This guidance details the procedure for transferring to and from hospital under the Mental Health Act 1983 (MHA) of any child or young person who is detained in custody in pursuance of any sentence or order for detention, remanded in custody or who is otherwise detained in custody.
The procedure for the transfer from custody of children and young people (CYP) to and from hospital under the MHA aims to help colleagues to work together more effectively in order to ensure timely transfer of mentally disordered young people and avoid unacceptable delays. With the recent expansion in the number of secure psychiatric beds for CYP nationally, the guidance document states “good practice indicates that transfers should be completed within seven days”.
The document is largely based upon the procedure for adults; however there are two important differences:
- parents should be involved as much as possible in decisions about the hospitalisation of their children; and
- CYP are on the whole more vulnerable because of their youth and lack of maturity.
It is not acceptable that they remain in a custodial setting without the health oversight and expertise that their mental disorder requires. This is the rationale behind the expectation of the shorter time frame of seven days to affect the transfer.
The guidance also contains information on which body has responsibility for the transfer of CYP. Although the commissioning body responsibility for secure forensic services for CYP lies with the National Commissioning Group (NCG), the “appropriate PCT” for CYP in custody in England, in the case of transfers to hospital under ss47 and 48 Mental Health Act 1983 is:
- the PCT where the CYP was registered with a GP prior to being placed in custody;
- in the absence of prior general practitioner (GP) registration, the PCT in whose area the CYP “habitually resided” before entering custody;
- if the CYP is not registered with a GP and has no determinable prior residence, the PCT in whose area the (alleged) offence took place;
- if the CYP is usually resident outside the UK, the PCT in whose area the secure estate accommodation lies; or
- where the CYP's last known or habitual residence was in Wales, practitioners should contact the Welsh Health Specialised Services Committee for guidance.
The role of responsible commissioner encompasses local commissioning procedures (ie, gate-keeping), providing assistance to healthcare staff in locating a bed, and paying the appropriate healthcare costs of the transferred CYP. While NCG units are funded from a top-sliced specialist NHS funding, PCTs remain responsible for assessments for the NCG units and for independent sector placements.
Disputes over the identity of the responsible commissioner must not be allowed to delay or adversely affect treatment.
The DH hopes that those involved in the process of transferring CYP to and from hospital under the MHA will pay close attention to this document to support them in enabling CYP in custody to have access to the same timely care and treatment as service users accessing mental health services in the community.