Involuntary admission: being admitted to hospital against your will

In certain circumstances, you may need to be admitted to hospital for treatment of your mental health.

In most cases, people go to hospital by choice. This is called a voluntary admission. If you feel you need a hospital admission, discuss this with your GP or psychiatrist.

An involuntary admission is when you are admitted to hospital against your will.

The Mental Health Act 2001 covers involuntary admissions.

Mental Health Act 2001 - irishstatutebook.ie

When an involuntary admission can happen

Involuntary admission can only happen if you are not willing to go into hospital and have 1 of the following:

a severe mental health difficulty
significant intellectual disability
severe dementia

One or more of the following things must also apply:

there is a risk you may cause serious harm to yourself or others
your judgement is so impaired that you need treatment that is only available in a hospital
your condition could get worse if you do not get the treatment that you need

When an involuntary admission cannot happen

An involuntary admission cannot happen only on the basis that you:

are addicted to drugs or alcohol
have a diagnosis of a personality disorder or social deviance

How an involuntary admission happens

Family members, a GP, carer or other professionals may have concerns about your mental health.

It is best if they discuss this with you, and together you make a decision about what help you may need, such as making an appointment with your GP to discuss further options.

But there may be times when there are stronger concerns about your mental health and your ability to make use of the help offered.

In these circumstances your relatives or the professionals involved in your care can ask for a formal assessment of your mental health.

There are 3 stages:

application
medical assessment
psychiatric assessment

Application

The only people who can apply to have you assessed are:

a relative or spouse
an authorised officer who is an employee of the HSE
a member of the Gardaí
a concerned member of the public
any other concerned person

They also must be age 18 and over and have seen you in person in the last 48 hours.

They apply to a medical professional (usually a GP) to have you assessed.

Medical assessment

The medical professional they apply to must examine and assess you within 24 hours of getting the application. They may recommend that you are admitted to hospital.

Psychiatric assessment

A psychiatrist in the hospital will examine you within 24 hours of being admitted to hospital.

If they decide you need to be admitted and you're not willing to stay, you will be admitted against your will.

Other circumstances for involuntary admission

You may be in hospital voluntarily and decide to leave the hospital against the advice of staff.

The psychiatrist, nurse or doctor may then decide to keep you in for up to 24 hours. This gives time for an independent examination by another psychiatrist.

Depending on the outcome, you might be admitted against your will to the hospital - or be free to leave.

Your rights

The Mental Health Act 2001 protects your rights.

Mental Health Act 2001 - irishstatutebook.ie

Mental health tribunal

The Mental Health Commission will refer your case to a mental health tribunal. It will provide you with a solicitor for free. The solicitor will visit you. They will help you prepare for your mental health tribunal hearing.

The tribunal will appoint an independent psychiatrist who works for the Mental Health Commission.

The psychiatrist will:

talk to you about your case and assess you
review your clinical file
interview the original psychiatrist

Each mental health tribunal has a:

chairperson - a barrister or a solicitor
consultant psychiatrist - independent from the hospital and the mental health service
third person - a member of the public who is not a registered medical practitioner, nurse, psychiatrist, solicitor or barrister

The tribunal will look at your involuntary admission to decide if it followed the law. Tribunals generally happen in the hospital.

The tribunal decision

The tribunal will make 1 of the following findings:

the procedures followed the law and you need to stay in the hospital
your case does not meet the conditions for involuntary admission and you can be discharged (leave hospital) - but you may continue to stay in the hospital as a voluntary patient, if you want to

Appeals

If you disagree with the tribunal’s decision you can appeal to the Circuit Court. You must do this within 14 days of the tribunal’s decision. Your solicitor will help you with the appeals process.