Collection

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 for stakeholders

Forms: Working with restricted patients

MHCS Guidance: Working with restricted patients

Published 27 February 2011
Last updated 18 August 2021 + show all updates
  1. Added form: Submit an Annual Statutory Report for a detained patient

  2. Added Mental Health Casework Section External Complaints Process

  3. Added MHCS performance management framework 2021/22

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

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

  6. Added MAPPA Guide to the collection docs.

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

  8. Added information for the next MHCS open session

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

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

  11. Updated 'information and updates for stakeholders’ collection

  12. Added Parole Board Reconsideration Mechanism guidance

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

  14. Added invite to MHCS January open session

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

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

  17. Added Invitation to MHCS Open Session

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

  19. added guidance on Authority to use medical leave

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

  21. Added december update to stakeholders

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

  23. Addition to information for stakeholders

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

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

  26. First published.