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

Published 27 February 2011
Last updated 9 November 2020 + show all updates
  1. added "Invitation to MHCS Open Session" page to collection

  2. Replaced Offender management statistics quarterly: October to December 2018 with Offender management statistics quarterly: October to December 2019.

  3. Updated 'information and updates for stakeholders’ collection

  4. Added Parole Board Reconsideration Mechanism guidance

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

  6. Added invite to MHCS January open session

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

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

  9. Added Invitation to MHCS Open Session

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

  11. added guidance on Authority to use medical leave

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

  13. Added december update to stakeholders

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

  15. Addition to information for stakeholders

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

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

  18. First published.