Dementia Support Line
Sections of the Mental Health Act for people with dementia
Some sections of the Mental Health Act may be relevant to people with dementia and their carers.
- The Mental Health Act 1983
- You are here: Sections of the Mental Health Act for people with dementia
- The key roles in the Mental Health Act
- Safeguards and challenges to a detention under the Act
- How to support a person with dementia who has been detained under the Mental Health Act
- Guardianship
- Lasting powers of attorney and deputies
- Deprivation of Liberty Safeguards and the Mental Capacity Act 2005
The Mental Health Act 1983 and guardianship
What does sectioning mean?
The Mental Health Act has over 100 parts, which are known as ‘sections’. Some sections allow people to be detained, so they can be assessed and/or treated against their will. This would be on a mental health ward in a hospital or in a specialist mental health hospital.
This is where the term ‘sectioned’ comes from. Although this term is commonly used, it is not used in the Act.
Section 2 – detention for assessment in hospital
Section 2 of the Act allows a person to be detained in hospital to have their mental health assessed.
This can happen if the person:
- refuses to agree to being assessed voluntarily or
- is likely to change their mind about going into hospital or
- doesn’t have the mental capacity to give ‘informed consent’ – this means they are not able to understand all the relevant information to agree to be assessed.
A person can only be detained for assessment if that is necessary to prevent harm to themselves or others. For example, a person with dementia may be detained under section 2 if they are seriously neglecting themselves. Or they may be detained if they are behaving in ways that challenge, such as being aggressive.
How long can you be detained under section 2?
A person would usually be admitted under section 2 initially, where they can only be detained for a maximum of 28 days for assessment. They can be discharged sooner, if that is appropriate.
Often, however, the person will move onto section 3. Section 2 also allows for a person to be given appropriate treatment, such as medication, whilst they are being assessed.
The key roles of the Mental Health Act
Learn more about key roles in the Mental Health Act, including ‘nearest relative’.
Section 3 – detention for treatment in hospital
Section 3 of the Act allows for someone to be detained in hospital for treatment. This could apply to someone who has already been detained under section 2 and who then needs to be treated for longer. It can also be used immediately if the relevant criteria are met.
How long can you be detained under Section 3?
Section 3 of the Act allows for a person to be detained for up to six months to begin with. After this, the period of detention may be renewed for another six months, and then for a year at a time. Having these regular reviews in place is to ensure that people don’t stay in hospital longer than they need to.
Sections 135 and 136 – powers of the police
Sections 135 and 136 of the Act give certain powers to the police. These include the power to remove a person from their home or a public place to a ‘place of safety’. This could be for a mental health assessment, or a referral for treatment or care. An AMHP and a doctor should be involved in this process.
The place of safety is usually a police station or a hospital. This might be used if, for example, the police find a person with dementia in distress in a public place and they are unable to find help for them elsewhere.
Section 117 – aftercare services
What is aftercare?
Section 117 of the Act deals with aftercare services. These are the services that a person must be given when they are discharged from detention for treatment under section 3. They are not available if someone has only been detained under section 2.
The local authority and the NHS have a joint duty to arrange aftercare services if a person needs them. This means they must find the ongoing support that the person needs.
There are many types of aftercare services. Examples include:
- providing a place to live that is suitable for the person, such as supported accommodation or a care home
- providing a package of care for the person in their own home
- providing daycare or other recreational activities.
A person with dementia who has been detained under the Act is more likely to be discharged to a residential care setting than back to their own home.
To receive aftercare, a person must have an ongoing need for support. The support must meet a need that is connected to their mental disorder. It must also reduce the risk of their mental condition getting worse and having to be readmitted to hospital.
It can take a while for an aftercare package to be arranged which may delay the person’s discharge from hospital.
What is NHS continuing healthcare?
Find out what NHS continuing healthcare is, who can get it, how to get assessed and what to do if it's not awarded.
An approved mental health professional (AMHP) and a person’s nearest relative both have the legal power to apply to have the person admitted to hospital under section 2.
However, it is very unusual for a nearest relative to do this as it is not a familiar process and it can be distressing. Instead, every local authority has a trained team of AMHPs who can help to do this role.
If someone is worried about a person with dementia and thinks they are a risk to themselves or others, they can contact the safeguarding adults team at their local council.
An AMHP can make an application under section 2 even if the nearest relative disagrees. This is different where section 3 is used.
Two doctors must agree that the person should be detained. They must follow strict legal rules. The doctors need to sign medical recommendations that say why the person needs to be detained in hospital to be assessed.
One of the doctors must have specialist experience of working with people who have a ‘mental disorder’. Some local areas may have doctors who specialise in assessing people with dementia. The second doctor should normally be someone who knows the person, such as their GP or their psychiatrist.
Once the person is in hospital they will be closely supervised. There will be significant restrictions on where they can go until they are discharged. This can be distressing both for the person and for those who care for them.