Overview

• Most people with a mental health problem are treated in the community. But you may need to go into hospital if you’re very unwell.
• You might go to hospital as a voluntary patient or as a compulsory patient, under the Mental Health Act.
• Doctors and other professionals will assess you and think about the best treatment for you. You might get medication, talking therapy and occupational therapy.
• There are different types of wards in hospital and professionals will decide on the right one for you.

Voluntary and compulsory

What is meant by voluntary and compulsory patients?

Most people with a mental health problem are treated in the community. But you may need to go into hospital if you’re very unwell.

Going into hospital is called an admission. When you go into hospital, doctors might say that you have been admitted.

You can go into hospital as a voluntary or compulsory patient.

What is a voluntary patient?

If you are very unwell, you may need treatment in hospital. You might be offered this if doctors think you can’t be treated in the community.

If you agree to go to hospital for treatment for your mental health, you’re known as a voluntary patient.

As a voluntary patient you can only be given treatment if you consent to it.

If you are so unwell you think you need treatment in hospital, you can try the following.

• If you’re with an NHS mental health team, speak to your care-coordinator or contact point there.
• Contact your local NHS urgent mental health helpline. You can find their details at: www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline.
• Contact your GP. There may also be an out-of-hours service.
• Go to an accident and emergency (A&E) department of a local hospital.

You might not be able to go into hospital even if you want to. It will depend on if doctors think you need to be there.

Doctors might think treatment is hospital is appropriate for you. If there is no free bed in your local hospital, you could be offered a bed in one further away.

You can leave hospital at any time, even if health professionals advise you not to. If this happens it’s a good idea to listen to their advice and reflect on it, before you decide what to do. If you’re unsure about any of their advice, ask them to explain it again and ask any questions you want to.

You might try to leave hospital. But a doctor might think you’re very unwell and a risk to yourself or others because of a mental disorder. They have powers under the Mental Health Act to detain you in hospital for up to 72 hours in an emergency. A nurse can also do this for up to 6 hours. You should then be assessed by professionals to see if you need to be detained further under the Mental Health Act.

For more information see our webpages on the following:

• NHS Mental Health Teams, and
• The Mental Health Act

What is a compulsory patient?

You’re a compulsory patient if you are detained in hospital and you’re not free to leave without the agreement of professionals.

You will be a compulsory patient if you’re detained in hospital under:

• the Mental Health Act, or
• a Deprivation of Liberty Safeguards (DoLS) order.

What is detention under the Mental Health Act?
You can be detained in hospital under the Mental Health Act if:

• you have a mental disorder,
• you are a high risk to yourself or other people because of your mental disorder, and
• treatment in the community isn’t appropriate.

You can be detained in hospital and given treatment, even if you don’t agree.

You should only be detained under the Mental Health Act if there are no other ways to keep you, or others, safe.

Being detained under the Mental Health Act is sometimes called being ‘sectioned.’ This is because you can be detained under different sections of the Act, depending on your circumstances.

You will only be discharged from hospital if:

• health professionals think you’re well enough, or
• you appeal your detention and you’re successful.

For more information see our webpages on the following:

• The Mental Health Act, and
• Discharge from the Mental Health Act

What are Deprivation of Liberty Safeguards (DoLS)?
DoLS can sometimes be used if you are in a hospital or care home and lack mental capacity. Mental capacity means you have ability to make your own decisions. ‘Deprivation of liberty’ means loss of freedom.

DoLS orders are made in line with the requirements of the Mental Capacity Act 2005.

The care home or hospital must get permission from a supervisory body before they can lawfully deprive you of your liberty. The supervisory body will usually be an NHS primary care trust or a local authority.

DoLS can only be used when:

• It’s in your best interests to protect you from harm,
• It’s needed because of the likelihood and seriousness of harm, and
• if there is no other way to keep you safe.

There are safeguards in place to make sure: ,

• you get a representative to support you with all things to do with DoLS,
• you and your representative have access to an independent mental capacity advocate, and
• the DoLS order is regularly reviewed.

DoLS can’t be used if you are detained in hospital under the Mental Health Act. It is more common for people with dementia or learning disabilities to be detained under a DoLS order than those living with a mental illness.

If you or another want to challenge a DoLS order, you have to apply to the Court of Protection.

You can learn more about DoLS by following this link: www.scie.org.uk/mca/dols/at-a-glance.

What are Liberty Protection Safeguards (LPSs)?
Liberty Protection Safeguards (LPSs) will replace the Deprivation of Liberty Safeguards (DoLS) in the future. The Mental Capacity (Amendment) Act 2019 says this.

The government have yet to provide a date when this will happen. We will update this factsheet when LPSs replace DoLs. For further information on the key changes under LPSs, please see the Government website link here: www.gov.uk/government/publications/liberty-protection-safeguards-factsheets/liberty-protection-safeguards-what-they-are

Preparation

How can I deal with important personal things?

What personal things should I take to hospital?

The things that people take into hospital can be different and personal to them.

If you go into hospital in an emergency, you might not have time to think about taking things in with you. If you don't take all the things you need, you could ask a loved one to bring things in for you.

You will be able to wear your own clothes on the ward.

You can take in things like:

• extra clothes,
• night clothes,
• toiletries,
• some money, including coins in case you need them for something like a pay phone,
• things to occupy you like books, magazines or games,
• notepad and pen, and
• your mobile phone, or other device, and charger.

The hospital shouldn’t have a total ban on you using mobile phones, tablets or laptops, or accessing the internet or your money. You should have the right to use these things in hospital as long as:

• health professionals think that using them won’t harm your recovery, and
• you can use these items in a way that doesn’t affect the right to privacy of other patients or hospital staff.

Some wards also have restrictions on items such as razors, matches, and lighters.

Alcohol isn’t allowed in hospital. Some higher security wards have restrictions on alcoholic mouthwash, aerosols, glass containers, perfume, aftershave, dental floss and nail varnish remover.

You should tell staff about any electrical items you have to make sure you’re allowed to use them.

It might be a good idea to not take valuable things such as jewellery or large amounts of money onto the ward. Unless there’s somewhere safe to keep them.

What about my moveable property and pets?

If you live alone you could ask someone to keep an eye on your home and look after your pets, if you have any. This could be a loved one or neighbour. If you have no one to do this the local authority might be able to help.

The local authority must protect your moveable property if it could get lost or damaged. This includes things like your personal possessions, furniture and pets. They might have to go into your home and move items into storage.

They can only do this if you agree. If you lack capacity to make decisions, someone who’s properly authorised to make decision for you can consent. That might be your attorney, deputy, or the Court of Protection. If no one is authorised to act on your behalf, the local authority must act in your best interests.

The law says that the local authority can charge you for actions they take. The policy on charging will vary from area to area.

If you are worried about your things when you are in hospital, you could try talking to:

• a friend, family member or neighbour,
• a social worker or member of staff at the hospital,
• your local social services department,
• your care coordinator in the community, if you have one, or
• the Approved Mental Health Professional (AMHP), if you’re being assessed for hospital detention under the Mental Health Act.

See our webpage on Mental capacity and mental illness for more information.

What about my children?

If you have children, you can arrange for them to stay with a friend or family member if necessary.

If this isn’t possible, you can contact your local authority and speak to children's social services about the situation. You should be able to find their contact details on the internet by searching for ‘[County or borough where you live] children's social services.’

What about my welfare benefits?

If you get benefits, it is important to tell the Department for Work and Pensions (DWP) that you are in hospital. If you aren’t well enough to do this, then you can ask for help from a loved one or a member of the ward staff.

Some of your benefits might stop or reduce after 28 days. If you don’t tell the DWP they may overpay you. This can create difficulties as you’ll need to pay the money back.

You can find more information about ‘How do I manage my money if I have to go into hospital?’ at: www.rethink.org/advice-and-information/living-with-mental-illness/money-benefits-and-mental-health

What is it like?

What information about hospitals might I find useful?

If you have questions about your treatment or your rights, you can ask a nurse, your doctor, or another member of staff.

See our webpage on NHS treatment – Your rights for more information.

You might be detained in hospital under the Mental Health Act. The Equality Humans Right Commission (EHRC) has information about your rights when detained under the Act in guides on their website.

Website: www.equalityhumanrights.com/en/publication-download/your-rights-when-detained-under-mental-health-act-england

Can I smoke?

Smoking can affect how some psychiatric medication works, so let staff know if you smoke.

You can't smoke on the ward. The government have made all hospitals smoke free zones.

Different hospitals and wards have their own rules about smoking and vaping on hospital grounds. You can ask staff for a copy of the hospital or the ward smoking policy.

In some places, you may be allowed to smoke or vape in an outside area. In other places, you may not be allowed to smoke or vape at all.

Health professionals may offer you:

• nicotine replacement therapy,
• e-cigarettes, or
• prescription medication to reduce your cravings for tobacco.

What about rooms and toilets?

You might have your own room or have to share a room with others. Men and women shouldn’t be mixed in the same room. There should always be separate toilets and bathrooms for men and women.

Arrangements for your accommodation should also consider your history and personal circumstances, including:

• history of sexual or physical abuse and risks of trauma, and
• the needs of transgender patients.

There should be an area where you can spend time away from your room during the day. This is called the common room or day room. These rooms may be for men and women. In some hospitals, there are separate day rooms for men and women.

What is chaplaincy?

Chaplaincy is a service in the hospital that can provide you with pastoral, spiritual or religious support. You can get support off the service whether you’re religious or not.

If you want support from the chaplaincy service, you can speak to a member of hospital staff.

What is observation?

If health professionals are concerned you’re going to harm yourself, they may put you on observation. This means that staff will watch over you to make sure that you’re safe. For example, staff might check on you every hour or stay with you all the time.

What if I have problems with other patients?

If you have any problems with any of the other patients, you can tell a member of staff.

Can I have visitors?

Keeping in touch with family and friends could help with your recovery. So, health professionals should do everything they can to make visits enjoyable. This includes providing you and your visitors with as much privacy as possible.

Some wards have fixed visiting hours and others allow visiting at any time. You can ask staff on the ward about this.

You can ask visitors to bring things to the hospital that you might have forgotten. Your visitors may be able to bring in food and drink for you.

There may be things that visitors aren’t allowed to bring into the ward such as sharp items, drugs, alcohol, matches and lighters. You can check with ward staff.

You can make decisions about visitors. You can decide:

• who you want to see and when, and
• the length of the visits, within the visiting hours rules.

If there’s anyone that you don’t want to see, tell staff on the ward.

There are circumstances where you might not be able to see your family and friends. Like when your doctor thinks:

• there is a risk to you, and you don’t have the mental capacity to make a decision about your own safety
• you’re detained under the Mental Health Act and it’s having a negative impact on your mental health and your recovery,
• there is a risk to the visitor, or
• a visitor is unable to keep to the ward procedures.

You should be able to show affection toward your family and friends as you would normally. This includes by holding hands or hugging. If health professionals prevent you from doing this, they should have a good reason to do so and tell you why.

The hospital must also make reasonable adjustments to make it easy for disabled visitors to come and see you.

See our webpage on Mental capacity and mental illness for more information.

Can I be searched?

Staff might think there’s a risk to the safety of you, other patients, or staff. Or that you have something that’s not allowed on the ward. They might ask you if they can search:

• you,
• your belongings, or
• or your room.

If staff search you, they must respect your dignity and privacy as much as they can. If they take something from you, they should tell you why they have done it.

The hospital should have a written policy on searches, and they should provide you with a copy if you ask for one.

What about if I’m detained under the Mental Health Act?
If you’re detained in hospital under the Mental Health Act, staff can search your things, even if you don’t consent. But if they do, they should:

• ask you first,
• ask your doctor to see if there is any reason why you can’t be searched, and
• give you a good reason why they need to do the search.

You should only be searched if staff have a good reason to do it. Some of the reasons staff might want to search you are:

• they think you’ve brought things onto the ward you shouldn’t have,
• you’ve had drugs on the ward before,
• you’ve self-harmed on the ward with something you hid, or
• you sometimes don’t take your medication and hide it.

If the staff take any of your items, they have to:

• tell you why they took it,
• tell you where they will keep it,
• tell you when they will give it back, and
• give you a receipt.

Can my visitors be searched?
The hospital staff might want to search a visitor. This is more common in higher security hospitals and forensic unit wards.

If your visitor doesn’t want to be searched, they can’t be forced. But they might not be able to see you, or the visit may be supervised. This depends on the hospital's security policies.

What should happen before I leave hospital?

Before you leave hospital to go live in the community there should usually be a discharge meeting. This is to plan your care and support. This should happen whether you are a voluntary or compulsory patient.

This meeting should involve:

• you,
• your care team in hospital, and
• staff from community mental health services who will support you when you leave hospital, and
• a loved one who cares for you, if you want them to be there.

What sort of ward will I be on?

There are different types of wards in mental health hospitals. Staff to support you will include psychiatrists, nurses, pharmacists, psychologists, occupational therapists and housing and social care workers.

What are acute wards?

Acute wards provide care with intensive medical and nursing support, if you’re in a period of acute mental illness. They are the most used type of ward for inpatients with mental health conditions.

There will usually be a mix of voluntary patients and those detained under the Mental Health Act.

You will usually spend fewer than 90 days on an acute inpatient ward. But it can be longer.

Sometimes these wards are split into assessment and short-term admission, and longer-term treatment wards.

What is a psychiatric intensive care unit (PICU)?

You might be put on a PICU ward if:

• you’re are very unwell, and
• need more intense support than provided on an acute ward.

These wards are secure, meaning that they are locked, and your entry and exit is controlled.

Staffing levels are usually higher than on an acute inpatient ward. You might have a nurse who just looks after you.

You might be transferred from an acute ward to a PICU. This might happen if health professionals think that the level of risk you pose to yourself, or others, is high. You’ll usually be detained under the Mental Health Act.

Your length of stay is normally short, such as a few days to a few weeks. You’ll usually return to the acute ward when your risk has reduced.

What are recovery and rehabilitation units?

These can be hospital or community based.

You may go to a recovery and rehabilitation unit if:

• you live with severe and long-term mental health problems,
• you can’t live independently in the community, even with support,
• you need help to become more independent and learn new skills, and
• you have complex needs.

You will get treatment and support that is individual to you that can include:

• medication,
• talking therapy,
• family and carer involvement,
• occupational therapy to help with skills and confidence for daily living, and
• help to take part in community-based leisure and work or volunteering-based activities.

Your usual length of stay would be 1 to 2 years.

With suitable rehabilitation even those with the most challenging needs can progress to supported community living.

The staff at the unit should inspire hope that you can live more independently in the community.

See our webpage on Supported housing for more information.

What are forensic mental health wards?

If you’re on a forensic ward, you’ll:

• be detained under the Mental Health Act, and
• probably have committed a criminal offence.

You’ll be on a high, medium, or low secure ward. This will depend on your levels of risk.

If you’re on a forensic mental health ward, you’ll have been assessed by health professionals as:

• needing a lot of treatment from different types of staff specially trained in forensic mental health, and
• showing disturbed behaviour linked to a serious mental disorder.

I addition to the above, you’ll have been assessed by health professionals as:

• needing to be in a secure hospital, if you’re in a low secure ward,
• possibly being a serious risk to others, if you’re on a medium secure ward, or
• showing a serious and immediate danger to others, if you’re on a high secure ward.

If you’re on a forensic ward, you might have been detained under one of several sections of the Mental Health Act.

For more information see our webpages on the following:

• Section 35 of the Mental Health Act - Criminal courts send you to hospital for a medical report,
• Section 36 of the Mental Health Act - The Crown Court sends you to hospital for treatment,
• Section 37 of the Mental Health Act – Hospital orders,
• Section 37/41 of the Mental Health Act - Hospital order given by a Crown Court,
• Section 38 of the Mental Health Act – Interim hospital orders by the criminal courts,
• Section 47 of the Mental Health Act - Transfer of a sentenced prisoner to hospital, and
• Section 48/49 of the Mental Health Act -Transfer of an unsentenced prisoner to hospital,

What are specialist wards?

You may be admitted to a specialist ward. These may include:

• personality disorder units,
• eating disorder units,
• mother and baby units, and
• young person units.

Children and young people should be in a ward that is suitable for people of their age. This would usually mean a unit with specially trained staff.

The availability of specialist wards varies from area to area. You may need specialist care that local NHS services can’t give you. Your NHS may offer to transfer you to a hospital in another area.

See our webpage on NHS treatment – Your rights for more information.

Treatment

What care and treatment will I get?

A psychiatrist will speak to you soon after you go into hospital. A psychiatrist is a specialist mental health doctor. They will think about what treatment options are best for you.

The treatment might be medication, talking therapy or a mixture of both. Other therapy might be available too, like creative activity groups or animal therapy.

If you are having challenges doing everyday tasks, you may be offered help from an occupational therapist. They can help you to overcome your problems and become more independent. This might involve learning skills like cooking or managing bills.

The staff at the hospital should do regular ward rounds. Ward rounds are when staff members meet with you to see how your treatment is going.

If you want more information, you might want to ask some questions like these.

• Can you explain my diagnosis or treatment?
• Will my medication cause side effects?
• How can I cope with side effects?
• What other medications might work for me?
• Will I have talking therapy in hospital?
• Do you think my symptoms might be caused by physical illness?
• How often will you see me?

See our webpage on NHS treatment – Your rights for more information.

What if I’m unhappy with my care or treatment?

If you’re unhappy with your care or treatment, then you can:

• try to sort the issue out informally
• contact the hospital’s NHS Patient Advice and Liaison Service (PALS),
• complain, or
• contact an NHS complaints advocate for help

See our webpage on Complaining about the NHS or social services for more information.

What if I’m detained under the Mental Health Act?

You can get help from an Independent mental health advocate (IMHA) if you are detained under the Mental Health Act.

IMHAs help you to tell staff about your concerns and help you understand what your rights are. They can also help you to understand your treatment. They are independent of the hospital staff.

Hospital staff should tell you about how to get help from an IMHA as soon as possible after you are detained.

If you think you would find it helpful to speak to an IMHA, ask staff about how to get in touch with one. You may have to ring a number to make an appointment. IMHAs can meet with you in private if you want them to.

Further help

Can a loved one help me?

When you’re in hospital, you might want a loved one to do things like:

• help you to remember information,
• help you raise concerns, or
• give you some support.

It is much easier for your loved one to do these things if you tell staff that it’s OK.

Your loved one isn’t usually allowed to be given information about your care unless you agree. This is because the hospital staff must protect your confidentiality. If you want your loved on to have this information, you should tell staff and they can put a note on your record. Also, you could sign a consent form and give it to staff.

You may feel comfortable with your loved one being told some things but not others. This is up to you. Make sure you tell the staff exactly what you want to happen.

See our webpage on Confidentiality for more information.

© Rethink Mental Illness 2023

Last updated May 2022
Next update May 2025

Version number 6

You can access a fully referenced version of this information by downloading the PDF factsheet by using the link at the top of this page.

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