Why Deputies and Attorneys should know about s.117 aftercare services under the Mental Health Act 1983
There are various levels of support available to P or an injured party when they are discharged from hospital following a detention under the Mental Health Act. Deputies should consider P’s eligibility for any such aftercare services available in the community to ensure that P is receiving all the assistance that is available to them; whether this relates to healthcare matters or housing.
The Care Act 2014 (“the Act”) sets out the general duty imposed on local authorities to conduct an assessment where it appears that P may meet the needs-based requirement for care and support in the community. In order to satisfy the relevant criteria, the need must be demonstrated to have arisen from or be related to a mental disorder. A local authority can undertake a detailed assessment of what those needs are. The Act further sets out a framework for charging for that care and enables local authorities to decide whether the provision of that support will be paid for by the local authority or by the individual.
There are however certain services (known as ‘aftercare’ services) which local authorities cannot charge for and it is important to understand what these are, to make the most of the assistance available to P.
Aftercare services are available under s. 117 Mental Health Act 1983 to those who have been detained under ss. 3, 37, 45A, 47 or 48 of the Mental Health Act 1983. Even if P is in receipt of a personal injury damages award or insurance pay-out specifically designed to cover the cost of future care, this does not affect their entitlement to S.117 aftercare.
Aftercare is broadly defined as help provided to an individual within the community following a discharge from hospital, with the aim of avoiding future hospitalisation. The discharge is usually permanent but might be transient, such as conditional leave from hospital, for a defined period of time. Eligibility to aftercare will involve assessing P’s needs on discharge and can include almost anything that would help P to transition back into the community; including but not limited to:-
- help with specialised accommodation;
- social care support;
- help with work or education;
- day centre facilities;
- recreational activities and help with meeting other people;
- support around prompting to take medication, prompting around self-care and establishing healthy diet.
Aftercare services may be withdrawn, or in other words P may be discharged from s.117, if social services or the relevant healthcare organisation believe that P no longer needs the relevant support, or the provision of services provided. However, the organisation(s) must reassess P’s needs before reaching that conclusion, stating their reasons for doing so. P must be involved in any withdrawal process and his carers should also be invited to input into any consultation to end support. P is also entitled to an advocate to represent his views on the withdrawal of the aftercare services.
If there are problems with the aftercare services, P should discuss these in the first instance with their care coordinator or their contact within the NHS or social services. Where P is unable to express their views adequately, an advocate can do this on P’s behalf. If matters cannot be resolved collaboratively, P or their advocate could instigate a complaint which can be referred to the relevant Ombudsman or ultimately, a judicial review of the decision might be considered.