Steps to follow
If you feel you have a mental health problem, your first stop should be your GP. They can provide advice or refer you for specialist services. Professionals who could help include community psychiatric nurses; psychiatric social workers; consultant psychiatrists; clinical psychologists; occupational therapists.
There are also several charities and self-help groups which can provide help and support (see links below).
To sort out what type of care you’re going to need, you’ll be given a mental health assessment. This could be carried out by your doctor at their surgery or at your home or by a specialist – a counsellor for example – at a hospital appointment.
An emergency assessment may be required if there’s a risk that you could hurt yourself or others and you’re refusing treatment, This involves an assessment by two doctors and a social worker who is specially trained in mental health.
Depending on their conclusions, this might lead to you being sectioned (ie admitted to hospital involuntarily under the Mental Health Act 1983). Emergency assessments arise in three main ways: by going to the accident and emergency department at a local hospital; by phoning the emergency number at the social services department of your local council; or by the police taking you to a place of safety.
Usually three months after your admission, your case will be reviewed and, if the doctors think you need to, you’ll be asked for your permission for the treatment to continue. If you refuse, you’ll be assessed by a “second opinion appointed doctor” (SOAD) who will be asked whether the care should continue against your will.
Being sectioned is rare: most mental health care takes place in the community either in your home, at your GP’s or as a hospital outpatient. There are a number of community care services and facilities available which your community care worker will be able to advise you on. They will also be able to talk you through access to employment, education or voluntary work and financial support such as benefits.
To access some of these services you’ll need to be assessed by your local authority social services department which will carry out a community care assessment. You can self-refer or a carer, friend or relative can ask for an assessment on your behalf. Some services you may have to pay for depending on the results of your means test; again this will be conducted by social services.
Support available includes: day care centres - usually voluntary and offer advice, support and activities (some are drop-in centres, others require a referral from your GP); befriending services - volunteers are given specialist training to provide personal support and friendship; domestic help - local councils can organise services such as laundry, meals on wheels and home helps.
If your community care assessment reveals a need for accommodation, you may be placed in supported housing or group homes; therapeutic communities; a hostel; or a care home.
If you’ve been treated by outpatient psychiatric services, inpatient psychiatric units, or a community mental health team, you may be offered a Care Programme Approach (CPA) assessment by a care co-ordinator who will draw up a care plan for you which will sort out who will be providing you with what care, emergency contacts for you and review arrangements.
A ‘discharge planning meeting' may be set up if you’re being discharged from hospital. This involves a CPA assessment and a community care assessment being carried out at the same time so that both health and social care is covered.
If you have a registered lasting power of attorney in place and you lose mental capacity, your nominated attorney/s will be empowered to make decisions on your behalf about your personal welfare and/ or your financial and property affairs. The Court of Protection will look at cases where your carer and healthcare worker or social worker disagree on what are your best interests.
What to watch out for
Under the Mental Health Act, your nearest relative (spouse, partner, adult child, parent, sibling etc) is given certain rights to protect your interests. They have the right to be consulted and can, for example, apply for compulsory assessment or treatment for you, or call for social services to ask an approved social worker to consider your case or apply to have you discharged (a doctor can overrule this power to discharge if s/he thinks you’re likely to act dangerously if discharged).
Solicitor’s top tip
If you have a long-term mental health problem, you may be covered by the Disability Discrimination Act which offers protection from discrimination at work, in educational settings and in the provision of goods and services.
MDF The Bipolar Organisation
Mental Health Foundation
Mind - National Association for Mental Health
Time to Change
Together: Working for Wellbeing
United Response (UR)
Mental Health Act 1983: an outline guide
Department of Health
Office of the Public Guardian
Supporting People programme
Disability discrimination (business)
Disability discrimination (personal)
Rights of carers
I need help with an elderly relative
Do I need a lawyer? (personal)