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- Section 117 aftercare - Under the Mental Health Act 1983
Section 117 aftercare - Under the Mental Health Act 1983
This page explains what free aftercare under section 117 of the Mental Health Act 1983 is. This information is for people who are 18 or over and affected by mental illness in England.
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- ‘Aftercare’ means the help you get when you leave hospital.
- You can get section 117 aftercare if you have been in hospital under the following sections of the Mental Health Act 1983 - 3, 37, 45A, 47, or 48.
- The NHS and social services should give your aftercare for free.
- The aftercare should focus on your mental health needs. It should help you to get better and stay out of hospital.
- You may get things like specialist housing, help to meet other people, help with work or education. Or free prescriptions for mental health medication.
- You can get a personal health budget to manage your healthcare in a way that suits you.
- Your aftercare should only stop when you no longer need it to stay well.
- If you have any issues your care coordinator, someone from your care team or an advocate could help you. If you are still unhappy, you could think about making a complaint.
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Some people who have been detained in hospital under the Mental Health Act 1983 can get free aftercare when they leave. This is called section 117 aftercare. ‘117’ is pronounced ‘one-one-seven’.
Being detained in hospital under the Mental Health Act is sometimes called being ‘sectioned.’
‘Aftercare’ means the help you get after you leave hospital to:
- meet needs that you have because your mental health condition or conditions, and
- reduce the chance of your condition getting worse, so you do not have to go back into hospital.
Section 117 begins when you leave hospital. But hospital staff should start planning your aftercare as soon as you go into hospital.
For more information, see our webpage on the Mental Health Act.
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You will get free aftercare if you have been in hospital under certain sections of the Mental Health Act. You can get it if you have been:
- detained in hospital for treatment under section 3,
- transferred from prison to hospital under sections 47 or 48, or
- ordered to go to hospital by a court under sections 37 or 45A.
You will only start getting aftercare services when you leave hospital.
You will not get free aftercare if you have been in hospital under other sections of the Mental Health Act.
What if I go on leave from hospital?
You may be allowed to leave the hospital for a short time. This is called ‘going on leave’ or ‘section 17 leave’.
You might go on leave while you are in hospital under sections 3, 37, 45A, 47, or 48. You will be able to get free aftercare when you are on leave.
What if I stay in hospital?
You might be entitled to section 117 aftercare and be discharged from the Mental Health Act. But you might stay in hospital as a voluntary or informal patient. This means you have agreed to be in hospital, but you can leave if you want to.
You will still get free aftercare when you leave hospital.
What if I go back to hospital?
If you go back into hospital, you will still get section 117 aftercare when you leave.
That is the case if you are detained under any section of the Mental Health Act or are a voluntary patient.
I am on a community treatment order (CTO). Can I get section 117 aftercare?
You may be discharged from hospital under a community treatment order (CTO).
If you are under a CTO, you can get free section 117 aftercare.
For more information, see our webpage on Community treatment orders - Made under the Mental Health Act 1983.
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Your aftercare should be arranged by the following organisations.
- Your local social services, which is a part of your local authority.
- Your local NHS integrated care board (ICB). The ICB is a group made up of GPs and other professionals from healthcare and non-healthcare backgrounds. They decide what services should be available in your area.
Who should pay for my social care?
Social services
The social services in the area where you usually lived before you went into hospital will pay for your care.This is still the case if you will stay in hospital under the Mental Health Act is not your first one.
2 local authorities might not be able to agree on who should pay for your care. Someone at the Department of Health and Social Care will decide.
NHS
The integrated care board (ICB) in the area where you usually lived before you went to hospital will pay for your care. This is if you left hospital after 1 July 2022.If you left hospital before 1 July 2022, a different ICB might be responsible for paying your care. But your care should still be free of charge.
What are direct payments for social care?
Direct payments are when your local authority gives you money to arrange and pay for your own social care.
This means you can choose how you get the support you need.
For more information see our following webpage:
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There are no limits to what services you can get. But the services should:
- meet the needs of your mental health condition or conditions, and
- reduce the chance of your condition getting worse, so you do not have to go back into hospital.
You may get:
- certain types of housing,
- services in your home or in a day centre, and
- help to get supported employment.
You may also get free prescriptions for mental health medication. Your care co-ordinator can arrange for you to get free prescriptions if you ask them.
The NHS and social services should ask you what kind of things you would like help with. Your carer could be involved in this too, if you want.
Other people that could be involved are your:
- psychiatrist,
- community psychiatric nurse (CPN),
- GP,
- psychologist,
- social worker,
- occupational therapist,
- advocate,
- local authority housing officer,
- attorney, if you have made a Lasting Power of Attorney for Health and Care Decisions, and
- Deputy, if one has been appointed by the Court of Protection with appropriate powers.
Your mental health might affect you in different ways. For example, you may find it hard to do some things for yourself. These things are called your ‘needs’. The NHS and social services should give you services that help you to meet your needs.
When everyone has agreed what services you need, they will put this in a written plan. This is called an ‘aftercare plan’ or a ‘care plan’.
You care plan might include things like:
- where you will live,
- what treatment you will get,
- what you will do during the day,
- what services will help you to stay well,
- what help you will get to go to work or study,
- what help with drug or alcohol use you will get, if you need it,
- things that might help you to keep in contact with your family, or to raise children,
- what you should do in a crisis, and
- what help you will get with benefits and managing your money.
Rachel’s Story
- Rachel has a diagnosis of borderline personality disorder (BPD), and a history of using drugs.
- She was in prison for a drugs offence and was transferred to hospital under section 47. Rachel has now returned to prison.
- She has a care coordinator who is writing a plan about what help she will get when she leaves prison. The plan says that Rachel will have:
- help at home on a weekly basis,
- help with finding employment,
- help to manage her drug use, and
- details of what she should do in a crisis
All this aftercare help will be free under section 117 of the Mental Health Act.
What if my needs change?
You might have a care coordinator to oversee your care. If you do not, speak to someone in your care team.
If they agree your needs have changed, they will look again at the help you need. They may call this a ‘review’ or a ‘reassessment’.
They should review your plan regularly, even if your needs have not changed. This should happen at least once a year.
When they review your needs, they will hold a meeting. They may call this a ‘review meeting’ or a ‘needs assessment’. Other people may be able to go to the meeting too, such as your GP, your psychiatrist, and your carer, if you have one.
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The rules about what housing you can get for free under section 117 are complicated.
We have included some guidance below.
Can I get free ordinary housing?
Ordinary housing will not usually be free under section 117.
‘Ordinary housing’ means things like house, flat, or room that you rent from the council, or a private or social landlord.
Can I get free supported housing?
Supported housing is where you get care, support, or supervision at home. It is not the same as a care home.
Supported housing might be free if it:
- meets needs that you have because your mental health condition or conditions, and
- reduces the chance of your condition getting worse, so you do not have to go back into hospital.
You may be charged separately for your rent and care.
Your local authority should pay your care costs under section 117. Unless they are paid for by another scheme.
Some local authorities will pay for your rent under section 117 but others will not. This is because local authorities can interpret the law on section 117 aftercare differently.
You might think your rent should be paid under section 117 aftercare. You can think about getting legal advice if you want to challenge your local authority. You can find more information about getting legal advice further down this page.
You might be able to claim welfare benefits to pay some or all your rent.
If you want advice on welfare benefits you can:
- Contact local benefits advice organisations. You can find them on Turn2Us. Choose ‘benefits’ from the drop-down menu and put in your postcode.
- Contact or visit your local Citizens Advice 0800 144 8848 for advice.
- Call Mind welfare benefits line. For anyone with mental health problems who needs benefits advice on 0300 222 5782.
For more information, see our webpage on Supported housing – For adults living with mental illness.
Can I get free care home accommodation?
Care home accommodation might be included as part of section 117 aftercare.
But the law about getting free care home accommodation under section 117 can be complicated.
For more information, see our webpage on Care home fees - Who pays? under the Care Act 2014.
Can I choose where I want to live?
You might get free care home or supported housing under section 117 aftercare.
You can choose the care home or supported housing you want to live in. Your local authority will have to let you to live there if: ,
- you are over 18,
- the local authority was going to offer you the same type of housing,
- it will meet your needs,
- the housing is available,
- the housing provider agrees to the local authority’s standard terms, and
- if your preferred housing is more expensive, you, or someone you know, will pay the difference. Whoever agrees to pay will have to agree in writing.
Roy’s Story
- Roy lives with schizophrenia and is in hospital under section 3 of the Mental Health Act 1983.
- Roy’s doctors think that he is well enough to leave hospital.
- One of his identified needs is ongoing support in a care home.
- This is to help give him the best quality of life and help make sure that he does not become unwell again.
- Roy’s care coordinator asks him what type of things he might find helpful, and they agree a services he needs.
- Roy’s care coordinator has found 3 care homes that meet his needs.
- Roy chooses the one that is closest to his family.
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You can get a personal health budget if you are entitled to section 117 aftercare.
What is an NHS personal health budget?
A personal health budget is an amount of money to support your health and wellbeing needs. It is planned and agreed between you and your NHS mental health team.
A personal health budget allows you to manage your healthcare in a way that suits you.
Together with your NHS mental health team, you will develop a care plan.
The plan sets out:
- your personal health and wellbeing needs,
- the health outcomes you want to achieve,
- the amount of money in the budget, and
- how you are going to spend it.
Your care plan should be regularly reviewed. You can ask for your plan to be reviewed if you think it is not meeting your needs or your needs change.
A care co-ordinator will be responsible for organising your care.
You can give up your personal health budget at any time. You will still be able to receive care and support in another way.
A personal health budget is different to direct payments for social care. You can have:
- a personal budget and direct payments at the same time, or
- an integrated personal budget, for both your healthcare and social care needs.
What can I spend my personal health budget on?
You should work with your NHS mental health team to identify:
- your health needs, and
- what support and treatment you need to meet those needs.
You can spend your personal health budget on care and support to meet your needs. You should agree this with your NHS mental health team. Your local Integrated Care Board (ICB) might need to be involved too.
You might be able to spend the money on a broader range of care and support than the NHS usually offer. For example, if a side effect of your medication is weight gain, you might be able to use your budget to pay for gym fees.
You should be supported by a suitable professional to think through how you would like to use your budget.
Your NHS mental health team is responsible for:
- giving you advice about your budget, or
- referring you to a suitable local organisation for advice.
Your personal health budget should be used for the specialist support and care you need because of your illness or disability. You do not need to use it to pay to see your GP or to get emergency care, for example.
You might want to know more details about what you can and cannot use your budget for. You can find out more at this link:
You can read more about NHS personal budgets here.
You can also look on the following website:
People Hub – Personal Health Budgets Network
People with a personal health budget and their families share their experiences. The website also includes information and resources on personal health budgets.Website: www.peoplehub.org.uk
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The NHS and social services must give you free aftercare for as long as you need it under section 117.
Even if you are doing well, you may still need aftercare services to make sure you stay well.
Ending section 117 aftercare is called being ‘discharged’ from it.
Your local Integrated Care Board (ICB) and local social services authority must decide that you no longer need aftercare services.
You should not discharge you from section 117 aftercare when you are still getting services you need.
If staff want to discharge you from section 117 aftercare, they should fully involve you in this decision.
They may involve you through a ‘discharge meeting’. You can bring an advocate, carer, or family member, if you want.
You should not be discharged from section 117 aftercare just because: ,
- you have been discharged from specialist mental health services, such as a community mental health team (CMHT),
- a certain length of time has passed since you left hospital,
- you go back to hospital voluntarily or under section 2,
- your community treatment order (CTO) ends, or
- you refuse aftercare services.
What can happen if professionals think I have been discharged too soon?
Professionals might discharge you from section 117 aftercare. But they might then think that they have discharged you too soon.
This might happen if your mental health starts to get worse as soon as you are discharged. If this happens professionals can put you back on section 117 aftercare.
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If you have a problem with section 117 aftercare, you can talk to your care coordinator. If you do not have a care coordinator, you can talk to a member of your care team.
What is advocacy?
If you are worried about talking to your care coordinator or care team, you may be able to get help from an advocate.
Advocates can help you to understand information and get your point across. The type of advocate you need depends on your situation.
For more information, see our webpage on Advocacy for mental health - Making your voice heard. The information includes how to find local advocacy services.
How can I get proof that I am entitled to section 117 aftercare?
There is no standard paperwork or register that records a person's rights to section 117 aftercare. So, it can be a good idea to ask your local authority and NHS integrated care board (ICB) to put in writing that:
- you are entitled to section 117 aftercare services,
- that these services are to:
- meet needs you have because of your mental health condition or conditions, and
- reduce the chance of your condition getting worse or so you do not have to go back to hospital.
- they will continue to pay for NHS and local authority services, for as long as you need them,
- if they want to discharge you from section 117 aftercare, they will fully involve you in this decision, and
- they will not discharge you from section 117 aftercare when you are still getting services you need.
How can I complain?
If you cannot solve the problem by talking it through, you can make a complaint.
For more information, see our webpage on Complaints about the NHS and social services.
How can I take legal action?
You could get advice from a solicitor, who could help you to get the services you are entitled to. You need to do this quickly because the time limit for taking the NHS and the local authority to court can be as little as 3 months.
For more information, see our webpage on Legal Advice – How to get help from a solicitor.
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© Rethink Mental Illness 2024
Last updated May 2024
Next update May 2027, subject to any changes
Version number 10