Understanding Detention or ‘Sectioning’ under the Mental Health (Northern Ireland) Order 1986
Admission to hospital for treatment
A situation may arise where someone close to you experiences an episode where their symptoms are of such severity that an in-patient admission to a psychiatric hospital may need to be considered. Where possible, try to speak to your loved one and check what they want to happen with the best outcome being that they agree to become a voluntary patient. In this case, your first point of contact could be a GP or, if your loved one is known to secondary mental health services, their key worker (e.g. CPN).
If a person is not willing to go to hospital voluntarily, you should contact social services / and or the person’s GP.It is legal for the relevant health and social care trust to arrange for them to be admitted to hospital for a period of assessment to a psychiatric hospital against their will. The legislation relating to this is contained within the Mental Health (Northern Ireland) Order 1986, and is known as a ‘detention order’. The person will then become an involuntary or ‘formal’ patient.
About the Mental Health (Northern Ireland) Order 1986 and detention for assessment
You may have heard of ‘sections’. This refers to a section of the Mental Health Order. These allow certain mental health care professionals to make assessments and admit people compulsorily to hospital, where they are thought to be a risk to themselves or others, or in danger of serious deterioration if compulsory intervention is not under taken. This legislation sets out a framework for the care, treatment and protection of mentally disordered individuals.
If a person meets the detention criteria, they can be detained for an assessment period, which can last for up to 14 days. This is to determine if the person is suffering from a mental disorder that requires treatment in hospital.
It is vital to note that however we look it, detention under the order does deprive a person of their fundamental human right, namely their freedom.
How the application for detention works
The application for assessment can be made by an Approved Social Worker (ASW) or the person’s nearest relative* and must be backed up by recommendations from two doctors, one of whom must be a psychiatrist.(*Note: A relative does not need to sign this form unless they wish too. The ASW must inform the relative (next of kin) that the ‘Detention Order’ or ‘section’, is being put in place, but relative does not need to sign on the grounds that it may damage their relationship in the future.)
Following an initial period of assessment, the person may be offered voluntary treatment, discharge or if necessary, may be detained for treatment for up to a further six months.An excellent way of understanding how the detention process works is to look at the GAIN flowchart outlining the different stages of detention.For more information on who is considered a ‘nearest relative’ and their role and rights in the detention process, please click on these links below:
Appealing compulsory detention – the role of the Mental Health Review Tribunal
A patient detained under the Mental Health (Northern Ireland) Order 1986 and their nearest relative can apply to the Mental Health Review Tribunal to have their detention considered if this is justified. For more information on the Mental Health Review Tribunal, please click on this link below to the Northern Ireland Courts and Tribunal Service.
New legislation in Northern Ireland to replace the current Mental Health (Northern Ireland) Order, 1986.
Currently, there is work on a new single bill progressing through our legislative process here in Northern Ireland which will ultimately replace the Mental Health (Northern Ireland) Order, 1986. The Bamford Review recommended the introduction of a single legislative framework for the reform of existing mental health legislation and the introduction of mental capacity legislation for Northern Ireland to include the enhancement of protections for those unable to make decisions and the embedding within the legislation of principles designed to protect the human rights of those with mental illness or a learning disability.
The proposed The Northern Ireland Mental Capacity (Health, Welfare, and Finance) Bill is the first joint Bill to be introduced to the Northern Ireland Assembly, and was developed in part from the recommendations of the Bamford Review. It seeks to adopt progressive proposals to protect the rights of people with disabilities, when making personal healthcare, financial or legal decisions.
If approved, Northern Ireland will become one of the first areas in Europe to introduce a Human Rights based approach to legislation governing this area; ensuring those with disabilities have as much involvement as possible in critical decisions affecting their lives.
See additional information on this from Disability Action.