Hospitalization and Sectioning – Autistic Adults In Crisis

Hospitalization and Sectioning

Hospitalization

In some cases your loved one may become so unwell they will need to be hospitalized. Criteria for hospitalization for a mental health crisis include intent to harm them-selves, or intent to harm a family member, deteriorating mental status, and where they need intensive support. However, getting into a mental hospital is not always easy and if your loved is reluctant or does not recognise they are in crisis measures such as sectioning may need to be sought by the family.

Sectioning

Sometimes, when a loved one becomes at risk of harming themselves or family members and they are suffering from a mental disorder or disability of the mind they may need to be sectioned or detained under the Mental Health Act. Mental health conditions such as depression, schizophrenia, anxiety disorder, obsessive-compulsive disorder, bipolar and personality disorders. Autism spectrum disorders are also included as one of these mental health conditions. Many adults suffering with mental illness may not have the capacity to make the determination that they need to go to the hospital. Therefore, it is important to know how to have a loved one sectioned if they become aggressive or a danger to themselves or others. If your loved one is to be sectioned at home, you may have to call your local NHS Crisis Team which consists of three Approved Mental Health Professionals (AMHP) who will come to conduct an interview in order to assess if the person needs admission to a Mental Hospital. It is important to remember the Crisis Team will only come if the person is experiencing a mental health emergency ie a “life threatening situation in which an individual is imminently threatening to harm self or others, lost touch with reality, has a severe inability to function or is distraught and out of control.” If this is the first time that you have used the mental health services the Crisis Team may not know the history of the patient. In some areas depending on where you live the Crisis Team may not be able to assess the patient immediately and there can be extended delays before they can come out. What does a family do? If the patient is aggressive or violent then you need to call the Police where the person will be taken to a police station and the Crisis Team will come to have them sectioned there. There is more information on www.rethink.org.

Section 2:

Under Section 2 the person is detained in hospital for assessment of their mental health problem and can be detained up to 28 days.

Section 3:

Under Section 3 the person can be detained for up to 6 months, and can be renewed for a further 6 months. You can be detained under Section 3 following an admission under Section 2. Under Section 3 you are detained in hospital for treatment that is necessary for your health, your safety or for your own protection.

Section 4:

Section 4 is used in emergency situations and needs the recommendation of just one Doctor (AMHP) or by your nearest relative. Section 4 is used when a person needs to go to the hospital for an assessment of their mental health, or medical treatment, and to protect themselves or people they are living with. You can be detained up to 72 hours.

For more information on Sectioning please see Rethink Mental Illness.

Section 136:

Section 136 is used in an emergency by a Police officer in a public place if he thinks a person is suffering from a mental illness and in need of immediate care to be taken to a place of safety. This allows for the Police officer to contact an Approved Mental Health Professional (AMHP) to assess the individual and make the necessary arrangements for care and treatment.

Discharge

Your Doctor who is responsible for your care can make a determination if you are ready to be discharged back to home following your in-patient treatment. Nearest relatives, Mental Health Act Managers, or a Tribunal can also discharge you from hospital. A care plan is written up under the Care Programme Approach (CPA) and follow up in the community by the Mental Health Team. However, in some cases some adults will need on-going treatment and need to be transferred to a specialised rehabilitation facility, or community placement under the Community Treatment Orders (CTO).

Community Treatment Order: (CTO)

This order is applied if your loved one is under Section 3 of the Act, or if they are sent to hospital from the criminal justice system. Under a CTO it states that certain conditions must be met in order for you to stay in the community, and if these conditions are not met you will be sent back to the hospital. For example, a patient can be transferred to a rehabilitative residential home under a CTO for a prescribed amount of time, in order to help learn coping and life skills before returning to their home.

Out of Area Placements: (OAP)

In other circumstances the Consultant at the Hospital may feel that your loved one will need to be treated in an out of area specialist unit where they have the resources and specialists to meet complex needs. However, in recent years there has been cuts to funding transferring patients to these units and in some cases Autistic patients are not getting the appropriate mental health support that they need. Please see the article in reference to this – Out Of Area Placements In Mental Health Services For Adults In Acute Inpatient Care.

The government has argued that patients transferred to OAPs endure incredible stress being away from their family but if there is now a policy to reduce these transfers the money needs to be invested in appropriate facilities to meet the needs of complex cases in their own communities. See the article here – Out Of Area Placements.

If you feel your loved needs to be treated in a specialised unit in order to get the appropriate treatment then it is important to have an outside assessment done by a Consultant Psychiatrist who specialises in Autism and mental health. If the transfer is approved for the out of area placement then it is a transfer between the Mental Health Trust and the out of area placement. Please read more on Out Of Area Placements In Mental Health Services For Adults In Acute Inpatient Care

Rehabilitation After Hospitalization

Aftercare Factsheet – Free Services For People Who Have Been Sectioned
The National Autistic Society – Accessing Adult Social Care