Some musings on your rights when people with mental health problems come into contact with healthcare professionals and the mental health system.
Here are some examples of when you might find yourself detained against your will
- You go to A&E after having used self-harm and, after the medical stuff’s been dealt with, the A&E doctor who treated you decides they want a psych assessment done on you by the psychiatric liaison team. They put you in a side room to wait. Time passes and still no-one from psych liaison turns up. You’re hungry. You’re tired. You feel dreadful, waiting alone in that room and decide to leave. You get up to go but there’s a security guard at the door blocking your way. Can you insist they let you go? Or can they hold you there against your will?
- In this same example, what happens if the psych liaison doctor arrives but you don’t find her approach helpful so, shortly after the psychiatric assessment starts, you decide you don’t want to contine with it any more and want to leave. Can you just go? Or can the hospital staff force you to stay to complete the mental health assessment? Can they restrain you – use physical force – to prevent you from leaving?
- You’re in a bad way mentally and police find you in the town centre at midnight crying and shouting. They decide they want you to be assessed by the mental health nurse assigned to their new ‘street triage’ scheme and stick you in the police car to wait. They close the doors to the squad car and they lock automatically, meaning you can’t get out. Do you have to wait there till the street triage nurse arrives? Or can you insist they unlock the car door and let you go?
- You’re on a mental health ward voluntarily but it’s busy and chaotic and you’re not getting the sleep you need to recuperate so you decide to leave. You pack your things, go to the door and ask to be let out – only to be told by staff you cannot leave until the doctor arrives. Do you have to stay? Can you get a chair and try to smash down the door to get out? What can you do to get out of there?
The basic rule of thumb under this country’s laws is you can come and go as you please anywhere, any way, any time of the day or night – unless there’s a specific legal power to stop you from doing so. Generally speaking, only the police can hold you against your will. Even people with mental health problems are protected from arbitrary detention. We too are human beings with rights. Personal liberty is to be respected.
However, when it comes to people known or suspected of having mental health problems, there are an awful lot of other professionals who think they have the right to boss you around and stop you from leaving. Often they don’t so, if you find yourself being held against your will, you could call the police and tell them to come and rescue you! There’s all sorts of well-meaning blundering and paternalism in the name of protecting people with mental health problems from ourselves but well-meaning isn’t the same as right or legal.
Here are some thoughts on detaining people against their will when they’ve committed no crime and aren’t suspected of having done so either – legal, illegal or grey area? They are just some preliminary jottings.
- Mental Health Act
- Mental Health Act Code of Practice
- Sessay (2010) (case law interpreting the MHA)