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.
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Section 117 aftercare
- What is section 117 aftercare?
- Who can get section 117 aftercare?
- What kinds of services are covered?
- Who is responsible for providing section 117 aftercare?
- How long will I get section 117 aftercare?
- What can I do if there are problems with my section 117 aftercare?
- If I can't get section 117 aftercare services, do I have to have to pay for my after hospital care?
- Ending section 117 aftercare
Under 18? We have information on going into hospital as a young person, and your rights if you’re sectioned
What is section 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'.
Who can get section 117 aftercare?
You can get free aftercare under section 117 if you have been detained:
- for treatment under section 3
- under a hospital order under section 37
- following transfer from prison under section 47 or 48
- under a hospital direction under section 45A
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 have been discharged onto a CTO for the entire period of your CTO, or
- you are a restricted patient on a conditional discharge.
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:
- leave hospital immediately, or
- stay on as a voluntary patient.
Examples
- Darren is being discharged from a section 2. This is not covered by section 117, so he is not entitled to section 117 aftercare.
- Hannah is being discharged from hospital after spending a month as a voluntary patient. Voluntary patients are not covered under section 117, so she is not entitled to aftercare.
- Clarence is on trial leave to a supported accommodation placement while he remains on section 3. As his leave is long-term and unescorted, section 117 should apply and the support he needs may be covered under section 117.
- Miriam was discharged from her section 3 but did not feel ready to leave hospital and so spent over a month as a voluntary patient. Section 3 is covered by section 117 aftercare, so even though she stayed on as a voluntary patient, she is entitled to free aftercare services under section 117.
- Steve has been transferred to hospital from prison under section 47. When the criteria for detention under the Mental Health Act no longer apply, he is returned to prison. He is entitled to aftercare services under section 117.
What kinds of services are covered?
The English and Welsh Codes of Practice have examples of what sort of things might make up aftercare services under section 117.
These include:
- healthcare
- social care and employment services
- supported accommodation
- services to meet your social, cultural and spiritual needs – as long as they meet a need that arises from or is related to your mental condition and help reduce the risk of your mental condition getting worse.
Housing
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
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.
Example
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.
Who is responsible for providing section 117 aftercare?
It is the duty of the:
- Integrated care board in England, or the local health board in Wales, and
- Local social services authority (usually the one in the area you lived in before you were detained)
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 integrated care boards, 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.
Direct payments
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:
- you must have the capacity to ask for direct payments
- if you want someone to act on your behalf, they must agree to this
- the local authority must be satisfied that you or anyone acting on your behalf are capable of managing the direct payments, if necessary with help from others, such as family members
- the local authority is satisfied that making direct payments is an appropriate way of meeting your needs for care and support
How long will I get section 117 aftercare?
You will be provided aftercare services under section 117 until the integrated care board/local health board and the local authority are satisfied that you no longer require these services.
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:
- you have been discharged from the care of specialist mental health service
- an arbitrary period of time has passed since the care was first provided
- you have been deprived of your liberty under the Mental Capacity Act
- you have returned to hospital as a voluntary patient or been detained under section 2
- you are no longer on a CTO or on section 17 leave
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.
What can I do if there are problems with my section 117 aftercare?
Integrated care boards/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:
- Raise your problem with your care coordinator to begin with. They may be able to find a solution for you.
- If your problem is with health-related services, you can follow the complaints procedure of that service. If you are not happy with the outcome of your complaint, or the way it was handled, you can ask the Health Service Ombudsman to investigate. They can make recommendations to put things right. (See our guide to complaining about health and social care).
- If the complaint is about social care provided or paid for by the local authority, you should follow that local authority's complaints procedure. If you are not happy with the outcome of your complaint, or the way it was handled, you can ask the Local Government Ombudsman to investigate. They can make recommendations to put things right. (See our guide to complaining about health and social care).
- Ask for a judicial review. You can take the integrated care board, local health board or local authority to court and challenge them in a judicial review. This is where the court does not decide whether the decision they made was wrong, but whether it was made properly, taking into account all the relevant circumstances. Judicial review claims have a very strict time limit and must be brought within 3 months of the decision you are challenging. Sometimes, just by writing a letter saying that you want to make a judicial review claim can convince them to reconsider their decision. If you want to do this, you should get the help of a solicitor (see Useful contacts for information on how to find a solicitor). You might be able to get legal aid to pay for it too.
If I can't get section 117 aftercare services, do I have to have to pay for my after hospital care?
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 page on financial assessments to find out more.
Ending section 117 aftercare
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
'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.
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 coordinator
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:
- a nurse
- a social worker
- another mental health worker.
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.
Visit our full listing of Legal TermsCommunity treatment order (CTO)
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.
Visit our full listing of Legal TermsConditional discharge
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 can only be put under a conditional discharge if you have been:
- sectioned by a court under certain sections of the Mental Health Act and have been charged with a crime and you are a restricted patient under a restriction order, or
- transferred to hospital from prison under the Mental Health Act and you are a restricted patient under a restriction direction.
Judicial review
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.
Visit our full listing of Legal TermsLocal Health Boards (LHBs)
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.
Visit our full listing of Legal TermsMental Health Act Code of Practice
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.
Visit our full listing of Legal TermsMental Health Act 1983 (MHA)
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.
Visit our full listing of Legal TermsResponsible 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 TermsVoluntary patient
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.
Visit our full listing of Legal TermsIntegrated care boards (ICBs)
ICBs are part of the NHS and look after the health needs of people in their area. They plan and provide services and 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.
