Section 117

Section 117 of the MHA legally formalises the duty of health and social services to jointly provide aftercare to people who have been discharged from a hospital where they have been compulsorily detained under a treatment order of the Act.
Sections 3,37,47,48 are all treatment orders, so you are legally entitled to aftercare if you have been detained under any of these Sections
.
Section 117 requires that, before someone is discharged from a hospital where they have been detained for treatment, a discharge planning meeting must take place at which an Aftercare plan is agreed and formalised.

A Care Coordinator must then be assigned to them from the CMHT to ensure that the plan is carried out and to coordinate the efforts of those involved.

The local authority is not allowed to charge for any services provided as aftercare under this section of the Act

What is aftercare ?

Aftercare is not specifically defined by the MHA. However the following statements all help to describe it :

" a central purpose of all treatment and care is to equip patients to cope with life outside hospital and function successfully without danger to themselves or other people."
" it deals with the after effects of the condition which led to admission in the first place."
" a service which responds to the patients assessed needs by assisting the patient to live in the community in circumstances that would diminish the prospect of re-admission to hospital"

Services are confined to those provided by Health and Social Services and may include:

CPN/Social work support;
medical supervision through outpatient appointments;
domiciliary and day services;
residential and nursing home care.

Section 117 and the Care Programme Approach (CPA)

Aftercare should begin prior to discharge from hospital and be dlivered through CPA so there is a requirement for the care team to:

individually assess a person's health and social care needs
formulate a care plan which addresses those needs
appoint a care co-ordinator to keep in close touch and monitor care
review on a regular basis and, if necessary, agree changes to the care plan

Section 25: Aftercare under Supervision (Supervised Discharge)

The Mental Health (Patients in the Community) Act 1995 came into force in April 1996, introducing section 25 - the power of supervised discharge - to the Mental Health Act. Supervised discharge is the name given to after-care under supervision. Any person who has been detained in hospital for treatment (i.e. under section 3 or 37, 47, 48) may be subject to supervised discharge and thus required to meet certain conditions. The mental health team can only place someone on this order if they consider that it is the only way to ensure compliance with planned aftercare and that non-compliance will result in that person becoming a danger to themselves or others. A "supervisor" is appointed from the Community Mental Health Team responsible for ensuring the Careplan is carried out.

This could mean, for example, someone discharged from hospital being required to live at a certain place and to attend a specified place for treatment or Day care. In addition the appointed 'supervisor' has the power to take and convey such a person to any place where they are required to be by their Care Plan, though they cannot make him/her stay or force any type of treatment.

Guardianship
Guardianship under the MHA gives the Social Services department the power to require some people with mental health problems to live in a certain place, or to allow care staff into their home, or to attend a day centre or day hospital for day care. People are placed under Guardianship only after discussion with the care team and recommendations by two doctors and an Approved Social Worker. Guardianship only lasts for a for a set period of time. People placed under Guardianship have the right to appeal to a Mental Health Review Tribunal to discharge the Guardianship.

Section 19 of the MHA allows for a patient who has been detained in hospital
under Section 2 or 3 of the Act to be transferred into Guardianship.