CTO Patient in Prison - MH Deteriorating - Recall on CTO or Forensic Order?

[A.Ramsden (Amy Ramsden)]

I am a MHAO, we have a patient serving a 14 week sentence in prison. He is subject to a CTO. The Prison have contacted the RC as the patient is refusing his medication and his mental health has deteriorated. They believe he should be transferred to hospital. Can the RC recall him on the CTO to hospital, or would there be a requirement to seek a hospital order? Can you please confirm the statute/case law that supports the answer? We are getting conflicting information from different sources.

[Rob_Beech (RB)]

If he’s serving a sentence then he needs to be transferred under s47

[mat_kinton]

Certainly agree there is no way a CTO recall could ever ‘trump’ a prison sentence, so on that basis only s.47 available. Given that MHA s.47 is the statutory power to transfer a sentenced prisoner to hospital, there can be no alternative route as a matter of law. The only way I can imagine the CTO recall power being relevant would be if the patient is some way through the sentence and early release might be being considered anyway, in which case I can’t see why such release from prison custody might not coincide with CTO recall. (This is a personal view, not a corporate one).

[RJ53 (Rajen Jussun)]

If a patient is in Prison, he is no longer ‘‘ in the community’’ for the purpose of the CTO framework.

But more importantly, Compulsory treatment under the Mental Health Act cannot occur in prison as the Act only authorises treatment in hospital and not prison. Therefore the legal route is transfer from Prison to hospital and not CTO recall.

As the two previous contributors have rightly stated, the relevant provision is Section 47 Mental Health Act 1983.

This allows a sentenced prisoner to be transferred to hospital for treatment of mental disorder with 2 medical recommendations, approval by the Secretary of State for Justice (MoJ) with the availability of a hospital bed.

Often a restriction direction (s49) is added so that once transferred, the patient becomes detained in hospital under S47 or S 47/49

RAJEN JUSSUN

RMN. RNLD. LLB