Hello, I'm Dr Beth Colby from Talk Mental Health, a psychiatrist in London.
Today I'm going to talk about Section 37/41 of the Mental Health Act.
Section 37/41 is a Hospital Order with an added Restriction Order on it.
A Crown Court can order hospital admission instead of a criminal sentence to a person who has
committed an offence which is punishable by prison sentence and if the person is mentally disordered
and requires treatment in hospital. Two doctors need to sign the papers, one of whom must be
a Section 12 Approved doctor. Section 37 has no end date, unlike a prison sentence, and after the
first six months can be renewed for six months and then a year after. However, if a Section 41
Restriction Order is added to a Section 37, then the patient cannot be discharged from hospital
without the authority of the Ministry of Justice; therefore Section 37 does not need to be renewed.
However, the Responsible Clinician will need to write an annual report to the Ministry of Justice
on the progress of the patient. A Section 41 will be added to the Section 37 in Court
if the mentally disordered offender is liable to be at risk to the population at large. In
deciding this, the Court will look at the nature of the offence, the events leading up to it,
and whether the offender is at risk of committing further offences if set at large - that is,
that the offender would cause serious harm to the public - and therefore this is for the protection
of the public. The name 'Restriction' means that the patient and also the Responsible Clinician are
restricted in what they can do. The Responsible Clinician cannot authorize Section 17 leave for a
patient with a Restriction Order. They would need to get this from the Ministry of Justice, having
completed a form with information about the patient's mental state and their progress,
and the Ministry of Justice is likely to authorize a small amount of leave, that is escorted,
for a short period of time first, and then it will gradually, gradually be increased as the patient
remains well and has been shown to be safe in the community with the previous Section 17 leave. This
is a lengthy process, and patients on Section 37/41 may be in hospital for years at a time,
or indeed may never be discharged from hospital. Depending on the nature of the offence, the Court
may also order a patient to be admitted to a low secure, medium secure or high secure unit. The
Responsible Clinician also is not able to transfer the patient to another hospital from the one that
they've been admitted to without the authorisation of the Ministry of Justice, and the patient
will not be able to be discharged from their Section without the authority of the Ministry
of Justice. After such time as the patient has had long periods of leave without any problems,
it may come to the point where a patient is discharged from hospital. There will be
conditions on this, and the Responsible Clinician and the Multi-Disciplinary Team will need to look
hard to find an appropriate placement for the patient that will support them to maintain their
mental well-being. The Ministry of Justice may then decide to give the patient a Conditional
Discharge, and the conditions will be where they live, that they may need to attend certain places
to see particular mental health professionals at intervals required by the Ministry of Justice,
and also to take medication; and they may also have to stay away from certain people in the
community for the protection of these people. if the patient breaks any of the conditions then they
can be recalled to hospital, and the Conditional Discharge will be taken away from them. As I said,
it may take a number of years for a patient to get a Conditional Discharge, and this will
depend on the nature of the index offence, their mental state and whether they are perceived by the
Ministry of Justice to continue to be dangerous or at risk to the population in the community.
Eventually a patient may get to the stage where they are given an Absolute Discharge from the
Ministry of Justice, and they will not need to be bound by the conditions of the Conditional
Discharge. Thank you for listening. You may be interested in some more videos
that I've done on the Mental Health Act or on other mental health subjects. 'Bye for now.