The courts and mental health
Explains what may happen if you are charged with committing a crime, what happens when you to go court, and how your mental health is taken into account.
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Section 37 hospital order
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
- appropriate treatment is available
- the court decides that a hospital order is the most suitable method of dealing with your case, and
- arrangements have been made for you to go to hospital within 28 days of the order.
If the court thinks that you are a high risk to the public it can add restrictions to the hospital order, known as a section 37/41.
How long will I be in hospital?
A section 37 lasts six months initially, but this can be extended ('renewed') by your responsible clinician.
It must be renewed:
- after the first six months
- again after a second six months
- and then yearly.
There is no limit to the number of times section 37 can be renewed.
If it's not renewed, the section 37 will end, and you will be free to leave hospital if you want to.
How can a hospital order be renewed?
In order to renew the hospital order, your responsible clinician must see you, consult with another professional and send a report to the hospital managers saying 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 will be able to attend if you don't agree.
How can I be discharged from hospital?
There are different ways you might be discharged from hospital:
- Your responsible clinician can end the hospital order at any time.
- You can apply to the Mental Health Tribunal.
- You can ask the hospital managers to discharge you at any time, even in the first six months. (See our pages on leaving hospital for more information.)
- Your nearest relative can apply to have you discharged. (See our pages on the nearest relative for more information.)
Once you are discharged from section 37, you will be eligible for free section 117 aftercare.
When can I apply to the Mental Health Tribunal?
You can't apply in the first six months of the hospital order. You should check the date of the order.
You can apply:
- once in the second six months, then
- once every 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.
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 which means you should be in hospital for treatment
- they don't think it's necessary for your health or safety, or for the protection of others, for you to get treatment, or
- appropriate treatment is not available for you.
Once you are discharged from section 37, you will be eligible for free section 117 aftercare.
See our pages on leaving hospital for more information about the Mental Health Tribunal.
Can I appeal the hospital order?
You may be able to appeal the court's decision to give you a hospital order as opposed to some other outcome, such as a prison sentence.
From the Magistrates' Court you can appeal to the Crown Court, and from the Crown Court to the Court of Appeal. Here is a flowchart that outlines this process:
You should get legal advice from your solicitor if you want to make an appeal.
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 July 2018.
This page is currently under review. All content was accurate when published.
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