Sentenced persons

Section 37 permits a court to order hospital admission (or, occasionally, guardianship) for a patient who has committed an imprisonable offence, and who is suffering from mental disorder of a nature or degree that makes this course appropriate. It is imposed as a 'disposal', that is, instead of, for example, a prison sentence. Two doctors, one approved, must give evidence. It lasts up to 6 months, and may be renewed, appeal to a Mental Health Review Tribunal being allowed in the second 6 months.

Section 38 (interim hospital order) allows a trial of psychiatric treatment for 3 months when a full Section 37 may be inappropriate.

A restriction order (Section 41) can be applied, in addition to Section 37, for serious cases in which the patient may not be given leave, transferred, or discharged without permission from the Home Secretary (in practice, a particular branch of the Home Office) in order to protect the public. The Home Secretary may sometimes come under pressure from MPs or members of the public in relation to individual patients on restriction orders.

Section 47 (transfer of a sentenced prisoner) and Section 48 (transfer of other prisoners, including those remanded) to hospital are by order of the Home Secretary, on two medical recommendations. A restriction on discharge may be added (Section 49) and applies until the end of the sentence with remission. The patient may appeal to a tribunal in the first 6 months.

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