Hospital treatment and compulsory care

In this summary, people talk about their experiences of being admitted to hospital, in some cases compulsorily via powers provided by the Mental Health Act 1983, or ‘being sectioned’. This law changed slightly as a result of the 2007 Mental Health Act to include supervised community treatment (i.e. increased powers to treat people in the community) and a broader definition of mental disorder. Rethink provides information to people about their legal rights and what someone may be going through (see ‘Resources’ section).
Only a few people we spoke to hadn’t been to a psychiatric hospital at some point in their lives. Several people had been to hospital a number of times. People sometimes sought help from their GP and were then referred to a psychiatrist who thought they should be admitted; others ended up in hospital because they had taken overdoses. A few people were taken to hospital by the police following serious concerns about their behaviour. A couple of people who went to A&E thought that they were dying or had other physical health problems such as heart palpitations, but eventually they were admitted to a psychiatric ward because of serious concerns about their well-being and safety.

What happens when you are ‘sectioned’?

To be sectioned, three people (an Approved Mental Health Professional [usually a social worker] or nearest relative and two doctors) must agree that the person is suffering from a mental disorder (e.g. schizophrenia, psychosis or bipolar affective disorder) and needs to be detained for assessment or treatment, either for their health and safety or for the protection of others. However, people can also be admitted to hospital as ‘voluntary’ or ‘informal’ patients.

Being admitted to hospital

People ended up in hospital for a variety of reasons. Arwen was found by someone she knew wandering down the road in her nightdress and was taken to a doctor, who arranged for her admission to hospital. Later she remembers being very frightened in hospital as she thought an electric drill was talking to her. Colin was round at his friend’s house and his friend thought he had taken an overdose, so took him to hospital where he had his stomach pumped. When they couldn’t find anything physically wrong with him, they eventually transferred him to a psychiatric ward. Rachel had stabbed herself in her liver when unwell and was transferred from a surgical to a psychiatric ward.
When people talked about being admitted to a psychiatric hospital, they often said that they found this a very confusing and distressing time. Sometimes they were completely unaware of what was happening to them as they didn’t know anything about psychiatric hospitals, or were too distressed to be able to understand. Nada even thought she was being taken to prison and was about to be executed. Some people felt they would be better at home and didn’t want to be taken by force, but Arwen said that when she was unwell hospital was the best place for her.

Graham describes going to his GP, who explained to him that he needed to go to hospital.

Age at interview 47

Gender Male

Age at diagnosis 22

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Pete describes going to his GP, after which his dad took him to hospital.

Age at interview 48

Gender Male

Age at diagnosis 30

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Margaret had a frightening experience at A&E when she thought her heart was stopping.

Age at interview 41

Gender Female

Age at diagnosis 27

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Whilst most people didn’t want to go into a psychiatric ward, a couple said that they were frightened but also a bit relieved, as now someone was going to take them seriously, or that something was going to be done about their distress. Most people were almost completely unaware of their legal status when they were first admitted, and a couple of people mentioned wanting to ring the police for assistance as they felt they were being unfairly held.

Life in hospital

Many of the people we spoke to had spent quite a bit of time in hospital. After people had been admitted they sometimes wanted more information about what had happened to them, or even simple things like where to keep their things or where things were. Often it was the other patients who helped them. Several people said that they were surrounded by people who were more unwell than they were. When people are held under a section of the Mental Health Act they can leave the ward only with the permission of their doctor – under Section 17 of the Mental Health Act. Initially this may only be for short periods in the local area and whilst escorted by staff.

David tried to walk off the ward and was sectioned. At first he was frightened by the strange…

Age at interview 40

Gender Male

Age at diagnosis 18

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Dolly was on a mixed ward where some men wanted sexual favours from the women.

Age at interview 39

Gender Female

Age at diagnosis 22

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Several people talked about psychiatric wards in negative ways, e.g. as being dirty, noisy, frightening and chaotic, with some staff who did not seem to talk to the patients. Graham talked about seeing simple indignities, such as an old man who was admitted and didn’t have a belt, so had to hold his trousers up. Others found day-to-day life in hospital boring and didn’t like the food and the general conditions.

André had an unpleasant experience of staff and the diet available in a secure unit he was in.

Age at interview 29

Gender Male

Age at diagnosis 23

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Andrew was in a county asylum in the 1970s and would have found life bearable, even though…

Age at interview 59

Gender Male

Age at diagnosis 24

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However people also mentioned positive things about being in hospital. For example, people made good friends whilst there. Some people said they got help from understanding and kind staff. Graham said that when he had slashed his wrists a nurse was wonderful and looked after him, and Janey said that she got hugs from the staff she knew in hospital. She also said that good care was when they knew her ‘as a person’ rather than a patient. Rachel said that she had a good psychiatrist with whom she could discuss her psychosis rather than just being involved in a ‘hoo haa’ about whether she would take her medication, whilst another man spoke about doing art work that he enjoyed while in hospital.

When Janey was first admitted she used to be bored, but now she brings a book, a pad and pencil…

Age at interview 52

Gender Female

Age at diagnosis 29

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Many people we spoke to were now treated at home, by Community Mental Health Teams or Early Intervention Teams or Home Treatment Teams, instead of going into hospital. You can read more about these, and the transition from hospital to home, in the ‘Experiences of Outpatient and community services’ section or in the ‘Resources’ section.

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