Working with restricted patients

Forms and guidance for professionals working with restricted patients (mentally disordered offenders).

The guidance covers work with restricted patients detained in hospital and those discharged into the community. It also covers transfers from prison to hospital under the Mental Health Act 1983.

Restricted patients are mentally disordered offenders who are detained in hospital for treatment and who are subject to special controls by the Justice Secretary due to the level of risk they pose. These controls include permission for community leave, transfer to another hospital, discharge and recall to hospital. The Mental Health Casework Section takes these decisions on behalf of the Justice Secretary.

Detained patients are usually treated in secure hospitals, and will be given gradual access to the community as part of their rehabilitation only when it is safe to do so. Detained patients have access to the independent First Tier Tribunal (Mental Health), which has a statutory duty to discharge patients who no longer meet the criteria for detention under the Mental Health Act 1983.

Conditionally discharged patients are generally supervised in the community by a psychiatrist and a social worker. The Mental Health Casework Section receives regular reports from both supervisors. These patients can be recalled to hospital if they pose a risk to others as a result of their mental disorder (they cannot be recalled simply for breaching their conditions).

Information and updates for stakeholders

Forms: Working with restricted patients

Guidance: Working with restricted patients

  1. Parole Board Reconsideration Mechanism
  2. The Designation & Management of High Profile Restricted Patients
  3. General consent for s17 medical leave
  4. Discharge conditions that amount to a deprivation of liberty
  5. Mentally disordered offenders: the restricted patient system
  6. Code of practice: Mental Health Act 1983
  7. Mental Health Casework Section: out-of-hours service
  8. Domestic Violence, Crime and Victims Act 2004: rights of victims
  9. Mental health casework: first tier tribunal guidance
  10. Lifting restrictions on restricted patients
  11. Repatriation of foreign national restricted patients
  12. Remand and sentencing powers for mentally disordered offenders
  13. Recall of conditionally discharged restricted patients
  14. MAPPA: changes to chapter 26 on mentally disordered offenders
Published 27 February 2011
Last updated 31 March 2020 + show all updates
  1. Updated 'information and updates for stakeholders’ collection

  2. Added Parole Board Reconsideration Mechanism guidance

  3. 'Invitation to MHCS Open Session – 20th April 2020' added

  4. Added invite to MHCS January open session

  5. Added Guidance: The Designation & Management of High Profile Restricted Patients

  6. Added MHCS and NHS Joint performance management framework 2019/20.

  7. Added Invitation to MHCS Open Session

  8. Added, 'Offender Management statistics quarterly: October to December 2018'.

  9. added guidance on Authority to use medical leave

  10. Added guidance on, 'Discharge conditions that amount to a deprivation of liberty'

  11. Added december update to stakeholders

  12. Letter about Christmas and New Year 2018 leave requests added

  13. Addition to information for stakeholders

  14. New guidance added - Mentally Disordered Offenders: The Restricted Patient System' Exisiting guidance updated - Mental health casework: first tier tribunal guidance

  15. New guidance document - delays in casework decisions - added.

  16. First published.