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.
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'.
You can get free aftercare under section 117 if you have been detained:
See our information on sectioning to find out more about what these different sections mean.
You also have the right to section 117 aftercare if:
You may have a right to aftercare when you are on leave from hospital. If your leave is open-ended, unescorted or for a long time, then you should able to get aftercare while on leave if you need it. You can speak to your responsible clinician about the support you need.
You have the right to section 117 aftercare after you leave hospital whether you:
The English and Welsh Codes of Practice have examples of what sort of things might make up aftercare services under section 117.
You will probably not be provided ordinary housing under section 117 aftercare services. So, for example, you will almost certainly not be provided with an ordinary flat by the council after you are discharged from hospital. However, you may be given free specialist accommodation under section 117.
In some circumstances, if the local authority are to provide you with accommodation, you can choose the accommodation you want to live in rather than accept what has been offered, though you will have to pay the difference if it is more expensive.
You can find out more in our information on your housing rights.
Medication can come under section 117, which means that it should be provided free. If you generally have to pay for your prescriptions, then speak to your care coordinator. They should be able to help you claim free prescriptions for any medication that is part of your section 117 aftercare.
Jorge is being discharged from hospital after being detained under section 3. He has a diagnosis of bipolar disorder and has a history of difficulties with drugs and alcohol, which have had an impact on his mental health. He also has type 1 diabetes.
Jorge is entitled to drug and alcohol counselling services under section 117, as these meet needs which relate to his mental disorder and reduce the risk that he will have to be readmitted to hospital for treatment of his mental condition. He cannot be charged for these services.
But he doesn't have the right to any free social care services under section 117 for his diabetes, as this is a physical rather than a mental condition.
It is the duty of the:
It is their responsibility to provide you with aftercare services, or to arrange for them to be provided. They often provide them together with voluntary agencies.
Sometimes there are disputes between different Clinical Commissioning Groups, Local Health Boards and local authorities about who has to provide or pay for your aftercare services. Even if this happens, your care planning and discharge should not be delayed.
Local authorities can make payments directly to you, or to someone else suitable, to pay for aftercare services under section 117. For this to happen, you must be an adult, and:
The English and Welsh Codes of Practice say that you should be fully involved in any decision making process to end your aftercare services.
They also say that aftercare services under section 117 should not be taken away because:
If your aftercare services have been taken away and your mental condition has begun to deteriorate, then the services should be put back to stop your condition from getting worse.
Clinical Commissioning Groups/Local Health Boards and local authorities have a legal duty to provide aftercare services under section 117, although they have a choice as to exactly what services are provided.
If you have problems with the aftercare services, you have a number of options:
If you aren't eligible for free section 117 aftercare (for example, if you have been discharged from a section 2), you will not have to pay for your ongoing medical treatment. But you may have to make a contribution towards the cost of your social care treatment on a means-tested basis (see our info on financial assessments to find out more).
There are no clear rules in the Mental Health Act for deciding when a person no longer needs aftercare; but section 117 of the MHA says that it is up to the health and social services who are dealing with your case to make a joint decision that you no longer need it.
They must be able to give clear reasons for their decision and your needs must be reassessed before the aftercare is ended, to see how your mental health and ability to manage would be affected.
Guidance says that even if you are well settled in the community, aftercare may still continue to prevent you from becoming ill again or from getting worse.
'Capacity' means the ability to understand information and make decisions about your life. Sometimes it can also mean the ability to communicate decisions about your life.
For example, if you do not understand the information and are unable to make a decision about your treatment, you are said to 'lack capacity' to make decisions about your treatment.
See our pages on the Mental Capacity Act for more information.See our full list of legal terms.
CCGs are groups of GP practices and other healthcare professionals and bodies that are responsible for commissioning most health and care services for patients. They have replaced Primary Care Trusts (PCTs) in England.See our full list of legal terms.
A care coordinator is the main point of contact and support if you need ongoing mental health care. They keep in close contact with you while you receive mental health care and monitor how that care is delivered – particularly when you’re outside of hospital. They are also responsible for carrying out an assessment to work out your health and social care needs under the care programme approach (CPA).
A care coordinator could be any mental health professional, for example:
This is decided according to what is most appropriate for your situation.
A care coordinator usually works as part of the community mental health team.See our full list of legal terms.
If you have been sectioned and treated in hospital under certain sections, your responsible clinician can put you on a CTO. This means that you can be discharged from the section and leave hospital, but you might have to meet certain conditions such as living in a certain place, or going somewhere for medical treatment. Sometimes, if you don't follow the conditions or you become unwell, you can be returned to hospital.
See our pages on CTOs for more information.See our full list of legal terms.
This is where you are discharged from hospital but will have to follow some conditions, such as living at a particular place or meeting healthcare professionals. If you break these conditions, you can be recalled to hospital.
You will only be put under a conditional discharge if you have been:
This is a type of court procedure where a judge reviews a public authority’s decision, policy, practice, act or failure to act, and decides whether it is lawful or not.
If it is not lawful, the court may cancel the decision or action (‘quash’ it), and require the public authority to reconsider it, lawfully. The court can order the authority to do or not do something.See our full list of legal terms.
These are organisations in the health service in Wales that have been set up to develop and provide health services based on the needs of the local community.See our full list of legal terms.
This tells health professionals how they should follow the Mental Health Act. It is not law, so it cannot be enforced by going to court, but health professionals should follow it unless there is a good reason not to.
The Code covers some areas not specifically mentioned in the Mental Health Act, such as visiting rights and the use of seclusion.
If a health professional doesn’t follow the Code, you can make a complaint.See our full list of legal terms.
This is a law that applies to England and Wales which allows people to be detained in hospital (sectioned) if they have a mental health disorder and need treatment. You can only be kept in hospital if certain conditions are met.
See our pages on the Mental Health Act for more information.See our full list of legal terms.
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.See our full list of legal terms.
Voluntary patients, also known as 'informal patients', are people who are staying in a psychiatric hospital but are not detained under the Mental Health Act. If you are a voluntary patient, you should be able to come and go from the hospital within reason and discharge yourself if you decide to go home.
See our pages on voluntary patients for more information.See our full list of legal terms.
This information was published in August 2018. We will revise it in 2020.
References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.