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.
Section 37 hospital order
This page covers:
What is a section 37 hospital order?
A section 37 is an order to send you to hospital instead of prison. A Crown Court or Magistrates' Court can make this order if it thinks that a hospital order is the most appropriate way of dealing with your situation.
The Crown Court or Magistrates' Court can give you a hospital order if:
- You’ve been charged with, or convicted of, an offence which could lead to a prison sentence
- Two doctors have given evidence that you have a mental disorder that means you should be in hospital for treatment, and treatment is available
- The court decides that a hospital order is the most suitable method of dealing with your case
- Arrangements have been made for you to go to hospital within 28 days of the order
If the court thinks that you’re a high risk to the public, it can consider adding restrictions to the hospital order. This is known as a section 37/41. Only the Crown Court can add restrictions to the hospital order as part of a sentence. So if the Magistrates’ Court thinks this is needed, it must send the case to the Crown Court for sentencing.
How long will I be in hospital under section 37?
A section 37 initially lasts for 6 months. But this it can be extended, or ‘renewed’, by your responsible clinician.
After the first 6 months, they can renew it for a further 6 months. And then after that, they can renew it for 12 months at a time. There’s no limit to how many times a section 37 can be renewed.
If it's not renewed, the section 37 will end. You’ll be free to leave hospital if you want to.
How can a hospital order be renewed?
For a hospital order to be renewed, several things must happen:
- Your responsible clinician must see you and assess you.
- Your responsible clinician must then consult with another professional about you. And then send a report to the hospital managers. They can use this report to say that they think the hospital order should be renewed.
- The hospital managers will likely have a hearing to decide whether the hospital order should be extended. You can join this meeting if you wish. This may include if you disagree with the responsible clinician’s recommendation to renew the order.
How can I be discharged from a section 37?
There are a few ways in which you might be discharged:
- Your responsible clinician can end the hospital order at any time.
- You can apply to the Mental Health Tribunal to end the section 37.
- You can ask the hospital managers to discharge you at any time. This includes in the first six months. See our page on hospital managers for more information.
- Your nearest relative can apply to have you discharged.
If you’re discharged from a section 37, you’re free to leave hospital and live in the community. You will be eligible for free section 117 aftercare. It’s also possible that you may be put on a community treatment order (CTO).
When can I apply to the Mental Health Tribunal?
You can't apply in the first 6 months of the hospital order. But if the order is renewed, you can apply:
- Once in the second 6 months
- Once per year after that
It doesn't matter when the hearing takes place. It's the date of the application that must be within these periods.
If you’re under a section 37 order, the hearing should take place within 2 months of your application. Or if your hospital order is restricted, for example under a section 37/41, the hearing should take place within 4 months.
See our pages on leaving hospital for more information about the Mental Health Tribunal.
When must the Mental Health Tribunal discharge me?
The Mental Health Tribunal must discharge you if:
- They don't think you have a mental disorder that requires you to be treated in hospital
- They don't think it's necessary to get treatment for your health or safety, or to protect others
- Appropriate treatment for you isn’t available
Magistrates' Court
This is one of the two types of criminal courts. It is the lower of the two courts, below the Crown Court.
Visit our full listing of Legal TermsCrown Court
This is one of the two types of criminal courts. It is the higher of the two courts, above the Magistrates' Court.
Visit our full listing of Legal TermsMental disorder
When the Mental Health Act talks about someone with mental health problems and whether or not they should be sectioned, it often uses the term 'mental disorder'. The Act says that this can include "any disorder or disability of mind".
Mental disorder can include:
- any mental health problem normally diagnosed in psychiatry
- certain learning disabilities.
Responsible clinician (RC)
This is the mental health professional in charge of your care and treatment while you are sectioned under the Mental Health Act.
Certain decisions, such as applying for someone who is sectioned to go onto a community treatment order (CTO), can only be taken by the responsible clinician.
All responsible clinicians must be approved clinicians. They do not have to be a doctor, but in practice many of them are.
Visit our full listing of Legal TermsHospital managers (also known as Mental Health Act managers)
Hospital managers are an independent team of people in a hospital who make sure that the requirements of the Mental Health Act are properly applied. They have certain important responsibilities and can make decisions related to your detention.
In practice, most of the day-to-day decisions are taken by individuals authorised by the hospital managers to do so. This can include hospital staff. Decisions about discharge are normally delegated to a team of people who are independent of the hospital. You can apply to them to be discharged from your section and they will decide whether or not to discharge you.
Visit our full listing of Legal TermsSection 117 aftercare
Some people who have been kept in hospital under the Mental Health Act can get free help and support after they leave hospital. The law that gives this right is section 117 of the Mental Health Act, and it is often referred to as 'section 117 aftercare'.
Health authorities and local social services have a legal duty to provide you with section 117 aftercare if:
- you've been detained under Mental Health Act sections 3, 37, 47 or 48, but have left hospital, or
- you're under a community treatment order (CTO).
Mental Health Tribunal (MHT)
This is a special court that deals with cases relating to the Mental Health Act 1983. The Tribunal decides whether you can be discharged from your section. It can sometimes make recommendations about matters such as hospital leave, transfer to another hospital, guardianship and community treatment orders (CTOs).
The court is made of a panel, which normally includes:
- a legally qualified chairperson
- a ‘lay member’ who has appropriate experience and qualifications in the area of mental health
- an independent psychiatrist, who will speak to you and examine you before the tribunal hearing in certain circumstances, and when you request to see them
Where you see a reference to the Mental Health Tribunal in this guide, it means:
- First Tier Tribunal (Mental Health), if you live in England, or
- Mental Health Review Tribunal for Wales, if you live in Wales.
Court of Appeal
The Court of Appeal deals with appeals from the Crown Court.
Visit our full listing of Legal TermsNearest relative
The nearest relative is a family member who has certain responsibilities and powers if you are detained in hospital under the Mental Health Act. These include the right to information and to discharge in some situations.
The law sets out a list to decide who will be your nearest relative. This can sometimes be changed.
See our pages on the nearest relative for more information.
Visit our full listing of Legal TermsThis information was published in April 2024. We'll revise it in 2027.
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