Saturday 16 March 2013

What its like being sectioned

There are many sections of the Mental Health Act that a person can be detained under. This may be my first admission to hospital, but since being here I have been held under the following sections : 5(2) (twice), 2 and 3. About a month before I was admitted, I was also detained under a 136; although this didn't lead to a hospital admission.

All these numbers!

What do they mean? And, more importantly, how does it feel?

In short, a section 5(2) is detention for a maximum of 72 hours. It can only be used to detain a patient who is already in hospital. It's a bit of an emergency measure- a useful tool for a doctor to prevent a patient from leaving the ward if they are deemed to be an immediate risk to themself or others.

A section 2 is detention in hospital for a period of up to 28 days. Importantly, this section is for assessment, which means (amongst other things) that a person cannot be compelled to accept medication unless there are extreme circumstances.

Section 3 is the 'biggie'.

Technically, being detained under section 3 means that you're detained indefinitely. The initial period  lasts for up to 6 months, but it can be renewed for a further 6 months, and then yearly after that. Another thing about a s3 is that it is for treatment. This means that you can be compelled to take medication (at least for the first 3 months) even if you don't consent. Everyone has the right to appeal against their detention, but only about 13% of appeals actually result in the section being lifted.

Obviously, a person is detained as a result of suffering from a mental illness or disorder that requires treatment that can only be accessed in hospital.  In short, the doctors have to show that you're so unwell that the only way to prevent harm to yourself or others is to restrict your freedom and autonomy. If there is a viable option that is less restrictive, then that has to be chosen instead of detention. It Is also necessary that three suitably qualified mental health professionals agree that detention is necessary, and that appropriate treatment is available.

THis is a quick (and hopefully correct) rough guide to sectioning.

How does it feel?

For me- and everyone is different- when I was held under section 3, I was relieved. Looking back, it seems to be a strange emotion to have when you've just had your liberty, autonomy and freedom of choice removed.

But I was out of control. I simply wasn't capable, at that time, of being autonomous. The depression that I was experiencing was unremitting and severe.  I didn't sleep, I couldn't concentrate, I could see no hope. And yet I didn't want to be in hospital. I wanted to be discharged, or to discharge myself, so that I could go quietly on my way, curl up in a ball, and die. Death seemed to be my only option. When life is unviable, death is the consequence. My continuing existence felt unviable. So dying felt like an entirely logical and rational next step. I even asked the consultant if he wanted me to sign a disclaimer so he wouldn't get into trouble at any inquest into my death.

Retrospectively, I can see that I was really quite ill, and because I refused to accept that I needed to be in hospital, the only option was to put me on a section. Being put on the s3 probably saved my life.

So I felt relief. I was no longer allowed to go out. Smoking was every two hours, escorted by staff. I felt safe, and 'contained'. Because of the slightly unusual circumstances of my admission, it also meant that the borough that the hospital is in took over financial responsibility for me. Previously, responsibility was with a different local authority, and a real lack of co operation between the two
areas was not  helping me to feel secure or safe. The unhelpful, and yet very real, threat of being transferred to another hospital without any notice was removed by being put on a s3. 

This gave me some desperately needed security. I suddenly felt like I had some breathing space. A place to rest and recover. A place where I could just stop. I knew I would be looked after. I knew that it was other people who held responsibility for my day to day life. And that was a huge relief. I was depressed, and I wanted to die. I planned to die. I intended to die. I didn't wash for weeks on end, ditto changing clothes. I slept on the floor and could barely understand simple instructions. It's a horrible place to be. It's bleak and lonely. It feels never ending. Existing, not living.


The irritations of being sectioned come when you feel a bit better. When I wanted to go out, and couldn't. Christmas, new year. When you don't feel suicidal, but you're still not allowed to pop to the shops and get fags. When you miss friends, family and freedom. When you don't want to be continually observed anymore. When you realise that you've got no choice. These are things that I only became aware of as I began to get better. Essentially, when you're well enough to start participating in life again, but you have to go 5 steps more slowly than you'd like. This is when ou notice the irritations and constraints of being detained.


I suppose when you're first sectioned, you're a child. Unable to make good decisions. Unable to keep yourself safe. It must be said that this 'unable' must be the direct result of an illness or disorder. So the professionals do it for you. They protect your life, and/ or the lives of others. You're told when to eat, smoke, sleep, take medication, have visitors. And in my case, when to wash, change and tidy up. When you're ill enough to be put on a s3, your mind, and your life, is in utter chaos. You have ceased to be able to make it better by yourself.

As you start to get well, you become more like a teenager. Wanting more freedom, but oh so carefully. Mistakes might happen. And they might be serious. At this point, you start to get 'leave'. This is a chance to show that you are well enough to be unsupervised in the community. You're on the mend. Still unwell- but not an immediate danger to yourself or society. From what I've seen, and experienced, this is where the bargaining starts. People 'chomp at the bit' for more say in their lives. People order take-away food instead of eating at regimented times, they smoke out of the window. A few go AWOL. Ward rounds become more demanding. You start to recognise people who are more ill that you are. For a lot of people, it seems that relationships and sex come back as desired for things. There is a world outside of mental illness.

In other words, by this point, you're ready for discharge. Now all you've got to do is convince the doctors!! (which might just send you a 'bit wonky' all over again!!)So, being sectioned isn't the end of the world. It's a temporary 'holding position'. It's a chance for people to get well, especially when they don't think they want it, or need it.

9 comments:

  1. Being told you are ill and need to be in hospital for a period of months not weeks is awful. I remember when I was first sectioned getting used to the regieme of it all was awful. And being on 24hour obs. Even when you didn't feel suicidal or like self harming and you have someone still watching you, it's awful!

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  2. I've found it to be awful at times too. There were a few days when I was on 2:1- and that level of observation was not nice. But, overall, I've found it necessary and I'm glad it happened now.

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  3. Perhaps it is strange that I felt relief. But I was desperate and out of control, and I didn't know what was going on really. Being told what to do, and being forced to stay safe and alive was just a relief at the time. Odd, I know.

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  4. It probably makes a difference that I'd already been in hospital for 4 and a half months by the time I was sectioned properly. It wasn't a shock.

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  5. This was a really good blog post. Very insightful and interesting to read. I have been sectioned before too, section 2. It was awful for me and I hated every minute of it. I didn't agree with it and it made me worse tbh. I hope your experiences have been better.

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  6. I am quite shocked at all these positive comments about being sectioned. I was nearly sectioned yesterday, despite trying very hard to address my complex issues. Having your liberty taken away when you are no danger to anyone but yourself, is barbaric. I will fight them all the way, I have sworn that if they section me, I will not come out alive. I may be a worthless piece of Sxxt, but I keep my word. I hate them so much as all they do is tick boxes.I am beginning to like the world, to understand my issues with sexuality and recently diagnosed bipolar, but now they want to lock me up. I hate them all so much it hurts to feel such a degree of hatred.

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  7. I remember when I was sectioned. It was horrific it made me feel even worse not better ! I remember on my first morning being there in the hospital. I was woken up at 7;am in the morning and One of the female nurses told me I had to go and see one of the male psychiatrists there. I wasn't' even allowed to get dressed first or put any shoes or socks at the very least. So I had to walk down to this psychiatrist bare footed and wearing my pyjamas. The psychiatrist spoke to me anyway and had a real go at me saying how did you end up in a place like this? Then after this psychiatrist had finished talking to me the nurse said to me that wasn't that bad was it. I mean was she kidding?! Another male psychiatrist in this hospital also had a go at me one day while I was in floods of tears. And a other day I had to have my blood taken and they were having trouble doing it. So a couple of the doctors took turns trying to do it and then this women walked into the room and said to me angrily I'm not gonna do it for you then she stormed out.

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  8. I couldn't' wait for it to be over and its not as though I was enjoying it either. I was offered no real help in this place apart form being fed pills all day. I was assigned my own nurse and she treated me ok. But over all I felt the nurses and the psychiatrists in this hospital weren't very understanding or compassionate. I think they were very judgemental as well. Is it normal to be treated like this in a psychiatric hospital? At least I only had a very short stay I was only in there 3 days.

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  9. This is very insightful.

    I've been begging for help with my issues for a while now, things that my regular Docs can't help with but I can't even see a psychiatrist.

    I honestly feel the only way I can even talk to someone is to "play" them and intentionally get myself sectioned; I'm not suicidal but they don't know that.

    Heck even if they just shove pills down me at least I can be numbed from reality, then they can just lock me away like societies dirty secret and forget I exist as a human being.

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