Nottingham Inquiry -- evidence about CTO and s117

Law and practice Mental Health Act
1

Can anyone explain how this statement came to be made in the evidence submitted to the enquiry by Nottingham City Council:

“44.At no stage prior to 13 June 2023 was a CTO effected at the point of VC’s discharge from psychiatric care and, as a result, NCC was not involved in the provision of any after care for the purposes of s.117 MHA.”

Richard Jones

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2

I haven’t followed the inquiry at all but from skimming that document it seems to be a muddled combination of things:

  1. The local authority needs to explain why it never provided any aftercare to Valdo Calocane.
  2. The document’s author seems to think that the s117 aftercare duty and a CTO are the same thing (or at least that there is no s117 aftercare duty without a CTO).
  3. No CTO was ever proposed so he uses that to explain the lack of aftercare.
  4. The document focusses on the AMHP service in particular, as they were only involved in detention and would only have been involved around discharge had a CTO been proposed.

The preceding paragraphs say:

  1. Once the immediate need to deal with an individual’s mental health crisis is
    met, by either, essentially, hospitalisation or treatment in the community, the
    AMHP’s statutory role comes to an end. NCC was not involved in the
    discharge of VC from the care of Nottinghamshire Healthcare NHS
    Foundation Trust.

  2. It is only resurrected in the event that, following in-patient treatment
    (detention for treatment under s3, as opposed to detention for assessment
    under S2 MHA) an individual is discharged under the provisions of s117(2)
    MHA (as amended) under what, since 2007, has been known as a Community
    Treatment Order (CTO).

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Yes, I noticed that too, and was very worried about the local authority submission as a result.

I noticed that their counsel also seemed in a muddle about the purposes of a MHA assessment, as being purely about detention and not also admission; and about the AMHP’s role in the Community Treatment Order, which is not simply to bring a social care perspective but is to satisfy themselves as to the criteria being met and the order being appropriate.

The problem is, that there was a s.117 aftercare duty upon the relevant local authority whether NCC recognised it or not.

The s.117 aftercare plan should have been made on discharge from hospital on at least two and possibly three occasions after his first s.3 detention in July 2020. We know what it should have contained-provision of care to treat his mental disorder and reduce the likelihood of his being re-detained under the Act.

There is no sign so far, either, that the s.117 aftercare duty was considered, either by the local authority or the ICB, when he was discharged from services in September 2022.

Additionally it opens the question, in relation to where he was living, which seemed to occasion the inquiry some difficulty, as to where exactly this s.117 duty was lodged. I too am not enough across the timeline yet but it would need to be shown, I think, that NCC was throughout the responsible local authority.

In any case, there was a statutory aftercare duty and it lay on a local social services authority whether they acknowledged it or not. It does offer a framework in which to consider the local authority’s duty towards VC quite outside that of AMHP duty services rushing about and I can well imagine they want to turn attention away from it.

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It goes on at para 56 with this ‘interesting’ statement:

“NCC suggests that there is work to be done here by National Government: currently, absent the formal structure of a CTO, there is no requirement that other agencies such as a local authority are informed when a patient is discharged from psychiatric care after being `sectioned’.”