Access to comprehensive psychiatric aftercare is necessary for patients who have been sectioned, but this is overlooked and undervalued by current mental health law, write Narut Pakunwanich , Jeremy Bjørndal , and David Seedhouse
Few professionals outside psychiatric services are aware that eligibility for aftercare depends on which section of the Mental Health Act 1983 a patient has been categorised under.1 This act underpins psychiatric care in England and Wales and allows for detainment and the treatment of severe mental illness, even if a patient with capacity refuses.
Section 2 of the act allows inpatient hospital detention for 28 days, while section 3 permits detention for six months but only after section 2 has been used. The concept of the “sick role” is entrenched in this legal model,2 with psychiatric “sickness” defined solely by compliance and section 3 reserved for “sicker” non-compliant patients. Thus, section 3 is used by clinicians for severe mental illness.
A difference in funding is that aftercare support under section 117 of the act is available only to people previously categorised under section 3. Importantly, section 117 provides non-means tested, fully funded aftercare. These aftercare services are defined …