There are many different reasons why a person might need - or want - to stay in hospital to get help for their mental health. It may seem like a scary thing to do, but for many people it is a key step in their recovery.
The important thing to remember is that while your journey is unique, you are not alone.
Here we answer questions you may have about going into inpatient care, what ‘being sectioned’ means, and what your rights are.
Inpatient care may seem daunting, but it’s an important step in getting back the more manageable life you deserve. It will be tough, but you’ll have lots of support from both specialists and peers to help you along the way. You can do this!
What are my freedoms and rights?
Being ‘sectioned’ means that you have to go into hospital so that you can get the urgent treatment you need to help you get better. This happens when a team of mental health professionals (usually including two doctors) have looked at all your options and decided that hospital is the best place for you to be. According to the law, you have to go into hospital even if you do not want to or you disagree with the doctors’ decision. This is also known as being ‘detained’.
You will only be sectioned if doctors think you are very unwell. They might be worried that your behaviour is dangerous to yourself or might be dangerous for others around you, even if you do not intend it to be.
The Mental Health Act 1983 is the law that gives mental health professionals the ability to ‘section’ someone. It also sets out the different types of ‘sectioning’ and your rights as a patient.
Tip: You can ask to speak to your Independent Mental Health Advocate to help you understand your rights while you are in hospital. Look out for a poster on your ward, or ask a nurse for more information.
You and your doctor might agree that it is a good idea for you to go into hospital without the need for you to be ‘sectioned’. If this happens, you will be known as an ‘informal patient’. As an informal patient, you will be expected to take part in your treatment plan, but you do have the right to refuse any treatment you do not want. You can also leave the hospital when you want.
If you want to leave but mental health professionals think that you are too unwell to do so, they may consider whether to keep you in hospital under section.
Tip: If you are an informal patient, no one is allowed to threaten you with being detained to force you to stay in hospital against your will, according to the Mental Health Act Code of Practice.
It may not be possible to challenge the health professionals' opinion while you are being sectioned. The decision to section someone is never taken lightly, but here are some possible ways you can get discharged once you are in hospital:
- Ask your hospital managers to consider discharging you.
- Ask your responsible clinician to discharge you.
- Ask your nearest relative to discharge you.
- Apply to the Mental Health Tribunal to be discharged.
This is a special type of court, which deals with mental health cases. They will read reports written by your care team and hear your views. Then they will decide if you can go home or not.
Tip: If you do not think you should be in hospital, talk to a member of your care team or the hospital manager. You can also speak to an Independent Mental Health Advocate who can tell you what your options are - look out for a poster on your ward, or ask a nurse for more information.
Download our guide to Mental Health Tribunals for more information.
You will stay in hospital for the length of time needed to allow you to get well enough to go home. The amount of time you spend in hospital will depend on your individual circumstances.
There are different types of section with different rules about how long you need to stay. Some people stay for a few days, while others can be in hospital for much longer. The two most common ‘sections’ are section 2, which means you can be detained for up to 28 days, and section 3, which means you can be detained for a maximum of six months. This can be extended if doctors think you are still too unwell to go home.
Each hospital will have rules on what you can and cannot do during your stay. These will include things to protect your safety and wellbeing, and the safety and wellbeing of those around you.
If you are not following the rules and expectations of the hospital, staff are likely to speak with you about your behaviour and find out why you are struggling. They should try to work with you to find a solution. But if you are risking your own health and safety, or the health and safety of anyone around you, they may have to remove you from the ward you are on and place you in another unit.
Every unit should have a confidentiality policy outlining what information about you can be kept confidential, and when confidentiality can be broken. Things that you say may be logged and shared by staff to help them support you. What information is shared, and with whom, may depend on your age, support needs and risk level.
You are entitled to know what information will be shared and with whom, and for your opinion to be taken into account in decisions about whether or not to share your information.
There are laws on data protection that your unit has to follow. Your information should be kept safe if it is stored online.
Having been to a Mental Health Tribunal, some advice I would give on how to prepare is to make sure you genuinely feel like you have a solid case behind you, and that you and those around you genuinely feel that it’s the right decision.
What about my things, my friends and my family?
It’s a good idea to bring comfortable clothes and something to read in with you. Think carefully before taking in anything valuable, and avoid taking in anything you wouldn’t want to get broken or lost.
Different units have different rules on what you are and are not allowed to bring with you. In many cases you will not be able to bring anything you could use to harm yourself with, or that someone else on your ward might try to harm themselves with.
Your hospital ward will have a policy on mobile phones and devices – in some places these are not allowed. You should tell staff about any electrical items you have to make sure you are allowed to bring them in. Sometimes electrical items may need to be safety tested.
Alcohol is not allowed in hospital. Some higher security wards have restrictions on alcoholic mouthwash, aerosols, glass containers, perfume, aftershave, dental floss and nail varnish remover.
Here are some things you could think about taking in, or asking someone to bring you:
- comfy clothes
- socks and underwear
- notebook or journal (not wirebound)
- colouring book
- playing cards
- wireless headphones
- sports clothes in case there are any opportunities for you to get active
- sleep mask
- ear plugs
- puzzle book
- your favourite cuddly toy
- blanket and pillow
- textbooks for school
Tip: If you go into hospital in an emergency, you might not have time to think about taking things in with you. If you don't take all the things you need, you could ask someone to bring things in for you.
Yes, you will be allowed visitors. Generally there will be allocated visiting times in which your friends and family can come and see you on the unit. They may be able to take you out during these times depending on whether your hospital agrees that this is a good idea for you.
Don’t forget, you will not be alone. You will be in a unit with other young people who are also struggling with their mental health, and while you might sometimes find this difficult, you are likely to make new friends and take part in group activities.
Most units have a general timetable that will show you what activities are happening and when. Usually, within the first few days of being in hospital, a member of staff will meet with you to talk through how the timetable will apply to you. They will also talk through your personal treatment plan, which may include individual and group therapy tailored to your needs.
The amount of access you have to the internet and TV depends on the type of unit you are in. You might be in a unit where your care team is trying to keep your stimulation to a minimum so you can focus on recovery and this might mean no internet or TV access.
Even if you are not allowed your mobile phone, units often have alternative phones you can use. Your unit should have a policy on phone use that makes it clear whether and when mobile phones can be used, and what your alternatives are.
Your doctor can allow you to leave your unit for a specified time period. This could range from a few hours up to a few days, depending on how well you are and whether the doctor feels you would benefit from spending some time away from the unit. If you are under a section, permission must be given in writing, and can only be given by the doctor in charge of your care. This is often referred to as ‘section 17 leave’.
Your doctor might attach special conditions to your leave. For example, you might have to be accompanied by hospital staff or family, or you might only be allowed to go to certain places.
I never thought I would gain friends from being in a hospital. I still talk to them a few years on, and because we lived with each other at our worst, it’s become a very strong relationship of sharing problems and understanding each other.
What care and support will I get?
Your care will involve lots of people. On the unit, nurses will look after your day-to-day needs and you will have meetings with specialist doctors and other mental health professionals. Take a look at our glossary to learn more about who’s who.
Your treatment will be based on your individual needs and might include things like:
- cognitive behavioural therapy (CBT)
- group therapy
- group activities
- occupational therapy
- family therapy
- many other types of therapy based what works for you, like art or drama activities
Staff at your unit will try to make you feel as included as possible in decisions about your care and treatment. Any decision about your treatment and care should be made in your best interests, and you should be kept informed of your treatment plan (often referred to as a care plan) and any changes to your care at every stage.
Your opinion matters. Your voice is important. You have the right to express yourself and to be listened to properly. Where it is possible, your treatment should be discussed with you and your views should be heard before anyone can decide whether you should have a particular treatment. This does not mean that your care team have to agree with you, but they should consider your views.
Your progress and care plan should be reviewed regularly, so that you and your team can decide whether there need to be any changes to your treatment.
Tip: Only you know how you are feeling, so do not be afraid to speak up and let people know what you think would be best for you. It is really important to ask questions if you have any. This will help you make decisions and can make you feel clearer and calmer about what is going on around you.
Not everyone finds it easy to speak their mind. Here are some things which can really help:
- Write things down. Keep a record of things people say about your treatment. That way you don’t have to remember it all and you can refer back to it if you need to.
- Plan what you are going to say, and write yourself some notes or bullet points. It might also help to think about how the person you are going to speak to might respond to what you have to say.
- Take someone else into meetings with you for moral support whenever this is possible.
- Talk to someone you trust, like a parent or guardian, and ask them to speak up for you.
- You have the right to request support from an independent advocate while in hospital. They can be helpful to speak to about your rights and what to expect from your time in hospital. They can also support you in meetings to help you to express your views should you need them to.
If you are receiving treatment before you go into hospital, it might be possible to keep a particular professional involved in your treatment. But it is likely that the people treating you in hospital will be a whole new team to the people you were seeing before, and this will almost certainly be the case if you are in a hospital away from your local area. While this can feel daunting, remember your new team really wants to help you get better and involve you in decisions about your care and treatment. Your new team will also have been sent notes about your situation from the professionals who were already working with you.
When it comes to looking at discharging you from hospital, it is likely the professionals you were seeing as an outpatient will be involved in looking at how you can be supported again once you leave hospital.
What about school?
While you are in hospital, you should have access to education that is suitable and right for you. Your unit will provide educational support according to the national curriculum. Hospital staff will speak to your school or previous education provider to find out what your educational needs are, and what work you will need to do to continue your educational progress.
If you are well enough, you will be allowed to sit your exams. Colleges will have a policy in place and can let you take a year out if you need to.
When you are leaving hospital, you will also get help finding your way back into education if this is something you want to do.
What happens when you leave hospital?
Being 'discharged' is the term used to describe you leaving hospital.
This can raise many different feelings for you and your family. Although it is generally a positive thing when doctors think you are well enough to go home, it is normal for you to have some worries around how you will cope once you are discharged, and how these risks will be managed when you are at home.
Before being discharged, a Discharge Care Programme Approach (CPA) meeting will be arranged outlining the plans for how you will be cared for in the community. It is very important that you and your family know who the main point of contact (generally referred to as a keyworker) will be in the mental health service you are being discharged to (usually CAMHS or AMHS). It is also important to know who your main contact is for any other services involved, such as a social worker, or Early intervention Support worker.
It is advisable to get dates for your first appointment with the mental health team you are discharged to in these meetings, so that you know what support will be available to you in continuing your recovery after discharge.
Your parent or guardian should be told who to contact if they have any concerns about your progress or who to contact in a crisis.
It may also be helpful for you to have a joint meeting with your parent(s)/carer(s) and your keyworker shortly before discharge to look at what was and wasn’t helpful during your time in hospital, and how you can be supported at home.
As well as community-based services involved with your treatment outside of the unit, it can also be comforting to know other services exist that you can contact if you want to speak to someone not already involved in your care, or hear other experiences. Have a look at the list of services and helplines at the bottom of the page.
Real stories and tips from young people on inpatient care
Complaints and how to make them
If you feel you have been treated unfairly by a member of NHS staff, whether that's in an inpatient ward, in CAMHS or in your GP surgery, you are entitled to make a complaint. To make a complaint about treatment in the NHS, follow these steps.
- If you're unhappy with how your treatment is going but you don't want to make a formal complaint, speak to the clinician treating you, or contact your local PALS (patient advice liaison service) at your hospital for confidential advice and support.
- Check the complaints process. Every NHS organisation has its own process, but they must all follow the same NHS rules. If you can't see the complaints process online, call or email the complaints department.
- Find out who to complain to. It will either be the service you used, or the commissioning group who paid for the service. The gov.uk website can help you find out where to send your complaint.
- Send your complaint and wait for a response. Your complaint should be acknowledged within three days, with details of what happens next.
- Need to take it further? If you're not happy with the results of your complaint, you can contact the Parliamentary and Health Service Ombudsman.
If none of this works, you can write to your MP who can complain on your behalf.
Advocacy and support
Advocates are trained support workers who are not connected to your treatment in any way. They listen to your concerns and help you understand your rights.
Advocates can support you to make decisions about your care, or can act in your best interest if you don't feel up to it.
You can find organisations that can help you make a complaint about health services via the Citizens Advice Bureau.
You're entitled to support from an independent advocate when you complain about an NHS service. To find out about complaints advocacy in your area, contact your local council (you can find your local council on the gov.uk website).
If you're in hospital for a mental health condition, you may be entitled to help from an independent mental health advocate (IMHA). They are trained to listen and advise you. Ask the hospital staff for more details.
Advocates also work privately and through charities, so if you're not eligible for an IMHA, other options are available.
With thanks to Ellern Mede and the Coborn Centre for Adolescent Mental Health