How to Get Someone Sectioned Under the Mental Health Act

Getting someone sectioned under the Mental Health Act 1983 (which applies in England and Wales) means applying for their compulsory detention in hospital for assessment or treatment of a mental disorder, even without their consent. You cannot section someone yourself: the process requires a formal assessment coordinated by an Approved Mental Health Professional and supported by medical recommendations from doctors. What you can do is request that assessment, and there are specific legal pathways for doing so depending on your relationship to the person and the urgency of the situation.

Who Can Request an Assessment

If you are worried about someone’s mental health and believe they may need to be detained for their own safety or the safety of others, the first step is usually contacting their GP, your local community mental health team, or social services. Any of these can trigger a referral for a Mental Health Act assessment. In a crisis, calling 999 or taking the person to an accident and emergency department can also set the process in motion.

A person identified as the “nearest relative” under the Act has a specific legal power to request an assessment. The nearest relative is not simply whoever is closest emotionally; it is determined by a fixed legal hierarchy that typically starts with a spouse or civil partner, then moves through parents, children, siblings, and so on. The nearest relative can formally ask local social services to arrange a Mental Health Act assessment, and the local authority is legally obliged to consider that request. If social services refuse, they must give written reasons.

Research has consistently found that many nearest relatives feel poorly informed about these rights and powers. A study focusing on relatives’ experiences found that greater attention needs to be given by lawmakers and policymakers to supporting relatives’ understanding of their rights under the Act if the role is to function as an effective safeguard for patient rights.¹ A separate quality improvement project confirmed that nearest relatives have a statutory safeguarding role under the Act, yet existing evidence indicates many feel inadequately informed about their legal rights and responsibilities.²

What Happens During a Mental Health Act Assessment

Once a referral is made, the assessment is led by an Approved Mental Health Professional, commonly known as an AMHP. This is a specifically trained and warranted professional whose responsibility is to assess whether a person meets the criteria for compulsory detention.³ Most AMHPs are social workers, though the role was opened to other professions including nurses, occupational therapists, and psychologists following changes to the Act in 2007.

The AMHP coordinates the assessment but does not act alone. Applications for detention under the civil sections of the Act require at least one recommendation from a registered medical practitioner approved under section 12 of the Act, meaning a doctor recognized as having specialist expertise in mental disorder.⁴ In practice, the usual arrangement involves two doctors: ideally one who already knows the patient (often their GP) and one who is section 12 approved. If a doctor with prior knowledge of the patient cannot be found, both doctors should be section 12 approved.⁵

The AMHP must personally see the patient before making any application. They must also consider all the circumstances, including less restrictive alternatives to hospital admission. The assessment is not a rubber stamp: the AMHP has the legal authority to decide not to make an application even if both doctors recommend detention, if they believe it is not the most appropriate course of action.

The Main Sections Used for Compulsory Admission

There are several different “sections” of the Act under which a person can be detained, each with different purposes, durations, and requirements. The ones most commonly relevant when a family member or professional is trying to get someone assessed and admitted are Sections 2, 3, and 4.

Section 2: This allows detention for assessment, or assessment followed by treatment, for up to 28 days. It requires an application by an AMHP (or, less commonly, the nearest relative) supported by two medical recommendations. Section 2 is typically used when the person is not well known to mental health services or when the nature of their condition needs to be established.
Section 3: This allows detention for treatment for an initial period of up to six months, which can be renewed. It also requires an AMHP application and two medical recommendations. Section 3 is used when the diagnosis is already established and the treatment plan is clearer. The criteria are somewhat more stringent: treatment must be available and appropriate, and it must be necessary for the person’s health, safety, or for the protection of others.
Section 4: This is an emergency admission for assessment, lasting up to 72 hours. It requires only one medical recommendation (from any doctor, not necessarily section 12 approved) and an AMHP application. It is meant to be used only when the need is urgent and getting a second doctor’s recommendation would cause unacceptable delay. In practice, a section 4 is usually converted to a section 2 once a second medical recommendation is obtained.

These civil sections were outlined in a review of current reform proposals, which confirmed that applications for compulsory admission are usually made by an AMHP supported by the requisite medical recommendations.⁶

Emergency Situations and Police Powers

Sometimes a mental health crisis unfolds in circumstances where waiting for a standard Mental Health Act assessment is not safe. Two additional sections of the Act give the police specific powers to intervene.

Under Section 136, a police officer who finds a person in a public place and believes they are suffering from a mental disorder and are in immediate need of care or control can take that person to a place of safety, usually a designated health-based suite or, as a last resort, a hospital emergency department. The person can be held there for up to 24 hours (with a possible 12-hour extension) while a Mental Health Act assessment is arranged. No warrant is needed, because the person is already in a public place.

Section 135 is different: it applies when the person is in a private dwelling and cannot or will not leave. A magistrate can issue a warrant allowing a police officer, accompanied by an AMHP and a doctor, to enter the premises and remove the person to a place of safety for assessment.⁷ If you are a concerned family member and the person is refusing all contact with services, asking your local AMHP team or the police about a Section 135 warrant is one route available, though it can be a slow and distressing process for everyone involved.

Holding Powers Inside Hospital

If someone is already a voluntary (informal) patient in a psychiatric hospital and tries to leave when staff believe they are at risk, two holding powers exist that can prevent them from leaving while a full Mental Health Act assessment is arranged.

Section 5(2) allows the doctor in charge of a patient’s treatment (or their nominated deputy) to detain an informal inpatient for up to 72 hours. Section 5(4) gives a similar but shorter-term power to registered mental health nurses. Under Section 5(4), a nurse of the “prescribed class” can detain an informal inpatient who is already receiving treatment for a mental disorder for up to six hours, specifically to allow time for a doctor to attend.⁸

A retrospective study in one mental health trust found that Section 5(4) was used on 803 occasions over a 24-year period, averaging about 33 times per year. The vast majority of these occurred in adult acute inpatient settings.⁹ These holding powers are not something a family member initiates. They are clinical decisions made by hospital staff to prevent a deteriorating situation while the formal assessment process catches up.

Rights of the Person Being Detained

Being sectioned does not strip a person of their rights. Anyone detained under the Mental Health Act has the right to appeal their detention to the Mental Health Tribunal, an independent judicial body. However, the number of successful appeals is low, which has prompted calls for reform of the appeal system.¹⁰ The nearest relative also has the power to apply for discharge of a patient from detention, though the responsible clinician can block this by issuing a “barring certificate” if they believe the patient would be a danger to themselves or others.

People detained under the Act are also entitled to an Independent Mental Health Advocate, known as an IMHA. Advocacy services exist to promote the voice of service users, represent their interests, and support their participation in decisions about their care. Given the context of rising detention numbers and heightened awareness of the potential for neglect and abuse in mental health services, statutory advocacy serves as an important safeguard supporting human rights.¹¹ If someone you care about is sectioned, encouraging them to access an IMHA can help ensure their preferences and concerns are heard during what can feel like a disempowering process.

The Emotional Reality for Families

Research into carers’ experiences paints a complicated emotional picture. A systematic review and qualitative synthesis of carers’ experiences found that themes were remarkably consistent across time and setting. Carers described conflicting feelings of relief that the person was finally receiving care, coupled with distress about how the patient might cope and how they might respond to the family member’s involvement in the process.¹² Other recurring themes included the availability (or lack) of support for carers themselves, the extent to which carers felt involved in decision-making, and the quality of care provided to the patient.

If you are going through this, those mixed emotions are normal. Many carers describe feeling as though they have “betrayed” the person, even when they believe it was the right thing to do. Support groups, carer support workers within the hospital, and organizations like Rethink Mental Illness and Mind can provide practical advice and emotional reassurance during and after the detention period.

What Sectioning Can and Cannot Achieve

Compulsory admission is not a cure. A scoping review examining the benefits and harms of involuntary psychiatric treatment found that patients admitted involuntarily did experience greater improvements in symptoms and functioning compared to voluntary patients, but this was likely due to greater symptom severity at the point of admission rather than anything inherently superior about compulsory treatment.¹³

Longer-term effects are more nuanced. One study found that involuntary hospitalization did not worsen treatment engagement or medication adherence over time when other factors were accounted for, but former involuntary patients did continue to feel more coerced in various treatment aspects and self-rated their medication adherence lower than voluntary patients did.¹⁴ Research on younger people paints a more concerning picture: some young adults who had been involuntarily hospitalized described being so frightened by the experience that they said they would avoid seeking help in a future crisis, and warned friends against disclosing suicidal thoughts to school staff for fear of being hospitalized.¹⁵

This does not mean sectioning is the wrong decision when someone is in danger. It means that compulsory admission works best as an acute intervention to keep someone safe while stabilization begins, not as a long-term solution on its own. Families should expect that discharge planning, follow-up care, and community support will matter at least as much as what happens during the hospital stay itself.

Community Treatment Orders After Discharge

When a person has been detained under Section 3 and is ready to leave hospital, the responsible clinician can place them on a Community Treatment Order, or CTO. A CTO allows the person to live in the community while remaining subject to certain conditions, typically around medication and attendance at appointments. If those conditions are breached, or if the person’s mental health deteriorates, they can be recalled to hospital.

A three-year cohort study found that about 40% of patients on CTOs were recalled at least once, and 19% were recalled more than once. The most common reason for recall was deterioration in clinical condition, accounting for roughly half of all recalls. Around two-thirds of recalls resulted in the CTO being revoked and the person being re-detained in hospital under compulsion.¹⁶ CTOs remain controversial: supporters argue they provide a safety net that prevents full relapse, while critics point out that the evidence for their effectiveness over voluntary aftercare is thin.

Racial Disparities in Detention Rates

One of the most well-documented and troubling patterns in sectioning is the disproportionate rate at which Black people are detained. A systematic review and meta-analysis of international data found that Black Caribbean patients had roughly two and a half times the odds of being compulsorily admitted compared to white patients, and Black African patients had about twice the odds. South Asian patients also had modestly elevated odds of compulsory admission. Migrant groups were about 50% more likely to be compulsorily admitted than native-born groups.¹⁷

These numbers are not easily explained by differences in rates of mental illness. Qualitative research has explored how racism and cultural misunderstanding operate within the system: one investigation found that a patient with a strong Caribbean accent was misunderstood as aggressive, and participants described feeling that Black people were more likely to be admitted compulsorily rather than offered home treatment as an alternative.¹⁸ These disparities have been a driving force behind calls for reform of the Act, including proposals in the government’s draft Mental Health Bill to address structural inequalities.

The Mental Health Act and the Mental Capacity Act

A common source of confusion is the relationship between the Mental Health Act and the Mental Capacity Act 2005, since both deal with situations where someone cannot or will not make decisions about their treatment. The Mental Health Act applies specifically to the treatment of mental disorders, while the Mental Capacity Act has much wider applicability to any decision where a person lacks the ability to make that decision for themselves, including decisions about physical health care, finances, and living arrangements.¹⁹

A person can lack capacity to make decisions about their care and still not meet the criteria for sectioning under the Mental Health Act, and vice versa. Someone experiencing psychosis might be detainable under the Mental Health Act even if they technically retain the capacity to make some decisions. If you are navigating these issues for a family member, it helps to know that different legal frameworks may apply simultaneously and that professionals should be considering both. If the primary concern is a mental health crisis with risk to the person or others, the Mental Health Act is the relevant route. If the concern is broader incapacity affecting everyday decisions and there is no immediate risk requiring hospital detention, the Mental Capacity Act and its safeguards may be more appropriate.

Practical Steps If You Need to Act Now

If you believe someone needs to be sectioned, the practical steps depend on urgency. In a non-emergency, contact the person’s GP, their community mental health team if they have one, or your local council’s social services department and request a Mental Health Act assessment. Be specific about what you have observed: describe the behaviors, risks, and changes you have witnessed. Vague concerns about someone “not being right” are harder for professionals to act on than concrete descriptions of someone refusing food for days, expressing intent to harm themselves, or behaving in ways that put others at risk.

In an emergency where someone is at immediate risk, call 999. Police and paramedics can use Section 136 powers in public places, and hospital staff can use holding powers if the person arrives at an emergency department. If the person is barricaded in their home and refusing contact, the AMHP service can apply to a magistrate for a Section 135 warrant, though this takes time to arrange.

One thing to prepare for: the process is not fast. Even after a referral, it can take hours or sometimes days for the assessment to happen, depending on the availability of AMHPs and doctors. Weekends and bank holidays are particularly difficult. If you are the nearest relative, make sure the AMHP team knows this, as your legal standing gives your request additional weight and triggers a duty to respond. Keep records of what you have reported and to whom, in case there are delays or disagreements about the urgency of the situation.