Summary: We will not investigate Miss X’s complaint about the recommendation to detain her under Section 2 of the Mental Health Act. She has appealed that decision to the First Tier Tribunal (Mental Health), which was the most appropriate way to challenge the detention.

The complaint

1. Miss X complains that an Approved Mental Health Professional (AMHP - for Durham County Council) and two Section 12 doctors (for Tees, Esk and Wear Valleys NHS Foundation Trust and North East and North Cumbria Integrated Care Board) wrongly recommended detaining her under Section 2 of the Mental Health Act 1983. Miss X says the AMHP and Section 12 doctors decided she was “crazy” and needed to detain her. She says they did not give her the opportunity to be an informal patient. Miss X says events heightened her post traumatic stress disorder and she has lost faith in Council and NHS services. She would like £1,000 to recognise the impact on her.

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The Ombudsmen’s role and powers

2. The Ombudsmen may decide not to investigate a complaint if the complainant had a right of appeal and it was reasonable to expect them to use it. (Health Service Commissioners Act 1993, section 3(2) and Local Government Act 1974, section 24A(6), as amended)

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How I considered this complaint

3. I considered information provided by the complainant and the organisations.
4. I considered the Ombudsman’s Assessment Code.
5. Miss X had an opportunity to comment on my draft decision.

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What I found

Relevant legislation

6. Under the Mental Health Act 1983 (MHA), when someone has a mental disorder and is putting their safety or someone else’s at risk they can be detained in hospital against their wishes. This is sometimes known as ‘being sectioned’. Usually three professionals need to agree that the person needs to be detained in hospital. These include an Approved Mental Health Professional (AMHP) and usually (but not always) two doctors who have been specially approved in Mental Health Act detentions (Section 12 doctors).
7. The AMHP is responsible for deciding whether to go ahead with the application to detain the person and for telling the person. Any admission should be in the best interests of the person and they should not be detained if there is a less restrictive alternative.
8. When Section 12 doctors make recommendations under sections 2, 3 or 4 of the MHA, they are acting under powers which have been given to them under the MHA. But sometimes those doctors make those recommendations under an NHS contract. In this complaint, one Section 12 doctor worked for the Trust (who ultimately decided to detain Miss X under Section 2). The ICB was responsible for the actions of the other Section 12 doctor because it paid them for their work. This explains why the Trust and ICB are organisations in this complaint.
9. People who have been detained under the MHA can apply for a hearing to the First-Tier Tribunal (Mental Health) if they disagree with the decision. The Tribunal must discharge the person from detention if, on the day of the hearing, they do not meet the criteria needed for detention.

My findings

10. In June 2023, following concerns about Miss X’s mental health and behaviour in public, the AMHP and two Section 12 doctors carried out a MHA assessment. They recommended detaining Miss X under Section 2 of the MHA. The same day, the Trust agreed to detain her to assess her mental health and to provide any treatment she might need.
11. Miss X appealed her detention under Section 2 to the Tribunal the next day. Before the Tribunal could consider Miss X’s appeal, the Trust discharged Miss X from Section 2.
12. Miss X had a right of appeal to challenge the Trust’s decision to detain her. Because she used that appeal, I have decided not to investigate the complaint about the AMHP and Section 12 doctors recommendations. The appeal was the most appropriate way to challenge her detention under Section 2.

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Final decision

13. I will not investigate Miss X’s complaint about the recommendation to detain her under Section 2 of the Mental Health Act. She has appealed to the Tribunal, which was the most appropriate way to challenge the detention.

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Investigator's decision on behalf of the Ombudsman