In the recently decided case of R (Mwanza) v London Borough of Greenwich and London Borough of Bromley [2010], the High Court considered the scope of local authority duties under section 117 Mental Health Act 1983 (the Act) under which people detained under section 3 of the Act (and 37, 45A, 47 and 48) are, when discharged, entitled to after care services from both the relevant primary care trust and the relevant local authority.
In this case, the court had to consider whether local authorities are obliged, under section 117, to provide “simple” accommodation to a previously detained patient. The patient sought “simple” accommodation because, due to his immigration status, he was not able to work and unable to claim benefits. He was therefore homeless, which would cause a deterioration in his mental health condition.
The court decided that section 117 does not create a duty to provide a service just because it will, or may, prevent a deterioration in the patient’s mental condition. The court said the duty is only to provide services which are needed as a result of the patient’s mental illness. The court stated: “an after-care service must be a service that is necessary to meet a need arising from a person’s mental disorder …”
The court accepted that the lack of accommodation, or employment, may contribute to a deterioration in a person’s mental health. However, the need for accommodation, or employment, are basic needs which do not arise from a mental disorder. Accordingly, the court said, such needs do not call to be met under section 117.
This indication that basic needs, such as a need for simple accommodation, are not eligible needs under section 117 is particularly important in relation to local authority duties as no charge can be made for section 117 services. If section 117 included a duty to provide simple accommodation per se without being connected to a patient’s mental illness, local authorities would be obliged to provide free accommodation to everyone previously detained under section 3. Also, because someone’s need for accommodation never ends, if there were a duty as above the duty would not end even if the patient fully recovered from their mental illness.
This judgment is also relevant to NHS bodies discharging section 117 functions. The court’s decision that the section 117 duty only extends to meeting needs which arise from a mental illness should also guide NHS bodies in determining which NHS services should be supplied under section 117 and which should be supplied via other mechanisms, for example, continuing healthcare.
