Inpatient care

You won’t be taken to hospital until a bed is available and the hospital agrees to admit you. If there’s no bed available, you may be taken to your local A&E department until one becomes free. Sometimes there might only be a bed available in a hospital further away from home, but professionals will try to keep you as close to home as possible.

When you do go into hospital, you’ll be given a bed in the inpatient mental health ward. To keep you safe, this could be a locked ward, meaning you won’t be able to come and go freely. On most psychiatric wards there will be a mixture of voluntary and sectioned patients, so even if you’re there by choice, you may need permission to leave. Some locked wards have secure outdoor spaces like a garden or courtyard.

If you’re under 18, you should be sent to a mental health ward for under-18s – called a CAMHS ward in England, or Tier 4 services in Wales. When you arrive, someone should show you around and help you settle in. Normally, you’ll be on a ward with other young people, but on rare occasions, you might have to stay on an adult ward instead. This could happen if:

• you need to go into hospital quickly but there are no beds on the young people’s ward
• being on an adult ward is better for your care – like if you're nearly 18 and don’t want to move wards soon after, or if you have a baby

Once you're there, you’ll meet your responsible clinician – the person in charge of your care. This is usually a psychiatrist, but it could be another trained mental health professional.

If you're going into hospital, it’s a good idea to pack a few things that help you feel comfortable. There are some rules about what you can and can’t bring for safety reasons, but hospital staff will let you know if you’ve brought anything that’s not okay.

If it’s a last-minute emergency and you can’t pack, don’t worry – someone can bring your things in later.

Here are some things to think about taking:

• comfy clothes
• pyjamas
• toiletries (like toothbrush, shampoo, etc.)
• socks and underwear
• a notebook or journal (not wire bound)
• colouring book or puzzle book
• playing cards or something to pass the time
• wireless headphones (if allowed)
• sports clothes (in case there's a chance to get active)
• a sleep mask or ear plugs
• your favourite cuddly toy
• flip-flops or slippers
• photos or something comforting from home
• a blanket or pillow
• schoolwork or textbooks if you want them

Avoid bringing anything really valuable or that you’d be upset about losing or breaking.

After you're assessed, the staff will work with you to make a treatment plan – sometimes called a care plan. This will be based on what you need and what will help you feel better.

Your care plan might include things like:

• one-to-one therapy
• group therapy
• medication
• creative or group activities
• occupational therapy (like help with school or routines)
• family therapy

It’s likely that lots of different professionals will be involved in your care. Nurses will support you day-to-day, and you’ll also meet with doctors, therapists and other mental health professionals.

Yes – you should always be involved in decisions about your care and treatment. Your thoughts, experiences and opinions matter, and professionals should take them seriously, whatever your age or situation.

Whether you’re able to make decisions yourself depends on a few things, like how old you are and whether professionals think you have the understanding and capacity to make safe choices at that time.

• If you’re under 16, professionals will assess whether you have enough understanding to make decisions on your own (this is sometimes called ‘Gillick competence’). If they don’t think you can make decisions on your own, they’ll usually work with your parents or carers to decide what’s best.
• If you’re 16 or older, you have the right to make decisions about your treatment. Professionals should assume you’re able to do this, unless an assessment shows you can’t. They should also support you to make decisions – for example by making sure you have all the information you need. If professionals do an assessment and they think you’re not able to make informed and safe decisions at the moment, they might make some decisions themselves, or together with your parents or carers if you’re under 18. This is outlined in the Mental Capacity Act. The decisions they make will always be in your best interests and they’ll still aim to take your wishes into account and explain decisions as much as possible.

If you're staying in hospital, you'll have a care plan (sometimes called a treatment plan). This sets out what support and treatment you're going to get – like talking therapies, medication, or support from nurses.

The people planning your care should think about:

• what treatments you feel have helped or not helped before
• your age and physical health
• your religion, culture or beliefs
• your gender identity or sexuality
• what might happen if you don’t get treatment

If something doesn’t make sense, it’s always okay to ask. You deserve to understand what’s happening.

Sometimes, if you’ve been sectioned, treatment can go ahead even if you don’t agree. But you still have the right to know what’s happening and to be treated with respect.

Yes – you’re allowed to have visitors, and seeing people you trust can be an important part of feeling supported.

Each hospital ward has its own rules, so it’s a good idea for your family or friends to check with staff before visiting. Some wards have fixed visiting times, while others are more flexible. There may also be rules about what visitors can bring in.

If visits feel difficult, you can ask for things to make them easier – like meeting in a quieter space or doing an activity together. Some wards have a garden or courtyard you can use.

If the staff feel it’s safe, you may be able to go on short trips with visitors, which might make visits feel more relaxed.

If seeing people feels like too much right now, that’s okay too. You can change your mind at any time. If you don’t want to see anyone at all, you don’t have to. It’s your choice.

If you're in hospital voluntarily, you can usually come and go freely, but some wards are locked, and you might need to ask staff to let you out. You can also talk to them about going home for a short time or spending time off the ward.

If you've been sectioned, you can only leave hospital if your responsible clinician agrees it's safe. This is called section 17 leave. You might get permission to go for a walk, visit home, go on a day trip, or go somewhere overnight – either on your own or with someone else. The staff will talk with you about what's possible and what kind of leave would work best for you.

It’s totally normal to wonder about this. You might be thinking about your background, culture, gender, sexuality, disability, or something else that’s important to who you are, and whether you’ll feel understood or find people you can relate to.

There are usually young people from all sorts of backgrounds in hospital. You might meet someone who really gets what you’re going through, or you might not. Some people find that helpful, others can feel a bit out of place at first.

Either way, you deserve to feel safe, respected and supported while you’re there. If you’re feeling unsure or worried about anything, like who you’ll be sharing a space with, what helps you feel comfortable, or any religious or cultural needs, talk to a member of staff. They’re there to help and can make any adjustments to support you.

You should still get education and support while you’re in hospital, in a way that works for you. Staff will usually get in touch with your school or college to understand what kind of work or support you need, so you can keep learning during your stay. And lots of mental health units have their own school attached to them.

If you’re feeling well enough, you might still be able to sit any exams you’ve got coming up. If that feels too much, you or your parent or carer can talk to your school or college about delaying your exams or taking more time out if you need to.

If you’re in hospital voluntarily, you can usually decide when you want to leave. But if your care team is worried about your safety, they might decide to section you to keep you safe.

If you’ve been sectioned under the Mental Health Act, you can’t leave hospital early just because you want to – your care team will decide when you're well enough to leave. They should keep discussing this with you and involving you in this decision.

If you don’t agree with this, you might be able to apply for a Mental Health Tribunal. This is a legal hearing where an independent panel decides whether you still need to be sectioned.

The tribunal is a group of three people who don’t work for the hospital. They include:

• a judge, who leads the hearing
• a psychiatrist (not from your hospital)
• a professional with mental health experience

They will:

• look at how you’re doing
• speak to you and your care team
• read reports about your mental health

They’ll then decide if you need to stay in hospital under your section or if you can leave.

Tribunals usually happen in the hospital, but they are independent and not part of your care team.

You can only apply for a tribunal under some sections of the Mental Health Act, for example if you're on a section 2 or section 3. If you’re under a short-term section (like section 136) or a court-ordered section, you probably won’t be able to apply.

If you’re not sure which section you're on or whether you can apply, ask someone on your care team. You can also get help from a mental health solicitor or ask your Nearest Relative to apply for you.

Leaving hospital – or being ‘discharged’ – can feel like a big step. It’s exciting but also scary. Before you leave, your care team will want to make sure you’re well enough to leave and you’ve got the right support in place for when you're back at home.

Sometimes, the end of your section doesn’t mean you’ll leave hospital straight away. If you still need support but don’t need to be sectioned, you might stay on the ward as a voluntary patient instead. This means you're there by choice and can usually leave when you feel ready – but staff will still want to make sure you're safe and supported.

There should be a discharge meeting where you and your family talk through what support you’ll have. You’ll be given:

• a discharge summary explaining how long you were in hospital and what treatment you had
• a care plan that says what support you’ll get and what to do if things get tough again
• the name and contact details of the main professional who’ll support you after you leave, like a care coordinator at Child and Adolescent Mental Health Services (CAMHS) or Adult Mental Health Services (AMHS)
• a crisis plan – this says what to do and who to contact if you’re in crisis
• info about going back to school or college, if that’s something you want to do
• appointment dates or a clear idea of what will happen in the first few weeks after leaving hospital

If you have a right to free support after leaving hospital, someone should tell you about this. It’s called section 117 aftercare, and it means you should get help to stop your mental health from getting worse. You can keep this support until your care team agrees you no longer need it. As a voluntary patient, you don’t have the right to section 117 aftercare.

Coming home can feel like a relief – but it can also take time to adjust. Your care team should still check in with you, either at home, at appointments, or through CAMHS or your GP. But there are also things you can do for yourself to help you settle back in:

• Talk to someone you trust if things feel hard – it could be a family member, a friend or someone from your care team.
• Spend time doing things you enjoy, even small things like watching your favourite show, baking, going for a walk, or playing sport.
• Take your time – you don’t have to feel okay straight away.
• Keep a list of people or services you can contact if you need support, like your care coordinator or a helpline.

The Equality Act is a law that says everyone must be treated fairly – no matter who they are. Hospitals have to follow this law. That means they can’t treat you unfairly because of things like:

• your disability or mental health condition
• your age, race or religion
• your gender or sexuality
• if you’re pregnant or have had a baby
• if you’re transgender

If you need extra help or support, the hospital should make what's called reasonable adjustments. These could include things like:

• getting a sign language interpreter
• making the ward wheelchair accessible
• providing a space to pray
• offering halal or other culturally appropriate food

If something doesn’t feel fair or right, you can talk to staff you trust or ask to speak to an advocate. You have the right to speak up, and there are people who can help.

Even in hospital, you should be able to:

• wash and get dressed in private
• see visitors privately
• send and receive messages without staff reading them

If staff are worried about your safety or someone else’s, they might check on you more or watch you more closely. But they should still treat you with respect and explain why.

Some wards use cameras in bedrooms. If you’re not sure or don’t want to be filmed, speak to your care team or an advocate.

Things you tell your care team should stay private, unless:

• you say it's okay to share
• it helps you get better care
• staff are seriously worried about your safety or someone else’s

If staff do need to share something, they should try to tell you first.

If you’re sectioned, you have the right to a special advocate called an Independent Mental Health Advocate (IMHA).

If you’re a voluntary patient, in England you don’t have the right to an IMHA but in Wales you do.

An advocate helps you understand your rights and speak up about your care. They don’t work for the hospital – they’re on your side.

If you're sectioned under section 2, 3, 4 or 37, you have a legal right to a Nearest Relative. This is usually a parent, carer or guardian. But it could also be:

• a brother or sister over 18
• a grandparent, aunt, uncle or another close family member

The law decides who your Nearest Relative is. You don’t get to choose them, which can feel unfair, but it’s usually someone close to you.

Your Nearest Relative has certain rights. They can:

• in some cases, say no to you being sectioned under section 3
• ask for your section to end if you’re on section 2 or 3
• get information about your treatment and care

Doctors should always tell your Nearest Relative if you’re being sectioned.

If you don’t want your Nearest Relative to get information about your care or treatment, tell your care team. They’ll talk it through with you and explain your options.

Your care team must explain:

• why you’re in hospital
• what your rights are
• when and how you can be given treatment
• how to challenge your section
• how to get support from an advocate (if you’re entitled to this)

They should give you this information in a way that works for you – like large print, easy read, Braille or in another language.