Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what steps his Department is taking to ensure that people who have been returned to their homes on condition of receiving medication after having been detained under the Mental Health Act 1983 do proceed to take that medication.

Decisions around the continuing treatment of patients who are or who have been subject to the Mental Health Act 1983 are a matter for clinicians.

Community Treatment Orders (CTOs), introduced by The Mental Health Act 2007, may be used in certain circumstances when a patient’s responsible clinician and an Approved Mental Health Professional agree that the risk of harm arising from the patient’s disorder is sufficiently serious to justify having the power to recall the person to hospital. These Orders may include a condition that a patient complies with arrangements made to ensure that he or she continues to receive medical treatment for their mental illness.

The responsible clinician may recall a patient on a CTO to hospital for treatment if the patient needs to receive treatment for mental disorder in hospital; or if there would be a risk of harm to the health or safety of the patient or to other persons if the patient were not recalled. The fact that the patient has failed to comply with a treatment condition can be taken into account when deciding whether to recall the patient.

Restricted patients are offenders who are detained in hospital for mental health treatment and who are subject to special controls by the Secretary of State for Justice. For these patients, Section 41 of the Mental Health Act 1983 provides for a “restriction order” which operates like a community section. This means that restricted patients who are conditionally discharged can be supervised in the community generally by a psychiatrist and a social worker, with a number of conditions imposed. The Secretary of State for Justice has a broad power of recall that applies to any conditionally discharged restricted patient. A condition of such a discharge may be compliance with treatment, on a voluntary basis, provided the patient has capacity to give consent.

Non-compliance with medication will lead to consideration of recall. Whether a recall takes place will, of course, turn on the circumstances of the particular case.