Brain is a bit fried today - and nothing I’m reading seems to make sense.
Patient on a 6 month CTO due to expire on the 2nd October 2024. Patient is currently in remand in prison awaiting sentencing. I understand if the patient remains in prison more than 6 months from the date of the CTO expiry the CTO can no longer be considered for renewal.
If the patient is released from prison before that period they are classed as AWOL from the date of their release and then does the MH Trust have 1 week to arrange for the patients return to hospital from the date of their release or 28 days?
I understand the renewal form must be completed within 7 days of the patient being returned to hospital following the patients examination.
The patient’s CTO is set to expire on 2nd October 2024. If the patient remains in prison for more than 6 months after the CTO expiry, the CTO can no longer be considered for renewal. This is because the Mental Health Act specifies that a CTO can only be renewed if the patient is under the community treatment framework. Once a patient has been in custody for an extended period, particularly beyond 6 months from the date of expiry, their eligibility for community treatment is significantly impacted, and renewal of the CTO is no longer viable.
Release from Prison and AWOL Status:
If the patient is released from prison before the 6-month period following the CTO expiry and does not return to their community treatment setting or a hospital, they would be classed as *mAWOL (Absent Without Leave). Under Section 18A of the Mental Health Act, a patient who is on a CTO but fails to comply with its terms (e.g., by failing to return to the hospital or attend their treatment) may be treated as AWOL.
Timeframe for Return to Hospital:
In cases where a patient is classed as AWOL following their release from prison, the Mental Health Trust has 28 days to arrange for the patient’s return to the hospital from the date they are deemed AWOL. This is in accordance with Section 18 of the Mental Health Act, which provides a 28-day window within which a patient who has absconded (or failed to return from leave) must be located and returned to the hospital.
The 1-week timeframe you mentioned applies to the Responsible Clinician’s ability to arrange for the renewal examination following the patient’s return to the hospital, not to the period within which the patient must be returned. This means that after the patient is returned to the hospital, the clinician has 7 days to examine the patient to decide whether the CTO should be renewed.
Renewal Examination:
If the patient is returned to the hospital following their release, the Responsible Clinician must examine the patient within 7 days** of their return to determine whether the CTO should be renewed. The renewal form (Form CTO7) must be completed within this period, provided the patient meets the criteria for continued community treatment.
The examination will assess whether the patient still requires community treatment and whether they continue to meet the conditions for the CTO. If they do, the CTO can be renewed for another period, provided all statutory requirements are met.
Summary of Key Points:
If the patient remains in prison for more than 6 months after the CTO expires, the CTO cannot be renewed.
If the patient is released from prison before that 6-month period, they would be considered AWOL if they do not return to their hospital or community treatment setting.
The Mental Health Trust has 28 days to arrange the patient’s return to the hospital after they are deemed AWOL.
Once returned, the Responsible Clinician has 7 days to complete an examination and file the renewal paperwork if the CTO is to be renewed.
I hope this provides the clarification you need.
Fatima Boujettif
Shield Solicitors
The 6 month period is not calculated from the expiry of the CTO. The CTO will expire 6 months from the date of imprisonment (if indeed imprisonment lasts that long). So in the case you describe, 6 months from the date that remand started.
The long reply above has two features that make me think it was created using ChatGPT or a similar service. The first is that ChatGPT is quite suggestible – here, it has taken the “I understand” sentence as the factual basis for its answer. The second is that it creates imaginary sources – here, the non-existent s18A MHA 1983.