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Leaving hospital
Explains the rights you have to get your section lifted if you are being detained in hospital under the Mental Health Act, and your rights to care and support after leaving hospital.
If you are under a section
Your responsible clinician should discharge you as soon as they think you don't need to be sectioned anymore. This would be because the medical reasons for keeping you sectioned no longer apply.
If your section is coming to an end because it's reaching its maximum time limit, your responsible clinician must decide whether to renew it. The time limit depends on which section you are under.
Renewal is normally possible only with some sections, such as section 3 or 37.
They must examine you in the last two months of your section and decide whether the conditions for renewing your section are met and whether you should be discharged. They should also discuss their decision with you.
Then they must do the following:
- Consult one or more professionals involved in your medical treatment.
- Explain in full their reasons in a report to the hospital managers. If they are satisfied that the conditions for renewing your section are met, they must put this in their report.
- Get agreement in writing from another professional. The professional must be involved in your care and treatment, have had recent contact with you and not be in the same profession as your responsible clinician.
If your section is not renewed, then when it reaches its maximum time limit, you should be:
- discharged and free to go, or
- placed under another section
If you think you are no longer sectioned, and are not discharged or free to go, you should
- report this yourself, or ask someone else to report this to the hospital managers as soon as possible
- report this to the Care Quality Commission as a serious incident
If you are not sectioned again, the hospital managers should make sure that a review is held within one month to:
- find out why this has happened
- find out what has been done to correct the situation
- make sure that it will not happen again in the future
If you're under a CTO
Your responsible clinician should make a decision about your discharge that considers:
- the least restrictive option and
- the maximum independence available to you.
They should think about whether you should be:
- discharged from your CTO into guardianship, or
- fully discharged from your CTO
Your responsible clinician must examine you in the last 2 months before your CTO reaches its maximum time limit.
And they must decide whether to discharge you or extend your CTO.
Only your responsible clinician can extend your CTO. In making this decision they should take the following steps:
- Consider whether the conditions for continuing your CTO are met. They must consult one or more professionals involved in your medical treatment.
- Consult the wider team involved in providing your care and treatment. This would include your care coordinator and anyone else involved in your care in the community.
- Consult you, your nearest relative, your IMHA or other representative, family and carers
- Consult the local authority and integrated care board responsible for your aftercare (or local health board in Wales). Plus any other organisation providing key services for you. This consultation should take place during a Care Programme Approach assessment (or Care and Treatment plan review in Wales). And it should happen before the responsible clinician decides whether or not to extend the CTO.
- Consider whether extending the CTO is appropriate in your case. For example, the longer you've been on a CTO without the responsible clinician having to recall you to hospital, the more carefully they have to think about whether the conditions for extending are met. Or whether you should be fully discharged from your CTO.
- Submit a report to the hospital managers if they decide not to discharge you from your CTO. They should explain their reasons in full in their report, and they must get an AMHP to agree in writing that it should be extended. They should give the AMHP enough time to interview you before they agree to the extension. But this doesn't need to be an AMHP who knows you already.
If you're under a section
The responsible clinician will do this by making an order in writing. This lets the hospital authorities know that:
- you're no longer under section, and that
- you should be allowed to leave hospital
- you should be supported to do this.
The law says that there are slightly different reasons for keeping you sectioned under a section 2 or section 3. But generally speaking, your responsible clinician must reach a decision that considers whether:
- your mental health has improved enough for you to leave hospital
- you still have a mental health problem
- you still need assessment and treatment or treatment in hospital
- your health would be at risk, or your safety or someone else's would be at risk if you were discharged from your section and/or left hospital
- there are other options available to you. Like whether it's possible for you to be treated for your mental health problem in the community, and whether appropriate treatment will still be available to you
Or, if your section has reached the maximum time allowed by the law, then the law says you should:
- be discharged
- have your section renewed, or
- be sectioned under another section. The length of time you are kept under the section may depend on which section you are under
Your responsible clinician can also discharge you for other reasons, and at any time.
If the conditions for keeping you under your section or your CTO are no longer being met, they must discharge you. They shouldn't wait until your section or CTO has ended before discharging you.
Your section or CTO doesn't automatically end if:
- the second professional doesn't agree to your section being renewed, or
- the AMHP decides not to agree to your CTO being extended .
But in this case your responsible clinician would have stronger reasons to think about discharging you.
If you're under a CTO
The factors the responsible clinician will look at will be similar to when you are being discharged from section.
But instead of looking at whether you're well enough to leave hospital or can get the right treatment in the community, they'll look at whether they still need the power to recall you to hospital. And possibly have you brought to hospital for treatment.
To find out more, see our information on CTOs.
What if my section has ended but I haven't been discharged?
If your section has reached its time limit, and it has not been renewed or replaced by another section, you should be free to go. If you think you should have been discharged but this has not happened, you should let the hospital managers know. If you need help to do this, an IMHA should be able to help you.
What if I only want to leave hospital for a short time?
You will need to get permission from your responsible clinician. This is covered under section 17 of the Mental Health Act.
Responsible clinician (RC)
This is the mental health professional in charge of your care and treatment while you're sectioned under the Mental Health Act.
Certain decisions can only be taken by the responsible clinician. For example, applying for someone who is sectioned to go onto a community treatment order (CTO).
All responsible clinicians must be approved clinicians. They don't have to be doctors, but many of them are.
Visit our full listing of Legal TermsSection
Being 'sectioned' means that you're kept in hospital under the Mental Health Act. There are different types of sections. Each have different rules to keep you in hospital. The length of time that you can be kept in hospital depends on which section you're detained under.
See our pages on sectioning for more information.
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. They make sure that the requirements of the Mental Health Act are properly applied. They have certain important responsibilities. And they 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 TermsGuardianship
This is where someone called a 'guardian' is appointed instead of you being sectioned and kept in hospital. Your guardian could be a person or a local authority.
You can only be placed under guardianship if it's necessary for your welfare or to protect other people. Your guardian has the power to make certain decisions about you. They can also make conditions that you'll be asked to keep to. For example, where you live.
Guardianship lasts for up to 6 months. It can be renewed: initially for a further 6 months, and then for a year at a time. You can appeal to the Mental Health Tribunal once in each of these periods.
Visit our full listing of Legal TermsCare coordinator
A care coordinator is your main point of contact and support if you need ongoing mental health care. They:
- Keep in close contact with you during your care
- Monitor how your care gets delivered – particularly when you’re not in hospital
They're also responsible for doing the assessment to work out your health and social care needs under the care programme approach (CPA).
They could be any mental health professional. But they usually work as part of the community mental health team. For example:
- A nurse
- A social worker
- Another mental health worker
It depends what's most appropriate for your situation.
Visit our full listing of Legal TermsNearest relative
The nearest relative is a family member. They have 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 TermsIndependent mental health advocate (IMHA)
An IMHA is an advocate. They're specially trained to help you find out your rights under the Mental Health Act 1983. And to help you while you're detained. They can listen to what you want and speak for you.
You have a right to an IMHA if you are:
- Detained in hospital under a section of the Mental Health Act, but not if you are under sections 4, 5, 135 and 136
- Under Mental Health Act guardianship, conditional discharge and community treatment orders (CTOs)
- Discussing having certain treatments, such as electroconvulsive therapy (ECT).
In Wales, voluntary patients can also have an IMHA.
See our page on IMHAs in England and Wales for more information.
Visit our full listing of Legal TermsClinical commissioning groups (CCGs)
CCGs were replaced by integrated care boards (ICBs) in 2022.
Visit our full listing of Legal TermsCare Programme Approach (CPA)
The Care Programme Approach (CPA) is a way that secondary mental health services are assessed, planned, coordinated and reviewed. It only applies to people who live in England.
Secondary mental health services include:
- Community mental health team (CMHT)
- Assertive outreach team
- Early intervention team
You should get:
- A full assessment of your health and social care needs
- A care plan
- Regular reviews
- A care coordinator who will be responsible for overseeing your care and support
See our pages on leaving hospital for more information.
Visit our full listing of Legal TermsApproved mental health professional (AMHP)
AMHPs are mental health professionals who can carry out duties under the Mental Health Act. They've been approved by a local social services authority. They're responsible for coordinating your assessment and admission to hospital if you're sectioned.
They may be:
- Social workers
- Nurses
- Occupational therapists
- Psychologists
Appropriate treatment or appropriate medical treatment
This means medical treatment for your mental health problem that is:
- Suitable for you
- Available
- Reflects the nature and degree of your mental health problem
- Reflects your individual circumstances
Integrated care boards (ICBs)
ICBs are part of the NHS. They:
- Look after the health needs of people in their area
- Plan and deliver services
- Manage the NHS budget
Membership of each board varies but usually includes healthcare professionals and local authority representatives. ICBs were introduced in 2022 to replace clinical commissioning groups (CCGs).
Visit our full listing of Legal TermsThis 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.
