The Care Act 2014 – changes to the meaning of s.117 after-care
The first provisions of the new Care Act 2014 came into force yesterday, 1 October 2014. Limited provisions are now in force, with the majority not being given effect until April 2015.
Significantly for mental health, several changes are being made to s.117 of the Mental Health Act 1983:
- The first is that the Care Act gives definition to the meaning of “after-care” under s.117 of the Mental Health Act 1983. After-care services are now defined as services which:
(i) meet a need arising from or related to the person’s mental disorder; and
(ii) reduce the risk of a deterioration of the person’s mental condition (and, accordingly, reduce the risk of the person requiring admission to a hospital again for treatment for mental disorder).
- The Care Act changes which local authority is responsible for funding s.117 after-care services. Previously it would have been the local authority where the discharged patient is resident. Now, it will be the local authority in which the patient was ordinarily resident immediately before their detention in hospital.
- Finally, there is now a power for the Secretary of State to make Regulations requiring a local authority to allow a patient the option of choosing a preferred accommodation funded under s.117. The patient can choose to pay top-up fees if they wish to reside in an accommodation above the threshold of what the local authority or NHS will pay for.
This last amendment is effective as of yesterday, 1 October 2014. The other changes above should be effective from April 2015.
The definition of after-care services in particular should be of assistance to discharged patients in obtaining support and care in the community, as it disposes with any suggestion that the after-care has to be related to the specific circumstances relating to the hospital admission. Instead, it “covers more than just one form of mental disorder, and is not necessarily limited to the specific disorder or disorders for which a person was previously detained under the [Mental Health] Act and which gave rise to the after-care” (Hansard (House of Lords), October 16, 2013, Vol.748).
In the meantime, previous case law trying to address the meaning of after-care services will continue to apply.