Information for Carers

In most cases when people are treated in hospital or another mental health facility, they have agreed or volunteered to be there. They may be referred to as a voluntary patient. But there are cases when a person can be detained, also known as sectioned, under the Mental Health Act (1983) and treated without their agreement.

The Mental Health Act (1983) is the main piece of legislation that covers the assessment, treatment and rights of people with a mental health disorder.

People detained under the Mental Health Act need urgent treatment for a mental health disorder and are at risk of harm to themselves or others.

Advice for carers and families

If your loved one has been detained, they will have to stay in hospital until the doctors or a mental health tribunal decide otherwise. You still have the right to visit.

Visiting arrangements depend on the hospital, so check visiting hours with staff or on the hospital website. In some cases the patient may refuse visitors, and hospital staff will respect the patient's wishes.

If you're unable to see your loved one, staff should explain why. With permission from your loved one, doctors may discuss the treatment plan with you. You can also raise concerns or worries with the doctors and nurses on the ward.

Hospital accommodation should be age and gender-appropriate. Not all hospitals will be able to offer a ward dedicated to each gender, but all should at least offer same-sex toilets and washing facilities.

For more information go to the NHS website.

Your right to have the freedom of choice to be a carer

Caring is a choice, and everyone has the right to choose whether to be a carer. You have the right to self-assess your ability to care and be supported to identify which needs of the person you are caring for you are willing and able to support.

Your right to be identified as a carer

You have the right to be identified as a carer at your GP surgery, with the local authority who are assessing the care and support needs of the person you care for, and in hospital and other health settings when the person you care for is admitted, or due to be discharged. You also have the right to register as a carer with your local carer support organisation.

Your right to a Carer’s Assessment

No matter the level of care you are providing, or how many hours you care for, you have the right to request a Carer’s Assessment from your local authority or local carer support organisation to determine your needs for support, if you have needs which arise as a result of your caring role.

Your needs may be around taking a break, seeing other important people in your life, help with travel or fuel costs you incur to carry out your caring role, or to help you to learn new skills to support you to care more safely. As part of the Carer’s Assessment process, you also have the right to create and register a Carer’s Emergency Plan with your local authority for if you cannot continue caring due to an unexpected circumstance or an emergency.

Your right to be included in care planning of the person you care for

As a carer you have the right to be involved in decision-making when decisions are being made around changes to or developments to a service for the person you care for with the local authority, where there is an expectation of you to provide care. You also have important new rights at hospital discharge.

NHS hospital trusts in England must ensure unpaid carers are involved as soon as possible when plans for a patient’s discharge after treatment are made. This covers all carers of adults needing care and support following hospital discharge, including healthcare support such as continuing healthcare.  

Your right to protection from discrimination

As a working carer you have the right to ask for flexible working from your employer and to be given time off in emergencies. The new Carer’s Leave Act 2023 has also introduced the legal right for carers to take a week of unpaid leave each year from work.

Your right to free NHS health checks, flu and Covid jabs

As a carer you have a right to receive a free NHS health check. The health checks are aimed at adult carers between the ages of 40 and 74 and carers at risk of admission to hospital (or if the person you are caring for is at risk of hospital admission). If you are a carer aged sixteen or over, you also have the right to request free flu and Covid vaccinations to help protect you and the person you are caring for from illness.

Your right to financial support

If you are 16 or over and caring for someone for more than 35 hours a week, you have the right to apply for Carers Allowance. Even if you are not entitled to any benefits due to your income, you will still be awarded an underlying entitlement. In certain circumstances, you may also be entitled to reductions in council tax due to a low income or a carers disregard if you need to stay over with the person you are caring for due to them having night needs, or because you have moved in with them to provide necessary care.

Your right to Carer's Leave

Under the Carer’s Leave Act 2023, eligible employees can take up to five days of unpaid leave each year to care for a sick family member or friend. This leave can be taken in shorter blocks, allowing you to balance work and caring responsibilities while ensuring job security. To use this leave, notify your employer as soon as possible.

Eligibility generally includes being a full-time or part-time employee (not casual) and having been with the company for a few months. The leave covers caring for family members or close friends, such as partners. For more details, check with your HR department.

Who makes up a mental health team?

Most staff in a mental health team will have a mental health or social care background. Staff can include psychiatrists, social workers, mental health nurses, psychologists, occupational therapists, and support workers. All staff work together and have meetings to discuss the progress of anyone they support. These meetings are called ‘multi-disciplinary meetings.’

Psychiatrists

A psychiatrist is a medical doctor who has specialist training in mental health. They can diagnose mental illness, prescribe medication, and recommend treatment.

Social workers

A social worker is trained to give practical help with your social needs. Such as housing problems, financial issues, or by giving general support and advice.

Community psychiatric nurses (CPNs)

A CPN is a mental health nurse who works in the community. They can give you medication and help you to manage your health in the community.

Psychologists

A psychologist specialises in how your mind works. They will ask you questions to try to understand how your thoughts and feelings affect your behaviour. They can offer advice and therapy. They don’t normally prescribe medication.

Occupational therapists

An occupational therapist will give practical support to help you to do activities that you find difficult. They will help you to think about different ways of doing the activity. They will often give support in your home to help you to be as independent as possible.

Care Coordinators

A care coordinator is responsible for organising and monitoring your care if you are under the care programme approach (CPA). Normally, you will see your care coordinator more often than other NHS staff. Care coordinators can be nurses, social workers, community psychiatric nurses (CPN) or occupational therapists.

Family members and carers are welcome to call the office phone in order to speak to a service user and they are encouraged to visit.

Please call the ward in advance to book a visit to ensure a suitable time slot and room is available.

Children under 18 cannot visit the ward. A family room can be booked for a visit, this needs to be agreed by nursing staff.

A ward round is when the treatment team meet with your relative to see how treatment is going. They decide if they need to make any changes. The treatment team is made up of people such as a psychiatrist, nurse, psychologist or occupational therapist.

If your relative is happy for you to go to ward rounds, you could ask some of the following questions:

Can you explain my relative's diagnosis or treatment?
Will the medication cause side effects?
Are there patient information leaflets available about the medication my relative is taking?
Is there anything you can do to help deal with the side effects?
What other medications might work?
Will my relative see a therapist?
Have you checked whether the symptoms might be caused by physical illness?
How often will my relative see you?

If your relative has any problems with the care they are getting in hospital, they can contact an advocate. An advocate is not employed by the NHS and might be able to help with problems.

If your relative is in hospital under the Mental Health Act 1983 they are entitled to see an Independent Mental Health Advocate (IMHA). Ward staff should have details of the IMHA service that covers the ward.

If your relative isn’t under the Mental Health Act 1983, they aren’t entitled to see an IMHA. However, there may be a general advocacy service in the area that can help. This is often referred to as “community advocacy”. You can search online, ask staff on the ward or contact the local authority to find a service.

For information about the ward round of the person you care for, please speak to a member of ward staff.

City and Hackney ELFT have a Hospital Discharge Team who will support the person you care to leave hospital. Please do contact them to discuss Hospital Discharge or speak to any member of staff on the ward, or your Carer Support worker from the Family, Friends and Carers Hub.

What should happen before my relative leaves hospital?

When your relative is well enough to leave, the doctors will say that they can be discharged from hospital.

The hospital staff might ask you to go to meetings to discuss what will happen when your relative leaves hospital. This might be called a discharge meeting or a pre-discharge meeting.

This meeting could involve:

you
your relative
the care team in hospital
staff in mental health and social care services, who will be supporting your relative when they leave hospital.

This meeting is to make sure that your relative has the support they need when they leave hospital. It is a good chance for you to tell them what care you think your relative may need.

You should tell them if you can’t continue to care for your relative. Or if you feel they are expecting too much from you.

Guidance for healthcare professionals says carers should be involved as much as possible in their relative’s discharge. But you can’t go to the meeting if your relative doesn’t want you there.

Your relative might lack the mental capacity to agree to you being involved. The hospital must involve you if it is in your relative’s best interests.

City and Hackney East London Foundation Trust (ELFT) hospital wards work to the eight key principles for effective discharge planning from all mental health inpatient services:

Principle 1: individuals should be regarded as partners in their own care throughout the discharge process and their choice and autonomy should be respected principle
Principle 2: chosen carers should be involved in the discharge process as early as possible
Principle 3: discharge planning should start on admission or before, and should take place throughout the time the person is in hospital
Principle 4: health and local authority social care partners should support people to be discharged in a timely and safe way as soon as they are clinically ready to leave hospital
Principle 5: there should be ongoing communication between hospital teams and community services involved in onward care during the admission and post-discharge
Principle 6: information should be shared effectively across relevant health and care teams and organisations across the system to support the best outcomes for the person
Principle 7: local areas should build an infrastructure that supports safe and timely discharge, ensuring the right individualised support can be provided post-discharge
Principle 8: funding mechanisms for discharge should be agreed to achieve the best outcomes for people and their chosen carers and should align with existing statutory duties

As a carer, you have an important role and may have information to share with health and care professionals in order to support the individual you care for.

Before you share information about the individual with the health and care team, you should be aware that the individual you are caring for may at some point access their health and care record and may see the information you have shared about them, and your name.

The individual you are caring for needs to give their explicit consent for their confidential information to be shared with you by the health and care professionals working with them. The individual can decide how much information they would like to share with you.

Health and care professionals will work with you to ensure that you have sufficient information to allow you to care for the individual safely. This may be more general advice rather than sensitive information about the individual, to respect the individual's preferences.

If you are experiencing difficulties caring for someone because you do not have the information you need, you can discuss this with the team providing care to the individual. Health and care professionals can explain to the individual the benefits of sharing information with you, however, any decision not to share will need to be respected.

If the individual lacks capacity to give consent, then information may be shared with you if the health and care team considers it in the individual’s best interests. They will share only the information which is needed to continue providing care. Information sharing can also be authorised by someone who has been appointed as a health and welfare Lasting Power of Attorney (LPA) for the individual receiving care.

If you know that a health and welfare LPA exists for the individual you are caring for, please inform the health and care professionals involved in their care at the earliest possible opportunity. If you are appointed as the health and welfare LPA, then you will have access to the record.

You can find more information about sharing information on the NHS website here or on the Rethink Mental Illness website here.