Getting treatment
For some people, a mental illness is a one-off; something that happens once and passes. Other people have many episodes of mental illness.
There are lots of treatments available to help people to recover from, or to live a better life with, a mental illness.
Of course, every person with a mental illness is different, and their road to recovery will be different. The best treatment for you will depend on the kind of person you are, as well as your diagnosis.
What treatment?
There are many treatments available to help people to recover from, or to live a better life with, a mental illness.
Every person with a mental illness is different, and their road to recovery will be different so the best treatment will depend on the kind of person they are, as well as the diagnosis.
This page discusses treatments:
- Talking treatments
- Medication
- Complementary therapies
- Lifestyle changes
- Electroconvulsive therapy (ECT)
- Time in hospital
Talking treatments
Many people find treatments that involve talking helpful.
These treatments can take many different forms. They can be one-to-one or in a group; they can involve conversations about your past or focus on actions for the future. Sometimes talking treatments work best if you are also taking medication, while others require that you stop taking it.
Every treatment and every person is different, so you may have to try a few kinds of talking treatment before you find one that works for you.
Medication
Your doctor may suggest that you try taking medication.
There are lots of different medications available, which can be taken in different forms and combinations. Some medications have side-effects, which can be unpleasant. Your doctor should discuss these with you.
Many people find that taking medication allows them to live a good life, although you may have to try a few different medications before you feel better. You may find it useful to take medication as well as using other treatments, such as talking therapy.
Complementary therapies
Some people find using alternative therapies, such as aromatherapy massage or hypnotherapy helpful for dealing with their symptoms. Most complementary therapies do not have any side effects.
If you are using mainstream treatments, such as medication or using talking treatments, it may be helpful to use alternative therapies alongside these. You should consult your doctor before you stop using any mainstream treatment.
Lifestyle changes
In some cases, changes to lifestyle can improve mental health. Exercise, taking time off work, or enjoying a hobby, like art or gardening, can make a big difference.
Of course, some people will require other treatments, but lifestyle changes can still be an important part of recovery.
Electroconvulsive therapy (ECT)
In severe cases of mental illness, where other treatments have not been effective, your doctor may suggest using electroconvulsive therapy (ECT).
This treatment is most often used for treating severe depression, although it can be used for other illnesses. It is performed under general anaesthetic and involves running an electric current through the brain to induce convulsions. It can be very effective for some people.
There are safeguards for ECT. If you do not give your consent, the approval of a specialist second opinion doctor, or designated medical practitioner, is required.
Time in hospital
Sometimes, spending some time in hospital can be helpful. As well as getting medical treatment, being in hospital can give you a break and give you access to specialists, such as occupational therapists or psychologists.
You might choose to have a stay in hospital, but sometimes, when people are very unwell, they are unwilling or unable to make decisions about their treatment. In these cases it may be necessary for you to be detained under the mental health act, or "sectioned". On this page, you can find out more about being detained.
For more in-depth information on treatments, visit Mind or Royal College of Psychiatrists.
Can I be forced to have treatment?
If you become unwell with a mental illness, you may need treatment. Sometimes, when people are unwell, they are unwilling or unable to give consent to treatment.
In some cases, you may be given treatment even if you do not want it. This is called compulsory treatment.
There are strict rules about when this can happen. The rules are different for different types of treatment and situations.
You can be given treatment without your consent in an emergency, if it is urgent.
In some cases, you may be detained in hospital, or 'sectioned'.
For some types of treatment, like electroconvulsive therapy (ECT) or artificial nutrition, there are special rules requiring a second opinion from a specially trained doctor: a designated medical practitioner (DMP). These treatments have safeguards.
If you need long-term treatment, you may be subject to a compulsory treatment order.
The law contains safeguards to protect your rights. For example, you have a right to appeal against being detained, and compulsory treatment orders must be approved by a tribunal.
You can also consider writing an advance statement, explaining the sort of treatment you would like to receive. This will be taken into account if you need treatment in future.
Physical force
Most people will understand that compulsory treatment means they do not have a choice. In some cases, it may be necessary to use physical force.
If you are in hospital for compulsory treatment:
- force can only be used if necessary.
If you are in your own home:
- force cannot be used to give you treatment.
If you are on a compulsory treatment order in the community:
- you can be taken to hospital and force can be used.
If you are unhappy about the use of force in your treatment, you can complain. Your named person or independent advocate can help you.
Leaflets for individuals
We produce service user and carer leaflets to explain our role, help people understand their rights, and to promote best practice in the use of mental health and incapacity law.
Being detained
If you become unwell with a mental illness, you may need treatment.
In some cases, if you refuse treatment, you may be detained under the Mental Health Act, or 'sectioned'. This means you will have to spend time in hospital, even if you do not want to.
There are three types of detention:
This allows a person to be held in hospital for up to 72 hours, while their condition is assessed. It can only take place when recommended by a doctor. Where possible, a mental health officer should also agree to it.
This allows a person to be detained for 28 days. It can only take place if recommended by a psychiatrist and a mental health officer.
This has to be approved by a tribunal. It allows treatment for six months initially, but could be extended for a further six months and after that, for a year at a time. It could be in hospital or in the community.
There are strict rules about when this can happen. The tribunal can only approve a compulsory treatment order if:
- you have a mental disorder.
- medical treatment is available which could stop your condition getting worse, or help treat some of your symptoms.
- there would be a significant risk to you, or others, if that treatment was not provided.
- your ability to make decisions about medical treatment is significantly impaired because you have a mental disorder.
The use of compulsory powers is necessary.
The law contains safeguards to protect your rights if you are detained. For example, you have the right to appeal against the detention, and to nominate a named person who will look after your interests.
If you or someone you know is affected by this, you may find it helpful to read this Scottish Government guide "A short introduction to the Mental Health Act". (This document has not yet been updated with changes to the Act in 2015)
Safeguarded treatments
Sometimes, when people are very unwell, they are unwilling or unable to agree to have treatment. In some cases, you may be forced to have treatment, in hospital or in the community.
If you are being treated under the Act, you can be given medications without your consent in the first two months of your treatment.
There are strict rules about when this can happen, which are in the Mental Health Act. The rules are different for different types of treatment and situations.
After two months, you can only continue to have medication if:
- you are capable of consenting and agree to take it, or
- your doctor contacts the Mental Welfare Commission to arrange a visit from a specially trained psychiatrist, or designated medical practitioner (DMP), and the DMP decides that you should have the treatment.
Some treatments require extra, special permissions, or safeguards
If you do not give your consent to them, these treatments cannot be given without a second opinion from a DMP. That applies right from the start of your treatment under the Mental Health Act.
Treatments with special safeguards from the start include:
- Artificial feeding
- Electroconvulsive therapy (ECT)
- Other treatments that act directly on your brain
- Medication where the purpose is to reduce sex drive.
If your doctor wants to use any of these treatments, they will contact the Mental Welfare Commission to arrange a visit from a DMP.
What is a designated medical practitioner (DMP)?
Designated medical practitioners (DMPs) are experienced psychiatrists. When you need the safeguard of a DMP, your doctor will contact us and we'll ask a DMP to see you.
The DMP who comes to see you will work in a different hospital to the one you are in.
We try to make sure that the DMP has experience of working with your condition, or specialist knowledge of the treatment that is being proposed. A DMP's duties are set out in the Act. They have experience as NHS consultants and are asked to undertake independent opinions for the Commission.
What does the DMP do?
Your own doctor will put forward a plan for treating you. The DMP's job is to decide whether the treatment the doctor has put in this plan is in line with the law and is in your best interests. The DMP can only give an opinion on the specific medical treatment. The DMP cannot give a second opinion on your diagnosis or general treatment. Before making a decision, the DMP will:
- talk to you and listen to your views about your treatment;
- assess your mental state;
- look at your case notes;
- pay particular attention to an advance statement if you've made one;
- consult others (including your named person) about your care, if practical.
Can I be forced to have treatment?
Sometimes, when people are unwell, they may need to have treatment, even if they don't want it. There are strict rules about when this can happen.