If you are detained under the Mental Health Act or on a community treatment order (CTO), your doctor may have to ask for a Second Opinion Appointed Doctor (SOAD) to check whether your treatment is appropriate and that your views and rights have been considered.
If you are detained in hospital
Your doctor must request a SOAD if:
They recommend you are given electro-convulsive therapy (ECT) and you are too unwell to make a choice about this.
If you are able to give consent, but refuse to do so, you cannot be given ECT (except in urgent situations).
3 months have passed after you started to take medication.
For the first 3 months, your doctor can treat you without having to ask for a SOAD. After 3 months, if you do not agree to take your medication or are too unwell to agree, the SOAD will review whether your medication is necessary and should continue.
After that, your doctor must request another SOAD if:
- your treatment has changed significantly
- you no longer agree to your treatment, or are no longer able to agree
Occasionally urgent treatment can be given to you without seeing a SOAD.
If you are on a community treatment order (CTO)
Your doctor must request a SOAD 1 month after the start of your CTO, if you are too unwell to agree to your treatment.
After that, your doctor must request another SOAD if:
- your treatment has changed significantly
- you no longer agree to your treatment, or are no longer able to agree
Neurosurgery to treat your mental health
You cannot have neurosurgery to treat your mental health unless you agree to this and are well enough to agree to this.
If you do agree or wish to have this treatment, your doctor must request a Mental Health Act second opinion even if you are not detained or on a CTO.
For this type of treatment, a SOAD is joined by 2 people who are not doctors. They will make sure that you agree to the treatment, are well enough to agree, and confirm that it is appropriate for you in your circumstances.
Related information
How we help protect your rights under the Mental Health Act
Your rights around treatment when you are under the Mental Health Act
What to expect when you speak with Second Opinion Appointed Doctor (SOAD)
Independent mental health advocates (IMHA)
Complain about the use of the Mental Health Act
Give feedback on care and tell us what you think about your care and treatment.