Section 48/49 - Transferred remand prisoners with restrictions

If you are detained under Section 48/49 Mental Health Act 1983 (as amended) (MHA 1983) you are a prisoner on remand without sentence but in the course of waiting for your hearing/trial or sentencing you have been transferred to a hospital on the recommendation of two doctors that you need treatment for mental disorder and it is necessary in the interests of your own health, safety or for the protection of others that you receive this treatment in hospital.

The Ministry of Justice must agree with the advice of the two doctors and issue a transfer warrant enabling you to be transferred from prison to a psychiatric hospital to receive appropriate medical treatment.

Section 49 is a restriction direction which is placed on a patient transferred from prison to hospital under Section 48. This addition to the transfer direction means you cannot be transferred to a different hospital, granted Section 17 leave or be discharged from hospital without the Secretary of State for Justice’s consent.

Duration

If you, or your relative, are detained under Section 48/49 MHA 1983, you will be kept in hospital until either your responsible clinician thinks you no longer require treatment in hospital or until your case has been decided by the court. On return to court for final sentencing the transfer direction and restrictions will cease to have effect and would be followed by sentencing to prison or possibly detention under Section 37 or Section 37/41 MHA 1983.

If during your detention under Section 48/49 your responsible clinician says you no longer need treatment you will be returned to prison, unless the court decides to release you on bail.

Rights

You should be informed of your rights by a member of hospital staff as soon as possible into your admission.  You have the right to:

• Information about your section and the reasons for detention
• Information about consent to treatment
• Information about your rights of appeal to the Mental Health Tribunal
• Information about how to contact a suitably qualified solicitor
• Information on how to obtain the help and support of an Independent Mental Health Advocate (IMHA)
• Information about correspondence and visitors
• Information on how to make a complaint
• Information about safeguarding
• Information about the Care Quality Commission

Consent to Treatment

Medication can legally be given to you without your consent for the first 3 months of your admission to hospital. After 3 months, staff can only treat you without your consent if a ‘Second Opinion Approved Doctor’ (SOAD) approves the treatment unless it is an emergency. Staff can only give you some treatments, like electro-convulsive therapy (ECT), if certain criteria are met.

Discharge from Section

To be discharged from Section:

1. Your Responsible Clinician (your doctor in the hospital in which you are detained) can recommend to the Secretary of State for Justice that you should be returned to prison
2. The Tribunal can notify the Ministry of Justice that you no longer meet the criteria for detention under MHA 1983 and they can recommend that you should be returned to prison to await your hearing/sentencing

Tribunal Procedure & Powers

You have one right to appeal to the Mental Health Tribunal during the first 6 months of your detention, one during the second 6 months of your detention and then on a yearly basis. For example, if you were detained under Section 48/49 on 3 January, the last day you could submit an application to the Tribunal would be 2 July. You would then have one right of appeal between 3 July and 2 January and then you would have one right of appeal between 3 January and 2 January of the following year.

Once you have submitted your application to the Tribunal, a Tribunal Hearing should take place within 12-14 weeks of the Tribunal Services receiving your application. Reports will be prepared by your doctor, your social worker/care coordinator and a nurse and these will be made available to you, the Tribunal Panel and the Ministry of Justice. The Ministry of Justice will provide their comments on your detention and provide a copy of your Police National Computer (PNC) record.

In the Tribunal Hearing, the Tribunal Panel will hear evidence from your doctor, your social worker/care coordinator, and a nurse. You will also have the opportunity to provide evidence.

You would usually only apply to the Tribunal if you would like to be returned to prison and your treating team does not agree with this. The Tribunal Panel cannot discharge you from hospital without the agreement of the Ministry of Justice but can recommend that you should be discharged from section and returned to prison. It is then, ultimately, the decision of the Ministry of Justice.

The Tribunal Panel can also make non-binding recommendations that you should be transferred to a different hospital or granted Section 17 leave. As the recommendations are non-binding, the Tribunal has no obligation to consider whether or not they should be made and there is no way to ensure they are acted on by your treating team even if they are made.

What can Biscoes Solicitors do?

• Meet with you promptly in hospital to advise you about your Section and your rights, including your right to appeal to the Tribunal to seek discharge from Section and a return to prison/non-binding recommendations for transfer to another hospital or the granting of Section 17 leave
• Advise you regarding consent to treatment issues
• Review your Section papers and assess their legality
• Submit an application to the Tribunal on your behalf
• Contact your treating team to find out their plans for your admission
• Attend Care Programme Approach (CPA) meetings and Section 117 aftercare meetings with you or on your behalf
• If you have a learning disability, we can request Care and Treatment Reviews (CTRs) and attend them with you or on your behalf
• Represent you in a Mental Health Tribunal Hearing
• Advise you on your rights to aftercare under Section 117 MHA 1983

India Jefferson-Grant is the Mental Health Law specialist in our Mental Health and Capacity Department and is a member of the Law Society’s Mental Health Accreditation Scheme having been independently assessed as an expert in Mental Health Law. If you have been detained under Section 48/49 MHA 1983 and need legal assistance, you can contact India on 02392 660 261 or IJefferson-Grant@biscoes-law.co.uk.