Section 3: Admission for Treatment

Section 3 can be applied when:

1. The patient is suffering from a mental disorder of a nature or degree that makes it appropriate to receive medical treatment in hospital.
2. It is necessary for the patient's health or safety, or the protection of others, that they receive treatment, and treatment cannot be provided unless they are detained.
3. Appropriate medical treatment is available — unlike under the pre-2007 Act, it is now a statutory requirement that treatment which is appropriate in the patient's case is actually available in the hospital to which they are being admitted.

Section 3 additionally requires that the AMHP must have consulted the nearest relative, and the nearest relative must not have objected to the application. If the nearest relative objects, the AMHP cannot make the application unless they seek a County Court order to displace the nearest relative.

Part 4 of the Mental Health Act 1983 sets out when treatment can be given without consent to detained patients:

• Medication (Section 58): For the first 3 months of any continuous period of detention, medication can be given without consent. After 3 months, a SOAD from the Care Quality Commission must certify that the treatment is appropriate. The patient's consent (if they have capacity) is sought; if they consent, the SOAD certifies consent. If they refuse, the SOAD may still authorise treatment if appropriate.
• Electro-convulsive therapy (ECT) (Section 58A): ECT cannot be given to a patient who has capacity and refuses. For patients lacking capacity, a SOAD must certify appropriateness.
• Urgent treatment (Section 62): In emergencies, treatment can be given without consent or SOAD approval where immediately necessary to save life, prevent serious deterioration, or alleviate serious suffering.

Section 3 detention can be renewed at the end of the initial 6-month period and annually thereafter. To renew:

1. The Responsible Clinician (RC) must examine the patient in the two months before the current authority expires.
2. The RC must consult at least one other person professionally involved in the patient's treatment (typically a nurse).
3. The RC reports to the hospital managers that the renewal criteria are met (the same criteria as for the original Section 3 application).
4. The hospital managers must then consider whether to accept the renewal — they have the power to discharge the patient instead.

Patients must be informed in writing of the renewal and of their right to appeal to a Mental Health Tribunal. If the hospital managers do not hold a hearing within the first 6 months of a patient's detained period under Section 3, they must hold one. Similarly, Tribunals must periodically review long-term detentions.

Discharge from Section 3 can occur through the same routes as Section 2 — RC, hospital managers, nearest relative (subject to the barring report), and Mental Health Tribunal. In addition:

• A patient can be placed on a Community Treatment Order (Section 17A) — a form of supervised discharge allowing the patient to live in the community subject to conditions, with power to recall to hospital if conditions are breached.
• On discharge from Section 3, the patient is entitled to Section 117 aftercare — a joint duty on the NHS and Local Authority to provide free aftercare services for as long as they are needed.