Discharge and Section 117 Aftercare

Section 117 aftercare includes any service designed to meet a need arising from the patient's mental disorder and reduce the risk of the disorder worsening or the patient being re-admitted to hospital. In practice, this can include:

• Mental health community support — community psychiatric nurse (CPN), care coordinator, outpatient appointments
• Supported accommodation or residential care in a mental health facility
• Day services and social activities
• Employment support
• Carer support services
• Medication management and pharmacy costs
• Accommodation (in some cases, where suitable accommodation is essential to prevent re-admission)

Whether a specific service falls within Section 117 depends on whether it is needed to meet a need arising from the mental disorder. The scope has been interpreted broadly by courts — the Mental Health Act Code of Practice encourages a holistic approach.

Aftercare planning should begin well before discharge from hospital. Under the Care Programme Approach (CPA):

1. The clinical team holds a pre-discharge CPA meeting with the patient and, where appropriate, carers, family members, and representatives from relevant agencies (social care, housing, employment).
2. A written care plan is produced setting out what aftercare services will be provided, by whom, and when.
3. A care coordinator is appointed — usually a community mental health nurse or social worker — who is responsible for coordinating the aftercare package.
4. The patient (and their carer, if applicable) should be given a copy of the care plan.

If you are facing discharge and are concerned that adequate aftercare has not been planned, you can request that discharge be delayed until a proper care plan is in place. An IMHA or solicitor can assist you in advocating for adequate discharge planning.

One of the most important — and most frequently misunderstood — aspects of Section 117 is that the services provided under it are completely free. Authorities cannot:

• Charge you for services that fall within your Section 117 aftercare entitlement, regardless of your income, savings, or assets
• Apply means testing to Section 117 services
• Reduce or withdraw Section 117 services on financial grounds

Local authorities have historically (and sometimes still do) unlawfully attempt to charge for services that should be provided under Section 117 — for example, charging for residential care when the residential placement is part of a Section 117 aftercare package. If you believe you are being charged for services that should be free under Section 117, you can:

1. Complain formally to the authority
2. Contact the Local Government and Social Care Ombudsman
3. Seek legal advice — in successful cases, unlawfully charged amounts can be recovered.

Section 117 aftercare continues for as long as it is needed. It does not automatically end when:

• A specified period of time passes
• The patient's mental health improves (unless they no longer need the services)
• The patient is re-admitted to hospital informally (it resumes on discharge)

Aftercare can be lawfully ended (by joint decision of the NHS and Local Authority) only when:

• The patient no longer has a need arising from their mental disorder that the aftercare was meeting, and
• There is no longer a risk of re-admission that the aftercare was preventing

The patient must be told that their aftercare is being ended and must be given the opportunity to discuss this. If the patient disagrees with the decision to end Section 117 aftercare, they can challenge it through the complaints process or with legal advice. Being re-sectioned after premature discharge can itself give rise to claims that the original aftercare decision was wrong.