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Section 48/49 – Removal to hospital of other prisoners with restrictions

Why am I on a Section 48/49?

You are a prisoner waiting to be sentenced. On the advice of two doctors, the secretary of state decided that you need to be in hospital for treatment of a serious mental health problem.

A Section 48 is also known as a “transfer direction”. A Section 49 is also known as a “restriction direction”.

The restriction direction means that you cannot be discharged from hospital unless the Secretary of State says that you can leave. And while you are in hospital your responsible clinician must get the Secretary of State’s agreement before you can go on leave or be sent to another 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. 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 direction will cease to have effect and would be followed by sentencing to prison or possibly detention under Section 37 or Section 37/41.

If your responsible clinician says you no longer need treatment you will be returned to prison, unless the court decides to release you on bail.

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. The Ministry of Justice will not normally grant leave unless there are exceptional reasons.

How can I appeal?

You can appeal to the Mental Health Tribunal, once in the first six months, once in the second six months and after that every year.

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.