So, you’ve been detained under the MHA, and you want to get out of hospital. Based on my decades of first-hand experience here a few hints and tips that might make your stay a little shorter.
1.
Appeal against your detention
When you are detained under a section of the MHA, it is the duty of the AMHP who detained you, and of the hospital staff, to inform you of your rights to appeal. Staff have a duty to help you if you want to appeal. Your case will then be heard by an independent Tribunal which is part of the judicial system. Around 15% of appeals to Tribunals are successful.
A formal appeal to a Tribunal will also concentrate the mind of your psychiatrist. If you are making a good recovery, they may well decide to discharge you from detention prior to the actual date of the appeal.
2.
Get a solicitor
Patients detained under the MHA have the right to free legal aid regardless of their incomes. There are solicitors with special training who will take on this work. The hospital staff will put you in touch with an approved solicitor. Although a patient can use almost anyone to help them present their case in a Tribunal, your chances will be improved by having a qualified legal representative.
3.
Allow the solicitor to present your case
Although Tribunals try to appear as informal as possible, it is nevertheless essentially a court of law. The chair of the Tribunal is a judge, and will not appreciate the patient making constant interruptions or challenging the testimonies of the psychiatrist or AMHP. You can ask your solicitor to point out inaccuracies or discrepancies in written and verbal reports. Your solicitor will frequently pick up on these issues without prompting.
4.
Be wary of opportunities to speak to the Tribunal
I’ve seen many cases appear to go well in the Tribunal right up until the moment when the patient is asked by the medical member or the chairman to tell them more about how they are or if they have anything they wish to say to the Tribunal. Many a paranoid or psychotic patient has then gone into great detail about their delusions or hallucinations, thereby proving that they have a mental illness “of a nature or degree which warrants detention in hospital” for assessment or treatment, and which would then make it very difficult for the Tribunal to discharge them.
I remember one Tribunal I attended. The patient had sat there quietly throughout, allowing his solicitor to question the psychiatrist and his care coordinator. It had been going quite well for him. The solicitor had certainly made the psychiatrist look uncomfortable at times. The medical member then said to him: “Is there anything you would like to tell us?”
“Yes,” he replied. “I don’t need any medication or anything like that. I’d be perfectly all right if it wasn’t for these voices. They never leave me alone. They’re always going on at me to do bad things. I think it’s my psychiatrist, he projects them into my head from a transmitter on his desk. I had a brain implant inserted into my head many years ago which has made me half robot and half human. The implant picks up the signals and then I hear them. Those voices, they drive me mad, I tell you.”
Strangely enough, he didn’t get off his section.
5.
Don’t threaten or assault the psychiatrist or other staff
This doesn’t look good in a report to the Tribunal. It will also tend to stay with you in every future risk assessment.
6.
Take the prescribed medication
As a rule, psychiatrists really do want their patients to get better. Nowadays there is intense pressure on hospital beds, and psychiatrists don’t generally want patients to remain in hospital longer than absolutely necessary. There is a wide range of medication that really can help people with depression, psychosis or mania manage their symptoms. Cooperating with the inpatient treatment plan and with plans for your aftercare after discharge will definitely make your stay shorter.
An important note: If you are detained under S.3 (for treatment) you will inevitably be subject to s.117 of the MHA. This refers to the duty of the NHS and the local authority to provide aftercare when you are discharged. The cost of any aftercare provided (including residential or nursing care, as well as provision of community support services) will have to be met by the local authority or the local NHS Trust.
Get a friend to help you select a solicitor from the approved list that staff will show you. Google your potential choice to try and get some idea (a) how experienced they are and (b) how hard they will argue your case. The trouble with the approved list is that too many people just point at the first name on the list, who inconsequence turns out to be well known to, and too friendly with, the staff whose judgement they are going to question. eg reporting back (after discussions with staff at which you weren't present) 'They shouldn't have done that. Really it was a bit naughty' but without proposing any challenge to what they've discovered. That said, as the Madked AMHP says, any hint of Tribunal and associated paperwork may provoke your prompt discharge - unfortunately with sven less forward care planning than usual.
ReplyDeleteGet ur NR to order ur discharge ✔️
ReplyDeleteBetter if you can do this so the 72 hours expire during a public holiday, or some other time your RC is likely to be away and not normally attend the hospital. The days leading up to Christmas are ideal for this.
DeleteThe RC can, technically, issue a barring certificate remotely without having "examined the patient", but in my experience the hospital managers don't look too kindly on that sort of thing in the automatic hearing that follows, and can often be persuaded that the RC hasn't really properly considered the issue of dangerousness if they were doing so from a beach somewhere.