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(5) A patient subject to after-care under supervision shall cease to be so subject if he—
(a) is admitted to a hospital in pursuance of an application for admission for treatment; or
(b) is received into guardianship.
(6) Where a patient (for any reason) ceases to be subject to after-care under supervision the responsible after-care bodies shall—
(a) inform the patient both orally and in writing;
(b) inform any person who they believe plays a substantial part in the care of the patient but is not professionally concerned with the after-care services provided for the patient under section 117 below; and
(c) take such steps as are practicable to inform in writing the person (if any) appearing to be the nearest relative of the patient,
that the patient has ceased to be so subject.
(7) Where the patient has requested that paragraph (c) of subsection (6) above should not apply, that paragraph shall not apply unless subsection (3)(b) above applied in his case by virtue of subsection (4) above.
(1) This section applies where a patient who is subject to after-care under supervision—
(a) is detained in custody in pursuance of any sentence or order passed or made by a court in the United Kingdom (including an order committing or remanding him in custody); or
(b) is detained in hospital in pursuance of an application for admission for assessment.
(2) At any time when the patient is detained as mentioned in subsection (1)(a) or (b) above he is not required—
(a) to receive any after-care services provided for him under section 117 below; or
(b) to comply with any requirements imposed on him under section 25D above.
(3) If the patient is detained as mentioned in paragraph (a) of subsection (1) above for a period of, or successive periods amounting in the aggregate to, six months or less, or is detained as mentioned in paragraph (b) of that subsection, and, apart from this subsection, he—
(a) would have ceased to be subject to after-care under supervision during the period for which he is so detained; or
(b) would cease to be so subject during the period of 28 days beginning with the day on which he ceases to be so detained,
he shall be deemed not to have ceased, and shall not cease, to be so subject until the end of that period of 28 days.
(4) Where the period for which the patient is subject to after-care under supervision is extended by subsection (3) above, any examination and report to be made and furnished in respect of the patient under section 25G(3) above may be made and furnished within the period as so extended.
(5) Where, by virtue of subsection (4) above, the patient is made subject to after-care under supervision for a further period after the day on which (apart from subsection (3) above) he would have ceased to be so subject, the further period shall be deemed to have commenced with that day.
(1) A supervision application may be made in respect of a patient who is subject to a community care order under the [1984 c. 36.] Mental Health (Scotland) Act 1984 and who intends to leave Scotland in order to reside in England and Wales.
(2) Sections 25A to 25I above, section 117 below and any other provision of this Act relating to supervision applications or patients subject to after-care under supervision shall apply in relation to a patient in respect of whom a supervision application is or is to be made by virtue of this section subject to such modifications as the Secretary of State may by regulations prescribe.”
(2) Schedule 1 to this Act (supplementary provisions about after-care under supervision) shall have effect.
(1) In section 18 of the [1983 c. 20.] Mental Health Act 1983 (return of patients absent without leave), for subsection (4) (which provides that a patient may not be taken into custody after the end of the period of 28 days beginning with the first day of his absence without leave) there shall be substituted the following subsection—
“(4) A patient shall not be taken into custody under this section after the later of—
(a) the end of the period of six months beginning with the first day of his absence without leave; and
(b) the end of the period for which (apart from section 21 below) he is liable to be detained or subject to guardianship;
and, in determining for the purposes of paragraph (b) above or any other provision of this Act whether a person who is or has been absent without leave is at any time liable to be detained or subject to guardianship, a report furnished under section 20 or 21B below before the first day of his absence without leave shall not be taken to have renewed the authority for his detention or guardianship unless the period of renewal began before that day.”
(2) For section 21 of that Act (duration of authority for detention and guardianship: special provisions as to patients absent without leave) there shall be substituted the following sections—
(1) Where a patient is absent without leave—
(a) on the day on which (apart from this section) he would cease to be liable to be detained or subject to guardianship under this Part of this Act; or
(b) within the period of one week ending with that day,
he shall not cease to be so liable or subject until the relevant time.
(2) For the purposes of subsection (1) above the relevant time—
(a) where the patient is taken into custody under section 18 above, is the end of the period of one week beginning with the day on which he is returned to the hospital or place where he ought to be;
(b) where the patient returns himself to the hospital or place where he ought to be within the period during which he can be taken into custody under section 18 above, is the end of the period of one week beginning with the day on which he so returns himself; and
(c) otherwise, is the end of the period during which he can be taken into custody under section 18 above.
(1) This section applies where a patient who is absent without leave is taken into custody under section 18 above, or returns himself to the hospital or place where he ought to be, not later than the end of the period of 28 days beginning with the first day of his absence without leave.
(2) Where the period for which the patient is liable to be detained or subject to guardianship is extended by section 21 above, any examination and report to be made and furnished in respect of the patient under section 20(3) or (6) above may be made and furnished within the period as so extended.
(3) Where the authority for the detention or guardianship of the patient is renewed by virtue of subsection (2) above after the day on which (apart from section 21 above) that authority would have expired, the renewal shall take effect as from that day.
(1) This section applies where a patient who is absent without leave is taken into custody under section 18 above, or returns himself to the hospital or place where he ought to be, later than the end of the period of 28 days beginning with the first day of his absence without leave.
(2) It shall be the duty of the appropriate medical officer, within the period of one week beginning with the day on which the patient is returned or returns himself to the hospital or place where he ought to be—
(a) to examine the patient; and
(b) if it appears to him that the relevant conditions are satisfied, to furnish to the appropriate body a report to that effect in the prescribed form;
and where such a report is furnished in respect of the patient the appropriate body shall cause him to be informed.
(3) Where the patient is liable to be detained (as opposed to subject to guardianship), the appropriate medical officer shall, before furnishing a report under subsection (2) above, consult—
(a) one or more other persons who have been professionally concerned with the patient’s medical treatment; and
(b) an approved social worker.
(4) Where the patient would (apart from any renewal of the authority for his detention or guardianship on or after the day on which he is returned or returns himself to the hospital or place where he ought to be) be liable to be detained or subject to guardianship after the end of the period of one week beginning with that day, he shall cease to be so liable or subject at the end of that period unless a report is duly furnished in respect of him under subsection (2) above.
(5) Where the patient would (apart from section 21 above) have ceased to be liable to be detained or subject to guardianship on or before the day on which a report is duly furnished in respect of him under subsection (2) above, the report shall renew the authority for his detention or guardianship for the period prescribed in that case by section 20(2) above.
(6) Where the authority for the detention or guardianship of the patient is renewed by virtue of subsection (5) above—
(a) the renewal shall take effect as from the day on which (apart from section 21 above and that subsection) the authority would have expired; and
(b) if (apart from this paragraph) the renewed authority would expire on or before the day on which the report is furnished, the report shall further renew the authority, as from the day on which it would expire, for the period prescribed in that case by section 20(2) above.
(7) Where the authority for the detention or guardianship of the patient would expire within the period of two months beginning with the day on which a report is duly furnished in respect of him under subsection (2) above, the report shall, if it so provides, have effect also as a report duly furnished under section 20(3) or (6) above; and the reference in this subsection to authority includes any authority renewed under subsection (5) above by the report.
(8) Where the form of mental disorder specified in a report furnished under subsection (2) above is a form of disorder other than that specified in the application for admission for treatment or guardianship application concerned (and the report does not have effect as a report furnished under section 20(3) or (6) above), that application shall have effect as if that other form of mental disorder were specified in it.
(9) Where on any occasion a report specifying such a form of mental disorder is furnished under subsection (2) above the appropriate medical officer need not on that occasion furnish a report under section 16 above.
(10) In this section—
“appropriate medical officer” has the same meaning as in section 16(5) above;
“the appropriate body” means—
in relation to a patient who is liable to be detained in a hospital, the managers of the hospital; and
in relation to a patient who is subject to guardianship, the responsible local social services authority; and
“the relevant conditions” means—
in relation to a patient who is liable to be detained in a hospital, the conditions set out in subsection (4) of section 20 above; and
in relation to a patient who is subject to guardianship, the conditions set out in subsection (7) of that section.”
(3) In section 22 of that Act (special provisions as to patients sentenced to imprisonment etc.)—
(a) in subsection (2) (detained patient in whose case application for admission for treatment or guardianship application does not cease to have effect), for the words “and 21” there shall be substituted “, 21 and 21A”; and
(b) after that subsection there shall be inserted the following subsection—
“(3) In its application by virtue of subsection (2) above section 18(4) above shall have effect with the substitution of the words “end of the period of 28 days beginning with the first day of his absence without leave.” for the words from “later of” onwards.”
(4) In section 40 of that Act (effect of hospital orders and guardianship orders), after subsection (5) there shall be inserted the following subsection—
“(6) Where—
(a) a patient admitted to a hospital in pursuance of a hospital order is absent without leave;
(b) a warrant to arrest him has been issued under section 72 of the [1967 c. 80.] Criminal Justice Act 1967; and
(c) he is held pursuant to the warrant in any country or territory other than the United Kingdom, any of the Channel Islands and the Isle of Man,
he shall be treated as having been taken into custody under section 18 above on first being so held.”
(5) In section 61 of that Act (review of treatment), in subsection (1) (report on treatment and patient’s condition to be given to Secretary of State), in paragraph (a) (report to be given when report furnished under section 20(3)), for the words “in respect of the patient under section 20(3) above” there shall be substituted “under section 20(3) or 21B(2) above renewing the authority for the detention of the patient”.
(6) In section 66 of that Act (applications to tribunals)—
(a) in subsection (1) (cases where application may be made), after paragraph (f) there shall be inserted the following paragraphs—
“(fa) a report is furnished under subsection (2) of section 21B above in respect of a patient and subsection (5) of that section applies (or subsections (5) and (6)(b) of that section apply) in the case of the report; or
(fb) a report is furnished under subsection (2) of section 21B above in respect of a patient and subsection (8) of that section applies in the case of the report; or”; and
(b) in subsection (2) (period within which application may be made), in paragraph (d), after “(d)” there shall be inserted “, (fb)” and, in paragraph (f), for the words “of that subsection, the period” there shall be substituted “or (fa) of that subsection, the period or periods”.
(7) In section 68 of that Act (duty of managers of hospitals to refer cases to tribunal), in subsection (2) (reference where detention is renewed under section 20 and three years have elapsed since last consideration of case), after “20” there shall be inserted “or 21B”.
(8) In Schedule 1 to that Act (application of provisions to patients subject to hospital and guardianship orders), in Part I (patients not subject to special restrictions), in paragraph 1 (provisions applying without modification), for “21,” there shall be substituted “21 to 21B,”.
(1) In section 17 of the [1983 c. 20.] Mental Health Act 1983 (leave of absence for patient liable to be detained in a hospital under Part II of that Act), in subsection (5), the words from “; and without prejudice” to the end (which cause a patient on leave of absence to cease to be liable to be so detained six months after the beginning of his absence even though he would not otherwise have by then ceased to be so liable) shall be omitted.
(2) In Schedule 1 to that Act (application of provisions to patients subject to hospital and guardianship orders), in Part II (patients subject to special restrictions), in paragraph 3(c) (modifications of section 17(5)), for the word “six” there shall be substituted “twelve”.
(3) Subsections (1) and (2) apply where leave of absence has been granted to a patient before the day on which this section comes into force (as well as where it is granted to a patient after that day).
(1) After section 35 of the [1984 c. 36.] Mental Health (Scotland) Act 1984 there shall be inserted the following sections—
(1) As respects a patient who is liable to be detained in a hospital in pursuance of an application for admission the responsible medical officer may, in accordance with section 35B of this Act, make an application (in this Act referred to as a “community care application”) to the sheriff for an order (in this Act referred to as a “community care order”) providing that the patient shall, instead of continuing to be liable to be so detained, be subject to the conditions specified in the order, being conditions imposed with a view to ensuring that he receives—
(a) medical treatment; and
(b) after-care services provided for him under section 8 of this Act.
(2) Sections 21(1), (2)(a) and (b), (3), (4) and (5) and 113 of this Act shall apply with respect to a community care application as they apply with respect to an application for admission.
(3) The sheriff shall, as respects a community care application—
(a) make a community care order in respect of the patient, subject to the conditions set out in the application or to such other conditions as the sheriff considers appropriate; or
(b) refuse the application.
(4) A community care order shall specify—
(a) the conditions to which the patient is to be subject;
(b) the name of the medical practitioner (the “special medical officer”) who is to be principally concerned with the patient’s medical treatment while the order is in force, who shall be a practitioner approved for the purposes of section 20 of this Act by a Health Board as having special experience in the diagnosis or treatment of mental disorder; and
(c) the name of the person (the “after-care officer”) who is to be responsible for co-ordinating the provision of the after-care services to be provided for the patient under section 8 of this Act while the order is in force, who shall be a mental health officer of the local authority which is to provide the after-care services to be so provided.
(5) The sheriff may defer the making of a community care order until such arrangements as appear to him to be necessary for the provision of medical treatment and after-care services to the patient following the making of the order have been made to the sheriff’s satisfaction.
(6) If, on the date when a patient ceases to be liable to be detained in a hospital in pursuance of an application for admission, a community care application has been made in respect of him but has not been determined, his liability to be so detained shall continue until the community care order comes into force or, as the case may be, the application is refused by the sheriff.
(7) If, on the date when a patient ceases to be liable to be detained in a hospital in pursuance of an application for admission, a community care order has been made in respect of him but has not come into force, his liability to be so detained shall continue until the order comes into force.
(8) On the coming into force of a community care order in respect of a patient, he shall cease to be liable to be detained in a hospital under this Part of this Act.
(9) The responsible medical officer shall, within 7 days of the making of a community care order, send a copy of the order to—
(a) the patient and any other person who has been consulted under subsection (3)(a) or (f) or (4) of section 35B of this Act;
(b) the Mental Welfare Commission;
(c) the patient’s special medical officer; and
(d) the patient’s after-care officer.
(10) The patient’s after-care officer shall, on receiving a copy of the community care order, take such steps as are practicable to explain to the patient, both orally and in writing—
(a) the purpose and effect of the order and of the conditions specified in it;
(b) the patient’s right of appeal to the sheriff under section 35F of this Act; and
(c) that the patient may make representations to the Mental Welfare Commission,
and shall send a copy of any written explanation to any other person who has been consulted under subsection (3)(a) or (4) of section 35B of this Act.
(1) A community care application may be made at any time after the expiry of the period of 28 days beginning with the day on which the patient was admitted to a hospital in pursuance of an application for admission.
(2) Before making a community care application the responsible medical officer shall—
(a) consult the persons specified in subsection (3) below; and
(b) consider the matters specified in subsection (5) below.
(3) The persons referred to in subsection (2)(a) above are—
(a) the patient and, if practicable and the patient does not object, his nearest relative;
(b) the persons who have been principally concerned with the patient’s medical treatment in hospital;
(c) the medical practitioner who is to be the patient’s special medical officer and the other persons who are to be concerned with the patient’s medical treatment after the community care order comes into force;
(d) the person who is to be the patient’s after-care officer;
(e) each other person who the responsible medical officer believes is to have a continuing professional involvement in any aspect of the after-care services which are to be provided for the patient under section 8 of this Act after the order comes into force; and
(f) any person who the responsible medical officer believes will play a substantial part in the care of the patient after the order comes into force but will not be professionally concerned with the after-care services to be so provided.
(4) If the patient has a propensity to violent or dangerous behaviour the responsible medical officer may consult the patient’s nearest relative notwithstanding any objection by the patient to such consultation under subsection (3)(a) above.
(5) The matters referred to in subsection (2)(b) above are—
(a) the after-care services mentioned in subsection (3)(e) above; and
(b) the conditions which should be specified in the order with a view to ensuring that the patient receives medical treatment and such after-care services.
(6) A community care application shall be in the prescribed form and shall include—
(a) the conditions which the responsible medical officer considers should be specified in the community care order for the purpose mentioned in subsection (5)(b) above;
(b) the name of the medical practitioner who is to be the patient’s special medical officer after the order comes into force;
(c) the name of the person who is to be the patient’s after-care officer after the order comes into force; and
(d) subject to section 35C(1) of this Act, the period for which the responsible medical officer considers the order should have effect.
(7) A community care application shall be accompanied by—
(a) two medical recommendations, in the prescribed form and complying with subsection (8) below, one of which shall be given by a medical practitioner approved for the purposes of section 20 of this Act by a Health Board as having special experience in the diagnosis or treatment of mental disorder and the other of which shall, if practicable, be given by another medical practitioner who has previous acquaintance with the patient; and
(b) a report in the prescribed form from the person who is to be the patient’s after-care officer after the order comes into force, and complying with subsection (9) below.
(8) The medical recommendations referred to in subsection (7)(a) above shall consist of statements of opinion that both the following conditions are satisfied, namely—
(a) that the patient is suffering from mental disorder of a nature or degree which makes it appropriate for him to receive medical treatment, but that the grounds set out in section 17(1) of this Act for admission to and detention in a hospital do not apply to the patient; and
(b) that the patient requires to be subject to a community care order—
(i) with a view to ensuring that he receives medical treatment and the after-care services to be provided for him under section 8 of this Act; and
(ii) in the interests of his health or safety or with a view to the protection of other persons;
and for the purposes of subsection (7)(a) above the recommendations do not comply with this subsection unless the patient is described in each of them as suffering from the same form of mental disorder (that is to say, mental illness or mental handicap), whether or not he is described in either recommendation as suffering also from the other form.
(9) The report referred to in subsection (7)(b) above shall include—
(a) information as to—
(i) the patient’s social circumstances;
(ii) the after-care services which are to be provided for the patient under section 8 of this Act after the order comes into force;
(iii) the care, other than medical treatment and the after-care services so provided, which is to be provided for the patient after the order comes into force; and
(b) a statement that in the opinion of the person making the report the patient requires to be subject to a community care order—
(i) with a view to ensuring that he receives medical treatment and the after-care services to be so provided; and
(ii) in the interests of his health or safety or with a view to the protection of other persons.
(10) Before making a community care application the responsible medical officer shall take such steps as are reasonably practicable to inform any person, other than the patient, who has been consulted under subsection (3)(a) or (4) above of his right, by virtue of section 35A(2) of this Act, to be heard by the sheriff regarding the proposed community care order.
(1) Subject to section 35J of this Act and the following provisions of this section, a community care order shall have effect for such period, not exceeding 6 months, as may be specified in the order.
(2) A community care order may be renewed under this section—
(a) from the expiry of the period referred to in subsection (1) above, for a further period not exceeding 6 months;
(b) from the expiry of any period of renewal under paragraph (a) above, for a further period not exceeding one year, and so on for periods not exceeding one year at a time.
(3) The special medical officer shall, within the period of two months ending with the day on which the community care order, if not renewed, would expire—
(a) examine the patient; and
(b) consult—
(i) the patient and, if practicable and the patient does not object, his nearest relative;
(ii) the patient’s after-care officer;
(iii) the other persons concerned with the patient’s medical treatment or professionally concerned with any aspect of the after-care services provided for him under section 8 of this Act; and
(iv) any person who the special medical officer believes plays a substantial part in the care of the patient but is not professionally concerned with the after-care services so provided.
(4) If the patient has a propensity to violent or dangerous behaviour the responsible medical officer may consult the patient’s nearest relative notwithstanding any objection by the patient to such consultation under subsection (3)(b)(i) above.
(5) If, after the examination and consultation required by subsection (3) above and any consultation under subsection (4) above, the special medical officer considers that the conditions set out in section 35B(8)(a) and (b) of this Act continue to apply to the patient, he shall send to the Mental Welfare Commission a report to that effect in the prescribed form, and the community care order shall thereby be renewed for such period as is, subject to subsection (2) above, specified in the report.
(6) The special medical officer shall notify—
(a) the patient and any other person who has been consulted under subsection (3)(b)(i) or (iv) or (4) above; and
(b) the patient’s after-care officer,
of any renewal of the community care order and of the period of such renewal.
(7) Subsection (10) of section 35A of this Act shall apply in relation to a renewal of a community care order under this section as it applies in relation to a community care order made under that section, but with the substitution of references to subsections (3)(b)(i) and (4) of this section for the references to subsections (3)(a) and (4) of section 35B.
(1) This section applies where the special medical officer, after consulting—
(a) the patient and, if practicable and the patient does not object, his nearest relative;
(b) the other persons concerned with the patient’s medical treatment;
(c) the patient’s after-care officer;
(d) the other persons professionally concerned with any aspect of the after-care services provided for the patient under section 8 of this Act; and
(e) any person who the special medical officer believes plays a substantial part in the care of the patient but is not professionally concerned with the after-care services so provided,
considers that the conditions specified in the order should be varied (whether by adding further conditions or deleting or amending existing conditions).
(2) If the patient has a propensity to violent or dangerous behaviour the special medical officer may consult the patient’s nearest relative notwithstanding any objection by the patient to such consultation under subsection (1)(a) above.
(3) Where this section applies the special medical officer shall prepare a note, in the prescribed form, of the proposed variation of the conditions and shall send a copy of the note to—
(a) the patient and any other person who has been consulted under subsection (1)(a) or (2) above;
(b) the patient’s after-care officer; and
(c) the sheriff clerk for the sheriff of the sheriffdom within which the patient is resident.
(4) If the patient wishes to object to or make representations concerning the proposed variation of the conditions he shall, within 7 days of receiving the copy of the note under subsection (3) above, so advise the sheriff clerk; and in that event the sheriff shall not approve the variation without holding a hearing.
(5) If the patient does not indicate, in accordance with subsection (4) above, that he wishes to be heard concerning the proposed variation of the conditions the sheriff shall, if he thinks fit, approve the variation without a hearing.
(6) Where a variation of conditions is approved under this section the special medical officer shall send a copy of the variation as so approved to—
(a) the patient and any other person who has been consulted under subsection (1)(a) or (e) or (2) above;
(b) the Mental Welfare Commission; and
(c) the patient’s after-care officer.
(7) Subsection (10) of section 35A of this Act shall apply in relation to a variation of conditions approved under this section as it applies in relation to a community care order made under that section, but with the substitution of references to subsections (1)(a) and (2) of this section for the references to subsections (3)(a) and (4) of section 35B.
Mental Health (Patients in the Community) Act 1995