Get help now Make a donation

Leaving hospital

Explains your rights about getting your section lifted if you are detained in hospital under the Mental Health Act. And your rights to care and support after leaving hospital.

  • This information applies to England and Wales.
  • This information applies to adults. It doesn't apply to children unless specifically stated.
  • In 2025 the government passed new laws making changes to the Mental Health Act. The changes will come in stages. For now, your rights under the Mental Health Act have not changed. We'll update our information when changes happen.

Who are the hospital managers?

Hospital managers are a panel appointed specially to look at whether people should be discharged. They are independent of the hospital, integrated care board, local health board or any organisation that runs your hospital. They cannot be officers or employees.

You should have been given information on how to contact them when you were sectioned or put on your CTO. Or you could ask an IMHA to find this out for you. This information should be available to you on your ward or at your clinic.

When can they discharge me?

Hospital managers can hold a review of whether you should be discharged at any time. They can consider discharging you themselves. Or they can arrange for a 'managers' panel' to use their power of discharge.

They must hold a review if:

  • Your responsible clinician sends them a report renewing your detention section or your CTO. Even if you have not challenged the renewal. 

They should consider holding a review if:

  • You request one. If you are under a detention section, guardianship, or a CTO, you can ask the managers to discharge you.
  • Your responsible clinician has made a report to them. This is called a 'barring report'. And it blocks your nearest relative's right to discharge you. For more information on this see our pages on the nearest relative.
  • Your section or CTO is coming to an end, and your responsible clinician has not held a review.

The hospital managers can't discharge you if you:

  • Have been sent to hospital by a court under sections 35, 36, or 38
  • Are being held in hospital under a section 5
  • Are in a hospital or place of safety under sections 135 or 136

See our information on sectioning to find out more about what these different sections mean.

Guardianship

Hospital managers can also give permission for you to transfer into guardianship. If your local authority agrees. This will usually mean you will move to a different care setting that is not a hospital. Your responsible clinician may be given the job of discharging you into guardianship.

Restricted patients or conditional discharge

If you're a restricted patient, or on conditional discharge, managers can only discharge you if the Secretary of State for Justice agrees. But you still have the right to ask the managers to review your detention. For more information see our pages on mental health and the courts.

Can they discharge me in the same way as my responsible clinician?

Yes, they can discharge you in the same way as your responsible clinician.

They also have a duty to consider certain matters independently of the responsible clinician and ward staff. Such as problems that may have arisen during your time under section.

But they don't have the power to:

  • Discharge you into the community onto a CTO or onto conditional discharge
  • Give you hospital leave, or permission to leave the ward and hospital for a short time, while you're still under section

Only your responsible clinician would be able to do these things.

Can they discharge me if the responsible clinician has blocked my nearest relative from discharging me?

Yes. They would look at the responsible clinician's barring report. And then they would decide whether they think you would be likely to be a danger to yourself or others if you were discharged.

What will they consider when discharging me?

This is different depending on whether you are under a:

If you're on a section

They can discharge you if the reasons for your sectioning no longer apply. They should consider whether:

  • You still have a mental health problem
  • You still need assessment and treatment, or treatment in hospital
  • Your health, your safety or someone else's safety would be at risk if you were discharged from your section or left hospital
  • You have other options. Such as whether you can have treatment for your mental health problem in the community. And if appropriate treatment will still be available to you

They are likely to look at reports from your:

  • Responsible clinician
  • Care coordinator
  • Named nurse
  • Other healthcare professionals involved in your care

This is because the managers will need to look at your past history of care and treatment. And also consider details of any future plans. This will include your care plan under the Care Plan Approach or Care and Treatment Plan, if you have one.

They will focus especially on any recent risk assessment or risk management plan. As well as any information that you have self-harmed in the past, or used violence against anyone else.

You should be able to see the reports. Unless the managers think seeing them is likely to cause serious harm to your physical or mental health. Or to someone else's. If that is their decision, they will need to give reasons.

Other people who may get a copy of the reports are your:

The managers have to consider these factors when deciding whether to discharge you. But they can discharge you anyway if they feel your individual circumstances would justify it. They should consider the least restrictive option for you to get treatment. And how best to maximise your independence.

Being discharged from the section may mean you leave the hospital at that time. But this will depend on:

  • Whether the managers think you are well enough and ready to leave hospital
  • Whether suitable care and treatment will be available to you in the community

Although the final decision will be theirs, the managers will also look at:

  • Your responsible clinician's views
  • Your care and treatment plan
  • The views of people who know you well

If you're on a CTO

The managers can discharge you in the same way as from a section. But the factors they consider will be slightly different.

How can I ask the managers to discharge me?

There are no special forms or procedures for this. And you can ask them as many times as you like. But the managers may choose to hold a 'paper review' in your absence rather than a full hearing if:

  • You've made frequent requests for discharge but your circumstances haven't changed 
  • You've recently had a tribunal hearing and the tribunal decided not to discharge you. And your circumstances haven't changed 
  • Your responsible clinician has decided to renew your section or CTO. But you don't want to or haven't yet challenged this

Getting support

If you want support when asking the managers to discharge you, you could speak to someone like your:

If you don't have the mental capacity to ask the managers for yourself, you could also get support from:

See our pages on the Mental Capacity Act for general information about mental capacity.

What if I get my tribunal hearing before my managers' meeting?

This will depend on which section you're under:

  • If you're under a section 2 and have applied to the tribunal. Your tribunal hearing will happen first. Your managers' hearing will only happen if you're not discharged, And you're kept under section and then put under a section 3.
  • If you're under a section 3 or another long-term section. Your tribunal hearing will happen first. If the tribunal doesn't discharge you from your section, and you're still asking for this, your managers' meeting will be arranged for a later date. If the managers find that your circumstances have changed, they may then hold a full hearing. Or ask the Ministry of Justice to refer you to the tribunal again.

What will happen at the managers' meeting?

There is no set formal procedure. For example, asking questions in any particular order. But the process that the panel chooses must be fair and reasonable.

Before the meeting, the panel will look at all the relevant information. This includes any recent reports from your responsible clinician and other healthcare professionals involved in your care.

You should also get this information in good time before the meeting. So that you, and your representative if you have one, have the chance to consider it and prepare for the meeting.

Where will the meeting be?

There's no set place for the meeting. But the managers will decide its location based on your best interests. If you're on a CTO or on leave from hospital, the hospital may not be the best place for you. The managers should consider other places that are more suitable. And that would be practical to use.

What is the process?

Here's what should happen at the meeting:

  • You should get the chance to explain why you should no longer be under your section. You should have any help you need with this from an IMHA.
  • If you don't have the capacity to put your views across, your deputy or attorney should be able to speak for you. If you have one.
  • Your responsible clinician and other professionals should give their views on whether keeping you under section or a CTO is justified. And their reasons.
  • You and the other people giving their views should have the option to hear each other's statements to the panel. And you should be able to ask each other questions. Unless the panel believes that would be likely to cause serious harm to your physical or mental health. Or someone else's. The English and Welsh Codes of Practice say you should get the option to speak to the panel alone. Unless there's a safety issue. And you can speak to them with or without anyone who has represented or accompanied you.
  • You can discuss other matters with the managers if you want to. For example, if you think your care plan doesn't meet your needs. Or you think your treatment in hospital hasn't been satisfactory. Or if you have any other concerns about your stay on the ward. Or other things that are happening while you are sectioned and in hospital. They may then be able to make recommendations about how the hospital services are run.
  • The panel will make their own decision. This will be based on the views of the professionals and other evidence they have. But if the professionals don't agree, the panel will form an independent judgement. This will be based on the least restrictive option that maximises your independence. They may need to consider adjourning the hearing. This is so they can ask for more medical or other professional advice.

Getting support

The managers should support you to take part in the process as far as possible. And you should have enough information so that you can understand the process and use it as fully as you can.

You can have extra support if you want. Managers should arrange hearings and give you enough notice to have someone there to support you. You have these rights:

  • A representative of your choice to help you put your views to the panel. This could be a legal adviser or solicitor.
  • A relative, friend, carer or advocate to support you, if you want.
  • The option to speak to the panel alone. This can be with or without your representative, or anyone else you have asked to support you. The only exception is if this is considered too unsafe.

When will the managers tell me their decision?

They must let you know the reasons for their decision as soon as they can. They should also:

  • Record the decisions and reasons at the end of the review
  • Give their decisions and reasons to your representative or legal representative, nearest relative, carer and professionals involved as soon as practicable
  • Give you the chance to discuss the hearing soon afterwards

If they decide to discharge you, they should give or send you an order in writing.

If they decide not to discharge you:

  • They should give you their reasons. And you can ask for these in writing if you don't get them.
  • At least one member of the panel should offer to see you or your representative, to explain the reasons for their decision. They should discuss the record of the decision and reasons with you.
  • Copies of the review papers should be placed in your medical notes.
  • You should be informed of your right to apply for discharge to the tribunal as soon as possible after the hearing.

Will there be any aftercare planning?

The managers will hold a meeting. They'll consider what discharging you from section and allowing you to leave hospital will mean for your future care.

Before the meeting, your responsible clinician and your multi-disciplinary care team will think about what care you might need if you are discharged. And whether this would be enough to make it no longer necessary for your section or CTO to continue. These may include:

Managers can adjourn the meeting in some situations:

  • They don't have enough information about your future care arrangements. And they want to ask for more information
  • They believe you should be discharged. But there are practical things that need to be in place for your aftercare first. They can adjourn for a short time for this to happen before discharging you. But they should try and make this time as short as possible.

Can the managers transfer me to another hospital?

Yes. They can give permission for you to be transferred. But they can't force another hospital to give you a place. Or another integrated care board or local health board to give funding for your care.

They might decide to transfer you because:

  • Your hospital can no longer offer you the care you need
  • They want to move you to a more specialised service
  • They want to move you somewhere closer to home

They will consider a number of factors, including these:

  • Whether a transfer would give you better access to your carers.
  • What effect a transfer is likely to have on your mental health problem or your recovery.
  • Whether there is a suitable place available for you at the hospital you might be transferred to.
  • Whether a transfer would allow you to be in a more suitable place culturally. Or an environment that meets your needs better. Or if it would have the opposite effect.

When making their decision about whether you should be transferred, they must think about what's best for you. This means that:

  • Your human rights should be respected. They should make sure their decisions don't interfere with your right to respect for private and family life under human rights law.
  • You should be involved in the decision-making. They should make sure you have the reasons for considering a transfer explained to you. And if you wish, to your nearest relative and carers. And the reasons should be recorded.
  • You should not be transferred to another hospital without warning. This should only happen in exceptional circumstances. If you feel this has happened to you without a good reason, you can complain about the decision. Or take legal advice if you have a legal adviser or solicitor.
  • If you're asking for a transfer, they should try to meet your wishes. For example, you might ask for a transfer because you want to be treated by a different clinical team. Or to be nearer your family or friends. If they decide not to transfer you, they should give you their decision and reasons in writing.

Does my nearest relative have to be consulted about my transfer?

The law doesn't need your nearest relative to consent to your transfer. But manager will normally consult your nearest relative before a transfer to another hospital. Unless you object. They will normally inform them about the transfer as soon as possible after making the decision.

Can I be transferred if I am on a CTO?

If you've been recalled to hospital under your CTO, the managers can give permission for a transfer to another hospital during your 72-hour maximum recall period. They could delegate this decision to your responsible clinician.

They should consider your needs and interests before agreeing to a transfer. Just like they should for someone in hospital under section.

The managers can also transfer responsibility for you at other times while you're under your CTO. So that a different hospital will become responsible for your care and treatment. They should make sure they consider your needs and interests before they do this.

Can I appeal against a managers' decision?

If you want to appeal against a decision not to discharge you, see our information on Getting my section lifted.

You can speak to a legal adviser or mental health solicitor if you believe the managers have reached a decision without considering all the relevant information. Or if you don’t believe they followed the right procedure. They can tell you whether it's worth trying to get the decision reviewed by a court. Because it’s hard to bring this type of legal claim and to get legal aid for it. Our useful contacts page has more information about your rights and available support.

When will the managers refer my case to the tribunal?

The managers may refer your case if you haven't applied to the tribunal yourself. This could happen if you can't apply yourself because of your illness. Or for other health reasons. For example, it could happen if you were detained under section 2 or 3.

There are some situations when they must apply on your behalf:

  • Six months have passed since you were first sectioned. Even if you're now on a CTO. But not if you've had a tribunal hearing since you were sectioned under section 3.
  • Three years have passed since the tribunal considered your case. Or one year if you're under 18.
  • You've transferred from guardianship to a hospital, and six months have passed. Unless you've already applied to the tribunal after this transfer.
  • You were under a CTO, but it's been revoked by your responsible clinician. And you're back in hospital under a section. Your case should be referred to the tribunal as soon as possible after your responsible clinician revokes your CTO.

Secretary of State/Welsh Ministers

If you’re a patient in England, the Secretary of State can refer your case to the tribunal. The Welsh Ministers can do this if you're a patient in Wales. Hospital managers should think about asking for this if the tribunal can't consider your case soon after you are first sectioned and kept in hospital. Or at reasonable time intervals after that. Because this violates your rights under the European Convention on Human Rights.

The hospital managers should normally ask for this if:

  • Your nearest relative is being displaced. And your section 2 is extended so you stay in hospital while this happens.
  • You don't have the mental capacity to ask for a reference yourself.
  • The tribunal has never considered your case. Or a considerable length of time has passed since they did.

Read more about when the tribunal can discharge you on our page about the Mental Health Tribunal.

< Responsible clinician Nearest relative >

This information was published in July 2020.

This page is currently under review. All content was accurate when published. 

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

arrow_upwardBack to Top