How restricted patients leave hospital, and how they come back.
What is conditional discharge?
Conditional discharge lets a restricted patient leave hospital while staying liable to recall. The hospital order and the restrictions stay in force, and they live in the community on conditions set by the tribunal or the Justice Secretary (s42(2), s73(4)).
It's the usual way out of hospital for a s37/41 patient. Absolute discharge may follow once they've been stable in the community for some years (, 2017). They can't go on a CTO instead, because the provisions don't apply to restricted patients (s41(3)(aa)).
Who can conditionally discharge a restricted patient?
- The tribunal. It must discharge a s37/41 patient if it isn't satisfied the detention criteria are met. If it thinks they should stay liable to recall, the discharge is conditional (s73(1) and (2)). If they'd need conditions depriving them of liberty to protect others from serious harm, it can discharge only if that's no worse for their mental health than hospital (s73(2)(c)).
- The Justice Secretary, at any time, by warrant (s42(2)). MHCS usually acts on an application from the , though the patient or their representative can apply too.
- Not the RC alone. The RC can't discharge without the Justice Secretary's consent (s41(3)(c)(iii)).
- Transferred prisoners. For a s47/49 or s45A patient, the tribunal can only tell the Justice Secretary whether they'd be entitled to discharge. Discharge then needs the Justice Secretary's agreement within 90 days, which is rare (s74(2); MoJ, 2017).
Most discharge decisions are made by the tribunal (MoJ, 2017). It can defer a conditional discharge until the arrangements it wants are in place, and the patient stays an inpatient until then (s73(7)).
What are the conditions of a conditional discharge?
There's no fixed list. The MoJ's discharge application suggests conditions like these:
- Residence. Live at a named address, and consult the supervisors before any night away. MHCS and MAPPA want 14 days' notice of a move.
- Treatment. Take medication as directed, and see the clinical team.
- Substances. Abstain from alcohol or illicit drugs, with random testing.
- Victims. No contact with named people, and exclusion zones marked on a map.
- Disclosure. Tell the supervisors about new relationships, work and education, and don't leave the UK without consulting them.
Conditions can't be enforced by force. doesn't apply to a conditionally discharged patient who hasn't been recalled (s56(3)(c)), so medication needs their consent, or the if they lack capacity. Breaking a condition doesn't by itself justify recall (MoJ, 2017).
Supervision and the conditional discharge report
Most patients have a clinical supervisor, usually a community psychiatrist, and a social supervisor allocated by the local authority (Code 22.79, 22.80). Both report to MHCS: the first report about 4 weeks after discharge, then quarterly.
The social supervisor completes Parts A and B of the MoJ report, and the clinical supervisor Part C. If you're worried between reports, investigate and contact MHCS straight away (Code 22.79).
Section 117 aftercare applies, and they're entitled to an (Code 6.8). After a stable period, the supervisors can ask MHCS to cut reporting to 6-monthly, or exceptionally to yearly.
Recall of conditionally discharged restricted patients
Only the Justice Secretary can recall, by warrant, at any time while the restriction order lasts (s42(3)). MHCS recalls where it's needed to protect the public from risk linked to the patient's mental disorder (Code 22.82):
- A change, not a relapse. There must be evidence that something has changed since discharge. A deteriorating mental state isn't required.
- Medical evidence that they're currently mentally disordered, except in an emergency, when MHCS can recall for assessment and get it afterwards.
- Not for unrelated offending. Recall isn't used for antisocial or criminal behaviour unconnected with the disorder.
- Supervisors' views count but don't decide. If at least one recommends recall, expect it unless there are compelling reasons not to.
- Admission under s2 or s3 almost always means recall, unless discharge is days away, or it's only for self-harm and likely to last under a month.
- Drink, drugs or stopping medication don't lead to recall automatically. Drink or drugs lead to considering it when they're risk behaviours or harm mental state, and stopping medication always does (MoJ recall guidance).
The recall procedure, step by step
- Discuss your concerns with MHCS and find a bed at the right level of security (Code 22.83).
- MHCS issues a warrant naming the hospital. Out of hours, its on-call service can authorise recall verbally, with the warrant to follow (Code 22.86).
- Give the patient a brief explanation of the reasons at the time, unless that's impossible because they're violent or too distressed (Code 4.19).
- Until they arrive, they're treated as absent without leave from the named hospital, so they can be taken there (s42(4)(b), s18).
- Give full reasons, orally and in writing, within 72 hours of admission (Code 4.19).
- Tell them the Justice Secretary will refer their case to the tribunal within one month of their return (s75(1); Code 4.24).
They're detained on the original order again. Their community leave has gone, so the RC must apply afresh (MHCS leave guidance 4.2). The annual statutory report now falls due on the anniversary of the recall.
Tribunal rights after conditional discharge
| When they can apply | Referral by the Justice Secretary | |
|---|---|---|
| Conditionally discharged | Between 12 months and 2 years after discharge, then every 2 years (s75(2)) | May refer at any time (s71(1)) |
| Supervised discharge | Between 6 and 12 months after the conditions began, then every 2 years (s75(2A)) | Must refer at 12 months, then every 2 years, unless the tribunal considered the case in that period. It must also refer if the tribunal hasn't considered it for 4 years and nothing is pending (s75(2C) to (2E)) |
| Recalled to hospital | Between 6 and 12 months after return, then yearly (s75(1)(b), s70) | Must refer within one month of return (s75(1)(a)) |
On an application from someone in the community, the tribunal can vary conditions or add new ones. It can also end the restriction order, which ends their liability to detention under the hospital order (s75(3)). See the Mental Health Tribunal.
Supervised discharge under the Mental Health Act 2025
Since 18 February 2026, a restricted patient can be discharged on conditions that amount to a deprivation of liberty. MoJ calls it supervised discharge. It reverses MM (2018), which held the Act didn't allow it (MoJ guidance, annex A).
- The Justice Secretary's test. The conditions are necessary to protect the public from serious harm (s42(2A), s73(5B)).
- The tribunal's test. They're necessary to protect another person from serious harm, and discharge on them would be no less beneficial to the patient's mental health than staying in hospital (s73(2)(c)).
- Who it's for. A small group, often with a static, lifelong condition, who'd otherwise stay in hospital indefinitely. It's not a stepping stone, and not for anyone able to use regular unescorted leave (MoJ guidance 2.1 to 2.3).
- How to apply. Speak to an MHCS senior manager first, then test the placement on escorted day and overnight leave. MHCS aims to decide a complete application within 28 days (3.4, 3.5, 4.5).
It replaces long-term escorted leave and technical recalls as the workaround (1.8, 3.10). One catch: the guidance still defines deprivation of liberty by the Cheshire West acid test, which AGNI overruled in June 2026.
Absolute discharge
Absolute discharge ends the hospital order and the restrictions, so there's no more recall (s42(2), s73(3)). The tribunal or the Justice Secretary can grant it. The Justice Secretary can also lift the restrictions alone (s42(1)). Someone still in hospital then becomes an unrestricted s37 patient (s41(5)).
Not the same as a court's conditional discharge
A criminal court's conditional discharge is a sentence, not a release from hospital. The court imposes no punishment, as long as the person commits no offence during a set period of up to 3 years (Sentencing Code s80). The conviction is treated as not being one for most purposes, with exceptions (s82).
A worked example
A 45-year-old man on a s37/41 has been conditionally discharged for three years. He has stopped his depot, is drinking again and has threatened a neighbour. His social supervisor is worried.
Contact MHCS today, rather than waiting for the quarterly report. Missed medication and drinking aren't enough on their own, but here they're risk behaviours linked to his illness, with threats to a named person. With a supervisor recommending recall, expect a warrant. Find a bed, give brief reasons at the time and full reasons within 72 hours. MHCS then has one month to refer him to the tribunal.
The rules in brief
- Who grants it. The tribunal (s73) or the Justice Secretary (s42). Conditions usually cover where they live, supervision by a psychiatrist and a social supervisor, and treatment.
- Deferred discharge. The tribunal can defer a conditional discharge until the arrangements are in place.
- Recall. The Justice Secretary can recall by warrant at any time, and must refer the case to the tribunal within one month of their return to hospital.
- Tribunal rights. A conditionally discharged patient can apply between 12 months and 2 years after discharge, then every 2 years.
- Absolute discharge ends both the hospital order and the restrictions.
- Supervised discharge. Since 18 February 2026, conditions can amount to a deprivation of liberty where they're necessary to protect others from serious harm. A tribunal must also be satisfied that it's no worse for their mental health than staying in hospital. Those patients can apply to the tribunal sooner: between 6 and 12 months, then every 2 years. It reverses MM (2018).
Read more: MHA 1983, s42 · MHA 1983, s73 · MHA 1983, s75 · Recall of conditionally discharged restricted patients (MoJ, 2009) · Supervised discharge guidance (MoJ, Feb 2026) (partly out of date)
Questions trainees ask
What happens after a restricted patient is recalled?
The Justice Secretary must refer their case to the tribunal within one month of their return to hospital. They're detained on the original order again, and their community leave lapses.
What is supervised discharge?
Since 18 February 2026, a conditional discharge whose conditions amount to a deprivation of liberty, where that's necessary to protect others from serious harm.
What are the conditions of a conditional discharge?
They're set case by case. Common ones cover where the person lives, taking medication and seeing the team, avoiding alcohol or drugs, and staying away from victims.
Who can recall a conditionally discharged patient?
Only the Justice Secretary, by warrant, in practice through MHCS. The supervisors usually ask for it, but MHCS can recall without a recommendation, and if the patient needs admission under s2 or s3, recall almost always follows.
When can a conditionally discharged patient apply to the tribunal?
Between 12 months and 2 years after discharge, then every 2 years. On supervised discharge it's sooner: between 6 and 12 months, then every 2 years.
Can a conditionally discharged patient be deprived of their liberty?
Since 18 February 2026, yes, under supervised discharge, if the strict tests are met. Before that, MM (2018) held that discharge conditions couldn't amount to a deprivation of liberty. If they lack capacity, the can authorise one separately, through or the Court of Protection.
How often do supervisors report on a conditionally discharged patient?
Usually about 4 weeks after discharge, then every quarter. The social and clinical supervisors each complete their part of the report.
Is a conditional discharge a conviction?
If you mean a criminal court's conditional discharge, that's a sentence, not a release from hospital. The Sentencing Code treats the conviction as not being one for most purposes, with exceptions (s82).
Test yourself
A conditionally discharged restricted patient stops his medication and starts making threats. The Justice Secretary recalls him to hospital. What must happen next?
Show the answer
B. Recall is by the Justice Secretary's warrant. Section 75(1) then requires a referral to the tribunal within one month of his return to hospital.
Quick-fire
After a recall, the Justice Secretary refers the case to the tribunal within
Show the answer
1 month