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Complaining about NHS mental health services - detained (sectioned) patients

This advice applies to England

This page tells you how to raise concerns if you’re a detained patient being treated under the Mental Health Act 1983.

What is a detained patient?

If you’re admitted to hospital compulsorily, without giving your consent, under the Mental Health Act 1983, you’re called a detained patient or sometimes a sectioned patient.

If you’re a detained patient, the rules about what can happen in hospital can be different to the rules about people admitted informally. For example:

  • detained patients can be examined and given medication for their mental health problem without their consent during an initial three-month period (although your consent should still be obtained as a matter of good practice before you’re given any medication)
  • a detained patient can’t leave hospital without the permission of their doctor. If you do leave the hospital, you’re considered to be 'absent without leave' and you can be returned to the hospital by a police officer or mental health professional.

If you don’t think that you should be a detained patient, there is a procedure that you can use to appeal against this. You can’t use the normal NHS complaints procedure.

Examples of things you can complain about

Even if you’re a detained patient, you can make a complaint if you’re not happy with your care and treatment. Here are just some examples of things you can complain about but remember there may be other things that aren’t in this list:

  • the same rules and restrictions are applied to everyone, whether or not they are needed in an individual case. This would include not allowing anyone access to the internet or phones, no outdoor access or rigid visiting times applied to everyone
  • unsuitable care plans
  • the same care plan is used for everyone
  • the lack of patient involvement and consultation in their treatment
  • the use of unsuitable restraint. There are government guidelines about the use of restraint
  • being sent to a hospital far away from home or being put in unsuitable accommodation
  • the withholding of mail in high security hospitals - there’s a right to appeal to the Care Quality Commission about this, which could be a possible breach of human rights law
  • inadequate planning for what should happen after your discharge
  • unsuitable aftercare
  • lack of information available to the carer of a detained patient.

The police are involved

If the police have been involved in your detention, for example, if they have taken you to the police station as a place of safety, you have rights in this situation. For example, you have the right to legal advice, and to get treatment from a healthcare professional. Also the police or hospital must tell someone where you are.

If you’re not happy with the way the police have treated you, you could make a complaint about the police. You can’t use the NHS complaints procedure in these situations.

How to complain about NHS care and treatment

Depending on what happened and what you want to achieve, you may have different options about how to raise your concerns. For example, you could:

  • use the NHS complaints procedure in the normal way, even if you’re a detained patient - see below. But remember this can’t be used to challenge your compulsory detention in hospital
  • take legal action, for example, for clinical negligence
  • report the problem to the Care Quality Commission, once you’ve made a complaint to the hospital - see below
  • report concerns about a professional to their regulatory body. For example, if you think a nurse is behaving unprofessionally, you could report them to the Nursing and Midwifery Council.

The NHS complaints procedure

If you are, or were, detained in hospital under the Mental Health Act 1983, and you have a complaint about something that happened during this time, you should first ask the managers of your hospital to investigate the complaint for you. You should also be informed of your right to complain to the Care Quality Commission (CQC) if you aren’t happy with the hospitals response.

Write or speak to the Complaints Officer at the hospital you are in, or were discharged from, or ask somebody to do this on your behalf.

The hospital managers will try to sort out your complaint. They will let you know what they found and tell you about any action that they plan to take to put things right.

If you aren’t happy  with the hospital’s response, you can ask CQC to investigate if the problem is to do with your care and treatment under the Mental Health Act - see below. If it isn’t to do with your care and treatment under the Mental Health Act 1983, you can complain to the Parliamentary and Health Ombudsman. Both these organisations share details of complaints so don’t worry if you’re not sure which organisation you need to complain to. Also you could get support to help you choose, for example, from an Independent Mental Health Advocate -see below.

The Care Quality Commission

The Care Quality Commission (CQC) has the power to investigate complaints about your care and treatment under the Mental Health Act 1983. For example, they can investigate complaints like:

  • your assessment for detention isn’t done in line with the law
  • you’re not allowed to have approved leave.

The CQC can’t:

  • sort out individual complaints that are about any other failure to meet government standards of quality and safety
  • arrange patient transfers
  • give medical advice
  • give legal advice
  • discharge people from hospital. You will need to use the appeals process if you’re asking to be discharged.

If your complaint is about your care and treatment under the Mental Health Act 1983, the CQC will need first to look at the results of the hospital’s own investigation into your complaint. They will carry out a detailed assessment of your complaint and the hospital’s response. If the CQC agree that the hospital has failed to sort out your complaint, they will decide whether to carry out their own investigation into the problem.

At the end of the investigation, they will send you a letter telling you what they have found out. This may include their recommendations to the hospital on what they should do to stop the same problem happening again.

If you are unhappy with the way the CQC have dealt with a complaint, you could contact the Parliamentary and Health Service Ombudsman.

Independent Mental Health Advocates

If you’re detained under the Mental Health Act 1983, you have the right to have access to an Independent Mental Health Advocate (IMHA). An IMHA is a specialist advocate who is specially trained to work to meet the needs of patients within the framework of the Mental Health Act 1983. They are commissioned by the local authority or, if in a high security hospital, by NHS England.

The role of an IMHA is to help you to get information about and understand the following things:

  • any medical treatment you’re receiving or might be given, the reasons for that treatment and the legal authority for providing the treatment
  • your rights under the Mental Health Act 1983
  • the rights which other people have in relation to you, for example, your nearest relative
  • any conditions or restrictions that you must keep to.

An IMHA may represent you or speak on your behalf, for example:

  • at Multi Disciplinary Team (MDT) meetings
  • to individual staff members on the ward
  • at a meeting to investigate a complaint you have made.

They can support you by helping you to:

  • plan or prepare what you want to say
  • think through the options available to you.

You can ask for the support of an IMHA at any time. You can also end any support you’re getting at any time. If you consent, the IMHA has a right to see any clinical or other records about:

  • your detention or treatment in hospital
  • any after-care services you're provided with.

To get hold of an IMHA, ask any member of ward staff, or look out for posters and leaflets on the ward and contact them yourself, or ask someone else to contact them for you.

Medical records

If you’re thinking of making a complaint about the medical treatment which you did or didn’t receive, you may find it helpful to obtain a copy of your medical records first. In some cases, you won’t be allowed to see these records if, for example if this would be likely to cause serious harm to you or someone else.

Get help

Depending on the circumstances, it can be difficult or distressing to make a complaint. It’s best to get help to do this. You could contact an IHMA. Also there are organisations that specialise in advice to people with mental health problems, or you could contact your local Healthwatch.

Next steps

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