MHA WHITE PAPER Implications for Intellectual Disability Autism

MHA WHITE PAPER: Implications for Intellectual Disability & Autism Prof Jane Mc. Carthy & Dr Harm Boer

MHA WHITE PAPER: Implications for Intellectual Disability & Autism Forensic Services

Caring for Patients in the CJS • Access to equivalent medical care and treatment to civil patients (same guiding principle) • But • Reformed criteria will not apply to patients under part III of the MHA • Not raising the threshold to detain someone • Nominated Person for part III will have limited powers • Limited to care and treatment planning • Tribunal powers will be different • Changes relating to section 3 will not apply to part III patients.

Transfers from Prison • Statutory time limit 28 days • 14 days for assessment in prison • 14 days for finding a bed Concerns from RCPsych that this may lead to unintended consequences • Independent role to manage transfer • For consultation • Advocacy to support transfers • For consultation

Restricted Patients Tribunal to be empowered to make a statutory recommendation in relation to community leave or transfer to a different hospital, which the Mo. J must consider Strengthen and develop the role of the social supervisor (guidance, who can take up role) Release of transferred prisoners by the Parole board • Parole Board hearing to take place swiftly after Tribunal

• Giving the tribunal the power to discharge with conditions which restrict freedom • Where risk (violent, dangerous or inappropriate sexual behaviour) would need continuous supervision in the community • Small number of patients Supervised Discharge • Would enable discharge of a restricted patient with conditions amounting to Do. L • Annual review by Tribunal • Independent of decision-making capacity • No longer therapeutic benefit • Level of risk requires supervision • Only least restrictive alternative to hospital

Discussion (Devil’s advocate) • Reformed Criteria • Different for part II and part III – is this right? • Are we wise to stop admissions to hospital under S 3 for people with learning disability and autism? • Supervised Discharge • Is there a risk that (as with CTOs) this will be much more used than expected leading to more patients in the community being deprived of their liberty? • There are definitely a number of patients currently in hospital who would benefit. • Are there any additional measures that can be put in place to avoid overuse?

White Paper Consultation • Deadline 21 April 2021 • MHAconsultation 2021@dhsc. gov. uk