April 2026 update

Updates MHLO monthly updates
1

Website

  • Magic Book. The Magic Book is a database of contact details. The main idea is to add the hospitals and other places you visit (not just your own place of work). To create/edit contacts, there is no need to log in and the process is very quick and simple. See Magic Book

  • Mental Health Law Online CPD scheme: 12 points for £75. Obtain 12 CPD points online by answering monthly questionnaires. The scheme is an ideal way to obtain your necessary hours, or to evidence your continued competence. It also helps to support the continued development of this website, and your subscriptions (and re-subscriptions) are appreciated. For full details and to subscribe, see CPD scheme.

  • Cases. By the end of this month, Mental Health Law Online contained 2557 categorised cases

  • Chronology. See April 2026 chronology for this month’s changes to the website in date order.

Cases

  • Case (Case management decision in anorexia case). Patricia’s Father v Patricia [2025] EWCOP 29 (T3) — “The issue is whether I should adjourn the decision using my case management powers until a bed is available at SEDU 3. The next issue, if I decide not to adjourn, is whether in principle I should consider re-visiting the 2023 orders and finally, if so, whether it is in Patricia’s best interests that I should discharge the orders.”

  • Case (Lifting of anorexia non-treatment order). Patricia’s Father v Patricia [2025] EWCOP 30 (T3) — In 2023 the court declared in accordance with Patricia’s strongly expressed views that it was in her best interests that no forced treatment should take place and that Patricia should be given autonomy to make her own decisions about whether she put on weight or not. Her parents and aunt argued that the 2023 declarations should be lifted so that Patricia could have the treatment the clinicians considered she needed as otherwise she was likely to die soon. The court noted that the hands-off approach, leaving it to Patricia to decide whether to increase her BMI, has not worked, and that without a change to the orders there was no doubt that Patricia would die. Having considered the balance of the imminent risk of death versus the harm which will be caused psychologically and emotionally by the lifting of the orders, the court decided that the balance was in favour of trying to save her life. The removal of the orders would allow the clinicians to work out and do what was best for Patricia.

  • Case (Non-forcible treatment of anorexia). Leeds and York Partnership NHS Foundation Trust v FF [2025] EWCOP 26 (T3) — The patient, FF, was detained under s3 MHA 1983 for treatment for anorexia. The trust decided to discharge her from detention, and to stop providing clinical artificial hydration and nutrition by force or the threat of force, and sought court orders declaring that this would be lawful. The court agreed that FF lacked capacity to make treatment decisions. It was in her best interests to receive treatment for anorexia, but providing this by force or the threat of force was futile (as treatment for her anorexia) and highly burdensome and so not in her best interests. A full merits review is required for MHA non-treatment decisions which could lead to death: the judge, having concluded it was not in her best interests and in the absence of any wider public issues, could see no reason not to declare that it would be lawful not to treat by force or threat of force under s63 MHA 1983. When a declaration about s63 is sought, a Part 8 claim form should be served so that the Civil Procedure Rules can be used, and the declaration should be under s19(2)(a) Senior Courts Act 1981 rather than the inherent jurisdiction or the MCA 2005. The “transparency” order, forbidding the naming of FF, her location, the identity of her father and other family members, and (while they continue to treat FF) the treating clinicians, would continue for six months after her death.

  • Case (Appeal against restriction order). R v Gordon [2025] EWCA Crim 1194 — The appellant had pleaded guilty to wounding with intent after stabbing his father, and was given a hospital order together with (against the psychiatric evidence) a restriction order. He appealed against the restriction order, but was unsuccessful: the question of whether to impose a restriction order is one for the judge, and it could not be said that his conclusion was irrational (Wednesbury unreasonable).

  • Case (Hybrid order vs hospital order). R v Turner [2025] EWCA Crim 1867 — The appellant had been convicted of diminished responsibility manslaughter, for shooting a man in a pub with a crossbow, and given a life sentence with a minimum term of 7 years and 61 days alongside a hybrid order under s45A. He argued that he ought instead to have received a restricted hospital order or, alternatively, that the tariff was manifestly excessive. The Court of Appeal decided that the trial judge had correctly followed Sentencing Council, ‘Manslaughter: Definitive guideline’ (1 November 2018) in respect to both grounds, noting in particular that the court should consider a hybrid order prior to a hospital order, that the court should reflect upon the importance of the penal element in a sentence, and that the judge had been entitled to conclude when considering recall and wider public protection that a hybrid order was better in this case.

  • Case (Disposal when unfit to stand trial). R v Wood [2026] EWCA Crim 480 — The Court of Appeal found that at the time of his conviction for arson the appellant had been unfit to stand trial, and also that the evidence he had done the act was overwhelming. The three options in those circumstances are hospital order (with or without restrictions), supervision order, or absolute discharge (in its criminal law meaning). A hospital order was not an option because the medical professionals did not support it. Neither was a supervision order, because neither the probation service nor the relevant local authority was willing to provide a supervising officer. The court therefore quashed the prison sentence (extended sentence of 9 years including a custodial term of 7 years) and, having expressed its concerns, granted an absolute discharge.

  • Case (No new evidence for criminal appeal). R v Thomas (previously Edgington) [2026] EWCA Crim 353 — In this reference by the Criminal Cases Review Commission it was argued that the conviction for murder was unsafe and should be replaced by diminished responsibility manslaughter. The Court of Appeal refused to admit fresh psychiatric evidence as it did not contain any material which had not already been properly considered at trial. The appeal would have been dismissed on all grounds in any event.

  • Case (IPP appeal and consecutive sentences). R v Jenkins [2025] EWCA Crim 1657 — (1) The Court of Appeal quashed an IPP sentence and replaced it with a s37/41 restricted hospital order. (2) During his imprisonment the appellant had been made subject to three separate sentences for assaults, ordered to run consecutively to his release from the IPP: (a) in relation to the two sentences from the Crown Court, the Court of Appeal allowed appeals and quashed the orders that the terms were to run consecutively; (b) in relation to the sentence imposed by the magistrates’ court, the power under s142 Magistrates’ Court Act 1980 to vary sentence was not available, so the Court of Appeal reconstituted itself for an oral appeal hearing under s108(1) MCA 1980 to achieve the same end.

  • Case (Ordinary residence definition). R (Shah) v Barnet London Borough Council [1982] UKHL 14 — Leading case on definition of ordinary residence. Lord Scarman said: “Unless, therefore, it can be shown that the statutory framework or the legal context in which the words are used requires a different meaning, I unhesitatingly subscribe to the view that ‘ordinarily resident’ refers to a man’s abode in a particular place or country which he has adopted voluntarily and for settled purposes as part of the regular order of his life for the time being, whether of short or long duration.” He also commented on the mental elements that “[t]he residence must be voluntarily adopted” and that “there must be a degree of settled purpose”.

  • Case (Section 139 permission). Khamba v Harrow London Borough Council [2025] EWHC 2803 (KB) — The patient blinded his mother and injured his sister, and all three sued in negligence and under the Human Rights Act 1998 for the earlier decision not to section him. The local authority sought strike out or summary judgment on some aspects of the claim. (1) The claimants argued that s139 leave was not required as the claim concerned an omission rather than an act, that s139 did not apply when the assessed person was not detained, and that s139 should be “read down” under the HRA to accommodate this claim. Those arguments were rejected so, in the absence of permission, the proceedings were a nullity. (2) In any event, the common law case on duty would have been struck out, for reasons including that the imposition of a common law duty would be inconsistent with the proper functioning of the AMHP’s statutory role, and that the AMHP had not assumed responsibility or control. (3) Similarly, the HRA claims, whether phrased in terms of Article 2, 3 or 8, would not have got off the ground because the required obligation on the state was not present (in particular, the local authority did not even know about the sister, and it could not be shown that the local authority knew or ought to have known that the patient presented a real and immediate risk of acting as he did), and the indirect victim claims would have failed as it was undesirable for close family members to claim for the same breach unless the direct victim had died or gone missing.

  • Case (Adjournment for aftercare information). CB v Dorset Healthcare University NHS Foundation Trust [2026] UKUT 138 (AAC) — (1) In refusing to adjourn the tribunal sought to distinguish SS v Cornwall Partnership NHS Foundation Trust [2023] UKUT 258 (AAC) on the ground that there was no “missing information”. They had applied the wrong test (which was whether “information or better information of aftercare is incapable of affecting the decision, and that an adjournment to secure its provision could achieve nothing beyond additional expense and delay and would therefore be inappropriate”: AM v West London MH NHS Trust [2013] EWCA Civ 1010, [2013] MHLO 73) and in any event had applied it wrongly (there was missing information, as accommodation funding had not been agreed and a community team had not been allocated). Neither of the two circumstances envisaged in SS (that “[t]he only reasons not to adjourn for aftercare information would be either because it is not relevant because the patient had not reached the stage at which discharge was a realistic prospect, or because there was no realistic prospect of such aftercare information being produced”) were applicable in this case. (2) The tribunal had decided on adjournment and discharge at the same time, without allowing the representative to make submissions on discharge. This was procedurally unfair and did not recognise the importance of the case for the patient or enable him through his representative to participate fully in the proceedings.

  • Case (Criminality and HRA claims). Al Hassan-Daniel v HMRC [2010] EWCA Civ 1443 — A drug smuggler swallowed a kilogram of cocaine and died of poisoning in custody after refusing all food and almost all drink for a week. The criminality defence (ex turpi causa non oritur actio: no claim arises from a dishonourable cause of action), more correctly understood as a control on jurisdiction, applies to common law claims, but not to Human Rights Act 1998 claims. The claims under Article 2 and 3 could therefore proceed, but the court doubted whether they would succeed on causation. The court also confirmed that a “victim” in the HRA can include close relatives such as the claimants.

  • Case (Ordinary residence of recalled restricted patient). R (WLT) v London Borough of Islington [2025] MHLO 19 (Admin) — The defendant local authority decided that it was not responsible for s117 aftercare services because the claimant, a s37/41 patient, had been living in another borough when recalled to hospital. (1) Permission to seek judicial review was granted, as the grounds were arguable, particularly in light of R (Wiltshire Council) v Hertfordshire CC [2014] EWCA Civ 712. The judge noted that there is no mandatory timetable for resolution of a dispute over responsibility under the Care and Support (Disputes between Local Authorities) Regulations 2014 and that it was not appropriate for the claimant to be expected to wait for mechanisms over which he has no agency, especially as responsibility has been disputed for around six months: in the absence of a prompt determination by the Secretary of State the court would have to resolve the question. (2) An interim injunction was made obliging the defendant to assess, fund and put in place s117 services pending the outcome of the judicial review. This was in the hope that the claimant would be discharged before the hearing: the defendant appeared to accept that it was certain or highly likely that the patient would have been conditionally discharged if some local authority had taken responsibility for aftercare services. (3) The defendant’s request that the other local authority be joined as a defendant, rather than an interested party, was refused as the claimant was not alleging that the interested party was acting unlawfully. (4) An extension of time was granted as there were good reasons for the claim not being issued within three months of the original decision, and it would be artificial not to examine the original decision when considering the claimed continuing failure. Abridgement of time and expedition of the hearing were appropriate as the steps taken in response to the interim order would affect the claimant’s ongoing detention. (5) Anonymity was ordered given the sensitive medical information relied on by the claimant.

  • Case (Open justice). Re H (publication of decision) [2026] MHLO 1 (FTT) — The starting point when considering publication of MHT decisions is rule 14 (“Unless the Tribunal gives a direction to the contrary, information about mental health cases and the names of any persons concerned in such cases must not be made public”): the rationale behind the presumption of privacy in mental health proceedings is to prevent the sensitive and personal information of often vulnerable individuals being made subject to public scrutiny. However, the High Court in R (Maher) v First-tier Tribunal (Mental Health) [2023] EWHC 34 (Admin) decided that “departing from the open justice principle can only be justified in exceptional circumstances when [it is] strictly necessary to secure the proper administration of justice”. In this case, (a) the review decision “provides a clear explanation as to the legal principles applied”, (b) it was worthy of public interest because it would “enable the reader to have insight into the work of the Tribunal including the permission to appeal process”, (c) the redacted version contained no identifying information so maintained the patient’s privacy, and (d) the patient wanted publication so had waived the right to privacy. There were therefore no exceptional circumstances and publication would be proportionate.

  • Case (Inadequate reasons about statutory criteria). Re H (inadequate reasons) [2025] MHLO 18 (FTT) — The patient challenged the adequacy of the tribunal’s reasons in relation to its refusal to adjourn or to allow withdrawal. That was unsuccessful but the decision was set aside on different grounds. The reasons in relation to the statutory criteria were inadequate: (a) the tribunal had recorded that the nature was “chronic, relapsing and remitting” but not why that made continued detention for treatment appropriate; (b) the tribunal had dealt with health, but in relation to safety and protection of others used phrases that did not adequately explain why the necessity test was satisfied (e.g. “the Tribunal cannot ignore the fact that members of the public might respond” and “the Tribunal would be concerned for the protection of others”).

  • Case (Contact). Re PX [2025] EWCOP 58 (T2) — The main issues at the final hearing concerned: (a) PX’s contact with her mother and father; (b) where PX should reside during school holidays; (c) whether either parents should be permitted to take PX on holiday outside the jurisdiction, in particular to Sri Lanka.

Legislation

Resources

News

  • MHA 2025 amendments. Two MHA 2025 provisions come into force on 6 April 2026: (1) Care providers are subject to the HRA 1998 when providing aftercare or NHS-arranged inpatient treatment; (2) The Secretary of State must review the circumstances in which the CQC is notified of children being admitted to hospitals or registered establishments. See Mental Health Act 2025 Overview for full details.