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Patients and carers

In hospital under section

Patients and carers

In hospital under section

Patients and carers

In hospital under section

Patients and carers

In hospital under section


If you are in hospital under a section of the Mental Health Act, a nurse should have given you a rights leaflet and explained what your section means.

Anyone in hospital under section has the right to free and confidential support from an independent mental health advocate.

Sometimes your section can be changed. You should always know which section you are on. Ask a nurse if you are not sure.

These are the main sections of the Mental Health Act that are used to keep people in hospital.

Emergency section – Section 4

Section 4 is used when an approved mental health professional is very concerned about your mental health and needs to act quickly so they can keep you, or others, safe.

Only one doctor is needed for a section 4. It lasts up to 72 hours and it might be followed by a section 2 or section 3.

Assessment and treatment section – Section 2

Section 2 is used to allow time to assess your mental health, and decide what treatment might help.

Two doctors and an approved mental health professional need to agree before someone is put on section 2. It lasts up to 28 days.

A senior doctor or consultant, also known as a “responsible clinician”, will be in charge of your care.


Treatment section - Section 3

Section 3 allows time for treatment to improve your mental health. Two doctors and an approved mental health professional need to agree before anyone is treated under section 3.

To start with, a section 3 lasts up to six months. If it is extended, the first extension lasts up to another six months. Any further extensions last up to a year.

A senior doctor or consultant, also known as a “responsible clinician”, will be in charge of your care.

After three months under section, if you do not want to take medication (or you are too unwell to decide) a second opinion appointed doctor (SOAD) will visit you on the ward.

These are independent doctors who check your views and wishes have been taken into account, and make sure your treatment is appropriate.

SOADs are appointed by the Care Quality Commission

Holding sections – Sections 5(2) and 5(4)

If you are a voluntary or informal patient and there are serious concerns about your safety a holding section might be used to keep you in hospital.

A doctor can use section 5(2) to detain you for up to 72 hours while you are assessed for a section 2 or 3.

If a doctor is not available, a nurse can use section 5(4) to detain you for up to six hours. It ends when a doctor sees you.

Section 136

Some people are brought to hospital under a section 136. This is a power which a police officer can use if you were in a public place and they had concerns about your mental health.

Time off the ward - section 17

If you are in hospital under section, time off the ward needs to be agreed by your responsible clinician. This is called section 17 leave.

If you are given leave, you will be told how much you have, and if you need a nurse or someone else to go with you when you leave the ward (escorted leave).

If you do not follow these conditions, for example you do not return by an agreed time, the police may be asked to bring you back to hospital.

Nearest relative

The Mental Health Act gives rights to a patient's “nearest relative”. This could be your partner (if you have one) or a family member.

If you are unhappy with your nearest relative, or you do not want them to know about your care and treatment, please tell someone in the team looking after you.

Leaving hospital

You can leave hospital, or be “discharged”, in four ways:
  1. Your section ends, usually because it is ended by your responsible clinician, and you are well enough to leave. If you were on section 3, you have the right to aftercare (known as section 117 aftercare) to help you meet your needs in the community.
  2. You are on section 3 and your responsible clinician thinks you are well enough to leave hospital under a community treatment order (CTO).
  3. You appeal against your section and either the Mental Health Tribunal or the Associate Hospital Managers agree that you are well enough to leave hospital.
  4. Your nearest relative writes to the trust asking that you be discharged, and they agree that you are well enough to leave hospital.

Patients sometimes choose to stay after their section has ended as a voluntary patient until they feel well enough to leave.

There are separate sections for people who come to hospital from court or prison.