What is the criteria for getting a family member sectioned?

breso

Hi all, hopefully there is somebody on this site that can help me out! A family member is currently a serious risk to himself (and others around him) due to an onset of intense paranoia, thinking somebody is following him etc.

Both myself and another close family member recently contacted the guards to try have him sectioned, he had threatened to kill himself and is clearly not in a good frame of mind. Myself and the family member were told by the gardai that he did not fit the criteria to be sectioned. We warned them that he would harm himself or somebody.... the latter unfortunately happened as he was out and thought a complete stranger was whispering about him and he attacked a complete stranger!!

He was arrested and the guards STILL let him walk free!! We have explained all of the things that he has been doing in recent months and they are absolutely CRAZY things!! They wont listen and the hospital said he is an adult so can make his own decisions.

It's only a matter of time before he causes real harm to himself or somebody innocent again with his behavior, he was completely sane and 'normal' but all of a sudden he is acting completely crazy.

The guards knew that we had requested to have him sectioned, then arrested him for (seriously ) randomly attacking an innocent stranger, and yet he still doesnt ''fit the criteria'' to be sectioned.

He needs help, yet we are being told that he has to get it himself?! How can somebody not in a fit state of mind be expected to make a rational decision?!

splinter65

From Citizensinformation.ie

Application for involuntary admission
An application for the involuntary admission of an adult may be made to a registered medical practitioner by a spouse, civil partner or relative, an authorised officer, a Garda or any other person. An authorised officer is an officer of the Health Service Executive (HSE) who is designated by the Chief Executive Officer of the HSE for the purposes of making such applications. This does does not include a separated spouse or civil partner or one against whom an application or order under the Domestic Violence Act has been made.

The following people may not make an application:

Anyone aged under 18
An authorised officer or Garda who is a relative of the person concerned or that person's spouse
A member of the governing body (not including a member of the HSE) or staff of the approved centre concerned
Anyone who has an interest in the payments to be made to the approved centre
Any medical practitioner who provides a regular medical service to the centre
The spouse, parent or other close relative of any of the people specifically mentioned above.
The person applying musrt have seen the person whose admission is sought within the 48 hours prior to making the application. If the application is being made by 'any other person', the application must include a statement of the reasons why it is being made, the connection of the applicant to the person whose admission is proposed and the circumstances in which the application is made.

Role of the Gardaí
If a Garda has reasonable grounds for believing that a person is suffering from a mental disorder and that, because of the disorder, there is a serious likelihood of the person causing immediate and serious harm to themselves or another person, the Garda may take the person into custody. If necessary, the Garda may use force to enter the premises where it is believed that the person is. The Garda must then go through the normal application procedure for involuntary detention in an approved centre. If the Garda's application is refused, the person must be released immediately. If the application is granted, the Garda must remove the person to the approved centre.

Medical assessment
If it is proposed that you be involuntarily admitted to an approved centre, you must be examined by a medical practitioner (who is not a relative and is not involved with an approved centre) within 24 hours of the making of an application. The doctor must tell you the purpose of the examination unless they consider that such information would prejudice your mental health, well being or emotional condition.

If the doctor considers that you are suffering from a mental disorder, they make a recommendation that you be involuntarily admitted to an approved centre (other than the Central Mental Hospital). This recommendation remains in force for 7 days. If the application is refused and a subsequent application is made, the applicant is obliged to inform the doctor about the previous application, if aware of it.

Removal to an approved centre
In general, the applicant is responsible for taking the person to the centre. If this is not possible, then the doctor who made the recommendation may ask the clinical director of the centre or a consultant psychiatrist acting on their behalf to arrange for the person to be brought to the centre by the staff. If necessary, the Gardai may be asked to help. In this situation, the Gardai have the power to enter premises by force and may detain or restrain the patient if necessary.

Admission to an approved psychiatric centre
When you are received at an approved psychiatric centre, you must be examined by a consultant psychiatrist on the staff. You may be detained for a maximum of 24 hours in the centre for this examination. If the psychiatrist is satisfied that you are suffering from a mental disorder, they then make an admission order. If the psychiatrist is not satisfied that you are suffering from a mental disorder, you must be released immediately. The admission order is valid for 21 days. It authorises your reception, detention and treatment in the centre for this period.

A renewal order may extend this period by a further 3 months. This must be made by the consultant psychiatrist responsible and they must have examined you in the week before making the order. A further renewal order may be made by the same psychiatrist for a period of 6 months and subsequently for 12 months at a time.

There are provisions for the review of all admission orders. You can read more in our document on the rights of psychiatric patients.

breso

Thank you for the information, I will look into this and hopefully there is something that can be done before it's too late!

Victor

Can we take it that you've spoken to his GP?

Rushden

breso wrote: »

Hi all, hopefully there is somebody on this site that can help me out! A family member is currently a serious risk to himself (and others around him) due to an onset of intense paranoia, thinking somebody is following him etc.

Both myself and another close family member recently contacted the guards to try have him sectioned, he had threatened to kill himself and is clearly not in a good frame of mind. Myself and the family member were told by the gardai that he did not fit the criteria to be sectioned. We warned them that he would harm himself or somebody.... the latter unfortunately happened as he was out and thought a complete stranger was whispering about him and he attacked a complete stranger!!

He was arrested and the guards STILL let him walk free!! We have explained all of the things that he has been doing in recent months and they are absolutely CRAZY things!! They wont listen and the hospital said he is an adult so can make his own decisions.

It's only a matter of time before he causes real harm to himself or somebody innocent again with his behavior, he was completely sane and 'normal' but all of a sudden he is acting completely crazy.

The guards knew that we had requested to have him sectioned, then arrested him for (seriously ) randomly attacking an innocent stranger, and yet he still doesnt ''fit the criteria'' to be sectioned.

He needs help, yet we are being told that he has to get it himself?! How can somebody not in a fit state of mind be expected to make a rational decision?!

The guards don't section people like you seem to think they can. They can detain someone for as long as it takes a doctor to come and assess the person if they believe there's an immediate danger , it's then up to that doctor to assess them and involuntary admit them if they deem it necessary. If the doctor doesn't admit them then they must be released from Garda custody so you can't expect the guards to just hold him .

Yourself and the family need to speak to his gp and explain what's happening, as a medical professional it's the gps duty to have them admitted if necessary .

It does seem to be a revolving door in mental health hospitals however with people constantly being in and out , frustrating for yourself no doubt but start with the gp and go from there

SaltSweatSugar

You don’t need the Guards to make an application to have him sectioned, a family member and GP can also do it.

If the Guards arrest a person under the Mental Health Act, they simply keep the person in their custody until they are assessed by a Doctor. Sometimes, depending on when the person is arrested that can be an on-call doctor that may have no previous knowledge or experience with the person so they may not know their history. Ultimately the Dr makes the call as to whether the person is to be involuntarily admitted or not.


As stated above, your family need to talk to his GP.

breso

It's really difficult as he is manipulating the doctors and saying 'the right things' to not fit the criteria. They wont listen to us, as he is an adult. I think they think that we are making it up. It's so bad to think that we are reaching out for help for him and being told no!

He keeps checking into A&E for chest pain, and keeps ringing the guards at night thinking somebody is in the house. He needs professional help at this stage, we are all scared that he is going to do something at night to somebody to the point that locks were purchased and fitted to bedroom doors. His Fiancee is so afraid of what he might do, she wont let him back to near his home or his children, my family are also near that point also with the crazy things he is doing (it's scary) he cannot be trusted, everybody is on edge.

We have all spoken with the DR's in A&E, the night we spoke to the gaurds, he told them he was going to jump off a bridge and yet that still didn't fit the criteria. They wont listen to us! Somebody will die if not himself if he isn't taken somewhere for treatment urgently.

He made the national news with the attack on a random stranger already! A poor innocent person got attacked for nothing - by standers jumped on him to stop him which resulted in a broken jaw, eye socket and ribs for him. The same guards that we asked to section him, arrested him a couple of days later for attacking a stranger that was ''whispering about him'', and knowing everything we have told them they still released him without being seen by anybody! The attack could have been prevented and what's to follow should be prevented. But nobody will listen to us, we are really trying to get him the help he really needs!

Dr's, Nurses and Garda are all caught up in policies and procedures, until he fit's this 'criteria' (which must be to murder somebody before action is taken) they cant/wont do anything to help!

Victor

Create a diary. Add the past incidents that you know of.

GalwayGrrrrrl

You must try to speak to his GP. Tell the GP what you’ve written here. A family member and GP can section someone.
Has he ever had contact with a social worker? They may be able to help you too. If this doesnt work, next time he’s in A and E insist that he gets a referral to psychiatry.

There are strict rules for sectioning people, to make sure people aren’t admitted to hospital unnecessarily but you seem to be a victim of these strict rules at the moment.

Mumser

This is a hugely stressful and difficult time for you and all concerned breso. My heart goes out to you.

As stated above write a log with dates and outline of events, including your visits to GP, conversations with A&E doctors and gardai. Return to the GP with a copy of this and express your concerns again.

Remember you are doing your best. Take care.

Peregrinus

The criteria for sectioning are these:

1. Is the patient mentally ill, suffering from severe dementia or suffering from a significant intellectual disability? If the answer is "no", then the patient can't be sectioned.

2. Is there a risk of harm to the patient or others as a result of the illness, dementia, disablity? Again, if "no", there can be no sectioning.

If the answer to both these questions is "yes", then a psychiatrist can recommend that the patient be removed to an "approved centre" for examination by another psychiatrist, who will form his own view as to those two questions, and in addition will consider a third question:

3. Does the patient need to be admitted to hospital for treatment? If the illness/dementia/disability is untreatable, the answer to this question is going to be "no", and it will also be "no" if the condition can be treated without a hospital admission. Only if the answer is "yes" can the patient be involuntarily admitted. But note that admission is not to restrain or confine the patient, but to treat them, and the admission will continue only as long as inpatient treatment is indicated.

As you'll see, the questions asked here are predominantly medical questions so, as others have said, it's not the guards you should be approaching, but the medics. Start with the patient's GP, but to proceed to sectioning you'll need to have the patient examined by a psychiatrist who will consider the first two questions outlined above.

notsoyoungwan

The above post has some inaccuracies.

Firstly, the first doctor to examine someone does not have to be a psychiatrist and in fact rarely if ever is, and if it is to be a psychiatrist it cannot be one working in the hospital where the person is to be admitted. It’s usually a GP or a doctor in the A&E.

Secondly, there are two criteria under which someone can be detained, section 3 (1) a and 3 (1) b, or indeed some people meet both criteria.

In a nutshell, they first have to have a mental illness/disability/dementia AND BECAUSE OF THAT either a) pose an immediate and serious risk of harm to self or others OR have impaired judgement to the degree that they require treatment and failure to treat would lead to serious deterioration in their conditon and that treatment can only be given in hospital and is expected to benefit them to a material degree.

I’m paraphrasing rather than quoting in full but that’s the bones of it.

A psychiatrist will only becoge involved when the person lands in hospital. All the GP is doing in the community is recommending a psych assessment to be carried out under the terms of the mental health act.

breso

Thank you all for your help! I'm really hoping that something can be done. A social worker contacted us from the hospital already as we have been trying with the the doctors and nurses to have him sectioned. He wont tell them the truth and keeps saying that he is only there for chest pain, so their hands are tied and they cant do anything other than treat him for chest pain. Either that or he is going down and checking in before disappearing. I think he is subconsciously crying out for help.

I think the best port of call is to contact the social worker and try get the ball rolling before it's too late!

notsoyoungwan

Sorry OP, I rushed my last post a bit and didn’t finish it.

Tbh, there’s not much a social worker can do except give you advice on what to do.

What you (as a family) need to do is document everything, all the details. That’s very useful info for the medics. Then make an apt with his GP, or a GP that someone else in the family knows if he doesn’t have his own GP. Give the GP the info you’ve written down, tell them your concerns and tell them you want to make an application under the mental health act. Whichever family member signs this form (GP will probably have it but can be downloaded from mhcirl.ie- look under statutory forms, it’s form 1 you want) will have to have seen him within the 48 hours prior to signing the form. Once you’ve that done, the GP is legally obliged to see him within 24 hrs of receiving the completed application form. If the GP feels he needs a psychiatric assessment then the GP completed a recommendation form (form 5) and then he can be brought to hospital and assessed by a psychiatrist.

breso

Thank you so much for the information! I really appreciate that!! We have just been dealing with A&E docs, I will arrange speaking with his GP asap! Thanks again everyone