental Health Act- Code of Practice
This is a document written by the government, working with an Expert Reference Group of service users and carers. It explains how healthcare professionals should apply the Mental Health Act.

Website:
www.gov.uk/government/uploads/system/uploads/attachment_data/file/435512/MHA_Code_of_Practice.PDF

You can find more information about:

Advocacy by clicking here.

Community Treatment Orders (CTOs) by clicking here.

Complaints by clicking here.

Discharge from the Mental Health Act by clicking here.

Going into hospital by clicking here.

Going into hospital- for carers, friends, and relatives by clicking here.

Legal advice by clicking here.

Nearest relative by clicking here.

Section 117 aftercare by clicking here.

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The Mental Health Act (MHA) says when you can be detained in hospital and treated against your wishes. You can be detained if professionals think your mental health puts you or others at risk, and you need to be in hospital. This is sometimes called 'being sectioned'

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Study into nursing and consent - assess findings? (Thea)

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NMC code - referencing this with any professional/ethical/legal dilemmas (Thea)