What does it mean if someone is sectioned?

The term ‘sectioned’ is generally used to refer to someone who is being detained under the Mental Health Act [1].

“The Mental Health Act is the law which can allow someone to be admitted, detained (or kept) and treated in hospital against their wishes.” [1].

Being sectioned is often extremely distressing for the person, but also for their family and friends.

Why do people get sectioned?

The Mental Health Act is only ever considered when a person is extremely unwell. There is certain criteria that has to be met in order for someone to be sectioned.

“This criteria is that someone has to be suffering from a mental disorder of a nature or degree which warrants your detention in a hospital for assessment or treatment and that you ought to be detained in the interests of your own health, your own safety or with a view to the protection of others. (Mental disorder is a broad term that includes conditions like schizophrenia, depression, bipolar disorder or personality disorder).“

When someone is sectioned and detained under the Mental Health Act they may be treated against their will, this is because “it is felt you do not have sufficient capacity to make an informed decision about your treatment at the time. This is also the case if you refuse treatment but the team treating you believe you should have it” [2].

For more information about the Mental Health Act, please see the links at the bottom of the page.

My Story

When I was about 13 or 14 I started to struggle in school, not so much with the actual work but with concentrating and controlling my temper. After months and months of getting into trouble (I was suspended numerous times every term) I was assessed and diagnosed with ADHD.

At first I didn’t think it was real. A lot of people believe that ADHD is just an excuse for bad or attention seeking behaviour. This is not what ADHD is.

What is ADHD?

“Attention deficit hyperactivity disorder (ADHD) is a behavioural disorder that includes symptoms such as inattentiveness, hyperactivity and impulsiveness.” [3].

“…many adults who were diagnosed with the condition at a young age continue to experience problems.” [3]

Some people with ADHD also have additional problems including sleep and anxiety disorders. Conditions related to ADHD include personality disorders and OCD.

After a short period of time I was diagnosed with OCD. This was a real shock to both me and my family.

What is OCD?

Obsessive Compulsive Disorder (OCD) is a common mental health condition that affects both men and women, even children. It can develop at any age. It is characterized by obsessive thoughts and compulsive behaviours.

What is an obsession?

An obsession is an unwanted or an unpleasant thought. It is a “though, image or urge that repeatedly enters your mind, causing feelings of anxiety disgust or unease” [4].

What is a compulsion?

A compulsion “is a repetitive behaviour or mental act that” someone feels they need “to carry out to try to temporarily relieve the unpleasant feelings brought on by obsessive thought” [4].

I was prescribed medication to help with the ADHD and a course of CBT (cognitive-behavioural therapy). The medication did help me to feel more settled and to concentrate, and to my amazement other people saw a difference straight away.

Although I was happy to continue taking the medication I had to learn to manage the side effects – all medication has the potential to cause various side effects. For me the only side effect was a reduced appetite. I would often forget to eat and even when I did remember to eat I would really struggle to eat a proper sized portion. I have had to train my body to eat at set times even when I don’t feel hungry. Now I tend to eat little but often, so small portions about 4 – 5 times a day, this way I am able to ensure that my body gets all the nutrients and stuff that it needs.

Fast forward a few years………

So fast forward a few years to my first year at university, this was when I first started to experience anxiety and a low mood. I would be sitting in a lecture and I would get this sudden sense of panic – I would panic that I was missing something or that I had forgotten something. I was able to recognise that I was struggling and after about a month I went to the counselling services on the university campus. After a few sessions I was able to continue with my studies.

I did my first year of university away from home but to a change in family circumstances I took a year out and then did my second and third year of university near home. Moving back home was never part of the plan but I wouldn’t change it for the world.

It was in my last year of university when I was first taken to hospital due to concerns about my mental health. I had self-harmed and one of my lecturers noticed and quickly got me to the universities health services who then called an ambulance.

I was at the hospital for about 4 or 5 hours, I was discharged with a referral to the crisis team.

It was the final year that my mental health really took a turn for the worse.

For months I had been struggling with a really low mood, and I started to hear voices. At first the voices sounded more like a radio chat show being played in the background but over time the voices started to become more sinister, they would demand that I do things and would criticize everything I did.

I took myself to A&E and asked for help – I didn’t know what else to do. After talking to numerous doctors and nurses I agreed to go to a mental health ward voluntarily. I was there a week, during that time I was attacked twice and restrained several times.

It was just over a week later, when I was at a GP appointment that my GP noticed that something wasn’t right. She called an ambulance and after a lot of persuasion I was taken to A&E. I was there for about an hour and after trying to leave I was sectioned.

Initially I was sectioned under Section 4 of the Mental Health Act,

“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.” [6]

Under Section 4 of the Mental Health Act you can be detained for up to 72 hours. During this time a second doctor should assess you as soon as possible, doctors will then decide if the section should be changed to a Section 2. The AMHP (approved mental health professional) doesn’t need to make a new application to change the section 4 to a section 2. [6].

About 24 hours later I was moved to a psychiatric hospital and was told that I was now being detained under section 2 of the Mental Health Act. I was on this ward for about 4 days before being transferred to a different ward. I was transferred to Eileen Skellen 1, although I don’t really remember moving to this ward I do remember being on this ward.

“Eileen Skellern 1 (ES1) is an 8-bed psychiatric intensive care ward at the Maudsley Hospital. We provide secure psychiatric and intensive hospital care for people who have severe and ongoing mental illnesses whose behaviour makes them unsafe, either to themselves or others, and who cannot be treated in an open ward. Our team includes health and social care staff from a range of professions. We provide assessment, treatment and intensive nursing care.” [7].

I was on ES1 for about 3 months, and to be honest with you I don’t remember most of my time there. So it is really hard for me tell you that much about it. (if and when I remember any more I will write about it then).

During the 3 months I was on ES1 I was placed on section 3 of the Mental Health Act.

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

“To start with, you can be detained for up to 6 months. 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.” [6].

After the 3 months on ES1 I was transferred to an acute ward. I spent about 4 months on this ward. It was a really dark time and I still don’t really feel confident in talking about my time there, but I am hoping that I will do soon. When I do I am sure I will write about it.

It was a year ago today that I was finally discharged and it has been a tough year. I am so happy to say that I feel like I am on the right path and although I still have a lot of healing to do everyday feels like a step in the right direction.