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Section 47/49 – Transfer from prison to hospital with restrictions

Why am I on a Section 47/49?

You are a sentenced prisoner. You have been transferred from prison to hospital because on the advice of two doctors, the Secretary of State agreed that you needed to spend time in hospital to have treatment for a serious mental health problem.

You are also under a restriction order (Section 49) from the Ministry of Justice. This means that the Ministry of Justice is responsible for granting leave and allowing discharge from hospital.

Two doctors, one who is Section 12 approved and has specialist experience in the treatment and diagnosis of mental illness, and a registered practitioner usually a doctor who knows you, such as your GP put you on the section with the agreement of the Ministry of Justice.

How long does it last and what happens next?

The mental health professional in charge of your care and treatment under the MHA is known as the Responsible Clinician or RC. If your RC notifies the Ministry of Justice that you no longer require treatment in hospital or there is no effective treatment.

The Ministry of Justice may return you to prison, release you on parole or allow you to be discharged. The restriction direction ends automatically on the date you would have been entitled to be released from prison.

If you are still detained in hospital on your release date, you will be treated as if you had been admitted to hospital as an unrestricted patient.

Can I be medicated against my will?

Yes. Medicine can be given to you with or without your consent. However, your consent will always be sought. Your responsible clinician and other hospital staff will talk to you about any medicine that you need for your mental health problem.

After three months, if you do not want the medicine you are being given, an independent doctor called a SOAD (Second Opinion Appointed Doctor) will talk to you and to staff who know you. They will decide what medicine you can be given and except in an emergency, no other medicine can be given to you without your agreement.

Can I get leave?

You cannot be granted leave without the agreement of the Ministry of Justice.

How can I appeal?

You can appeal to the Mental Health Tribunal to say that you should be discharged from detention. You can apply to a Tribunal once at any time during the first six months, once during the next six months and then once in every year you are kept in hospital after that.

However, if the tribunal thinks that you should be discharged from detention this can only happen with the agreement of the Ministry of Justice. If the Ministry of Justice refuses to consent to discharge, you would be returned to prison unless the tribunal orders that you remain in hospital.

You can also appeal to the Hospital Managers. You can do this at any time. They cannot discharge you, but can only recommend discharge to the Ministry of Justice. Hospital Managers are an independent group of people, who are separate from the hospital. Their job is to ensure that the Mental Health Act is being correctly applied and that service users’ rights under the Act are being upheld.

For help with an appeal speak to a member of the hospital staff or to an advocate.

What are my rights?

You have certain rights when you are in hospital. These include 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 about your right to appeal to the Hospital Managers
  • Information on how to obtain the help and support of an Independent Mental Health Advocate (IMHA)
  • Correspondence and visitors
  • Information on how to make a complaint
  • Information about safeguarding
  • Information about the Care Quality Commission

The Mental Health Act 1983 Code of Practice

The MHA Code of Practice should be followed by professionals who are involved in your care and treatment. The Code of Practice provides guidance to health professionals about the MHA and is also intended to be helpful to you, your family, carers, representatives, friends, advocates and anyone else who supports you. A copy of the code should be available on the ward for you to see.