Information for people detained in hospital

Page last updated: 12 May 2022

Find out about your rights in relation to consent to medication and electro-convulsive therapy (ECT).


You may be required to take medication prescribed for you by your doctor if you have been detained in hospital under the Mental Health Act.

There are rules in place, called consent to treatment, that cover whether you should take it. These rules also ensure that you understand why you need to take the treatment, how it will be given to you and possible side-effects.

These rules however, may not apply to you if:

  • your life is at risk.
  • your health will deteriorate without the treatment.
  • you are a danger to yourself or others.

When you are first given medication for your mental illness, your doctor should:

  • explain what the medication is for.
  • tell you about any side-effects.
  • ask for your consent.

What if I do not consent?

If you are detained in hospital, you may have to take medication for the first three months of treatment.

This applies even if you do not give your consent, or if you are too ill or unable to give it.

What happens next?

After three months, your doctor must have a certificate that gives them the right to continue giving you your medication (even if you do not give your consent).

If you give your consent to continue taking the medication, your doctor will record your views in a certificate which states that they have explained the medication to you and you have agreed to continue taking it.

Your doctor must be sure that you are well enough to give full consent and that you understand the nature, purpose and likely effects of the medication.

What if I don't give consent after three months?

If after three months of treatment, you do not want to continue taking your medication, or you are too ill to give consent, your doctor must get in touch with us.  

In these cases, an independent expert known as a Second Opinion Appointed Doctor (SOAD) will visit you and decide whether you should continue taking the medication.

If the SOAD agrees that you should continue with all of your medication, or just some of it, they must fill in a certificate stating this and describing the medication you need to take. Your own doctor needs this certificate to continue with your treatment.

Electro-convulsive therapy

While you are detained in hospital under the Mental Health Act, your doctor may recommend electro-convulsive therapy (ECT) to you.

Your doctor will give you more information on ECT - including what it is and why they think you should receive it.

ECT can only be given to you with your consent, except in very urgent circumstances.

You can change your mind about receiving ECT, even if gave your consent at first.

We have produced a leaflet detailing your rights regarding consent to ECT.

This leaflet is available in both standard and easy to read formats below.


What if I don't want to receive ECT?

You can refuse to receive ECT, but you’ll need to put this in writing and sign it in front of a witness (who will also need to sign it). You'll then need to return it to a member of your treating team.

What if I cannot give my full consent?

If you are unable to give consent, your doctor must tell us if they think that you need to receive it.

We will arrange a visit from an independent expert known as a Second Opinion Appointed Doctor (SOAD) who will decide whether you should receive ECT or not.

If the SOAD does not agree, your doctor cannot give you ECT.

I'm under 18 years old - what are my rights?

If you are under 18, both your doctor and the SOAD must agree that you should receive ECT before it can be given. This applies even if you have already given your consent.

Independent Mental Health Advocates

You have a legal right to receive support from an Independent Mental Health Advocate if you are detained under the Mental Health Act.

These advocates help you get information that relates to your particular circumstances under the Mental Health Act.

As well as providing information, they can also help to ensure that you participate fully in decisions regarding your care and treatment.

How do I get support from an Independent Mental Health Advocate?

There are several different services providing Independent Mental Health advocacy across England.

The hospital where you are receiving treatment should provide you with information about how to contact your nearest independent mental health advocacy service.

A member of your treating treating team will also be able to give you more information.