Anyone who may have a need for community care services is entitled to a social care assessment when they are discharged from hospital to establish what services they might need. However, Section 117 goes much further than this and imposes a duty on health and social services to provide aftercare services to certain patients who have been detained under the Mental Health Act.
Section 117 states that aftercare services must be provided to patients who have been detained in hospital:
- For treatment under Section 3
- Under a hospital order pursuant to Section 37 (with or without a restriction order) or
- Following transfer from prison under Section 47 or 48.
This also includes patients on authorised leave from hospital and patients who were previously detained under Section 3 but who stayed in hospital after discharge from section.
It also includes people who are living in the community subject to a community treatment order and restricted patients who have been conditionally discharged
However, Section 117 does not apply to:
- Patients detained in hospital for assessment under Section 2
- Patients detained in an emergency under Section 4
- Patients detained while already in hospital under Section 5(2)
- Patients who were not detained under any section (informal or voluntary patients).
Aftercare and the Care Programme Approach (CPA)
The care programme approach or CPA is a way in which mental healthcare is planned and delivered. It means that a person should be allocated a care coordinator, have multi-disciplinary care planning and review meetings and a written care plan. Not all patients will receive mental healthcare under the CPA. Even if mental healthcare is not provided under the CPA, patients should have their aftercare needs assessed if they are likely to need services to support them in the community when they are discharged from hospital.
Aftercare should be planned with the patient, their family and carers, as well as professionals, looking at both health and social care needs. The type of aftercare required will depend on the circumstances of the individual and health and social services are entitled to consider their resources when assessing needs. The care plan should be reviewed at regular intervals.
In England, detained patients and people on community treatment orders, conditionally discharged restricted patients and people subject to guardianship orders have the right to have an Independent Mental Health Advocate (IMHA) to support them in understanding their rights and expressing their views. The right to get help from an IMHA is much wider in Wales. All inpatients in Wales who are receiving treatment for mental health problems, even informal patients who are not under any section of the Mental Health Act, have the right to an IMHA. It may be helpful to ask for an IMHA to attend assessment and aftercare planning meetings.
Services provided to a person before admission to hospital, and which meet needs identified under Section 117, will become part of the aftercare package. Therefore, if someone was paying for their residential care before they were detained in hospital under Section 3, this will become part of their aftercare following discharge and responsibility for payment will pass to the clinical commissioning group, if the patient is in England (in Wales, the local health board) or to the local social services authority. If medication was being paid for before detention then that should also be provided free of charge.