Working with restricted patients

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

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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).

The Mental Health Casework Section (MHCS) will only share information where it is in the public interest to do so, or there is a statutory requirement. We aim to ensure that our processing and sharing of information is fair and complies with the Data Protection Act 2018 and UK General Data Protection Regulations (GDPR) where applicable.

MHCS will ensure that the six data protection principles set out in Chapter 2, Article 5 of the UK GDPR and Sections 35 to 40 of Data Protection Act (DPA) are complied with in relation to the processing of information. Most of the information we share falls under Part 3 of the DPA and we will only divulge confidential personal information if it is necessary to do so in order to discharge our responsibilities and/or obligations under the Mental Health Act 1983, prevent crime and protect the public.

Information for stakeholders

Forms and Guidance: Working with Restricted Patients

This guidance is correct at the time of publishing and will be reviewed on a yearly basis. If you have any queries regarding the validity of the information within the guidance documents, please contact for advice.

Published 27 February 2011
Last updated 24 March 2023 + show all updates
  1. Updated, 'An Introduction to the Restricted Patient System' online session details.

  2. Added form: Submit an Annual Statutory Report for a detained patient

  3. Added Mental Health Casework Section External Complaints Process

  4. Added MHCS performance management framework 2021/22

  5. Added three guides to the Guidance section collection of documents.

  6. Document titled 'General Consent for s17 medical leave' removed from the collection of documents.

  7. Added MAPPA Guide to the collection docs.

  8. Covid-19 Guidance for Healthcare Professionals moved to the top of the list.

  9. Added information for the next MHCS open session

  10. added "Invitation to MHCS Open Session" page to collection

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

  12. Updated 'information and updates for stakeholders’ collection

  13. Added Parole Board Reconsideration Mechanism guidance

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

  15. Added invite to MHCS January open session

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

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

  18. Added Invitation to MHCS Open Session

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

  20. added guidance on Authority to use medical leave

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

  22. Added december update to stakeholders

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

  24. Addition to information for stakeholders

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

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

  27. First published.