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The courts and mental health

Explains what may happen if you're charged with committing a crime, what happens when you to go court, and how your mental health is taken into account.


Sometimes people with mental health problems may come into contact with the criminal justice system. This might include going to court.

Our legal information on the police and mental health has more information about what happens if you have contact with the police. This includes if you’re arrested and if you’re taken to the police station.

Quick facts

  • If you’re charged with an offence, you’ll have to go to the Magistrates' Court for a hearing. At this first hearing, the magistrates will decide which court your case will be heard in: the Magistrates’ Court or the Crown Court.
  • You should get legal advice from a solicitor if you can. A solicitor can help you understand what's happening and get the best possible outcome. Sometimes you can get legal aid to help you pay for this.
  • If you’re charged with a crime and have to go to court, you’ll need to enter a plea. This means saying you're guilty or not guilty. Sometimes, your mental health might mean it’s difficult to understand the meaning of a charge against you. In this case, the court might say that you're unfit to plead.
  • Before your trial, the court will decide where you're allowed to stay. This will depend on your situation. You might be allowed to go home on bail or to a different address. Or you may be kept in prison on remand, or sent to hospital for a report on your mental health.
  • If you have a trial, the prosecution will try to prove that you're guilty. You’ll try to argue that you’re innocent. You generally can't use a mental health problem as a defence – except in certain situations.
  • If you're found guilty, the courts have several options for what your outcome might be. The courts should take your mental health problem into account when they decide. You may be able to appeal the decision if you disagree with it.
  • There are some sections of the Mental Health Act that may affect you, depending on your circumstances:
    • Section 37 – this is an order to send you to hospital instead of prison.
    • Section 37/41 – this is an order to send you to hospital instead of prison, with restrictions added. The Crown Court might add restrictions if it thinks you’re a serious risk to the public.
    • Section 47 – if you're serving a prison sentence, the prison can transfer you to hospital for treatment.
    • Section 47/49 – this is a transfer from prison to hospital, with restrictions added. The Ministry of Justice might add section 49 restrictions if it thinks it’s appropriate.
    • Section 48/49 – under section 48 you can be sent to hospital when you’re on remand in prison, or in an Immigration Removal Centre. Usually, the Ministry of Justice will add special restrictions to your transfer under section 49, making it a section 48/49.

This information was published in April 2024. We'll revise it in 2027.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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