You have the right to see an independent mental health advocate (IMHA).
An IMHA can help you understand:
With your agreement the IMHA can do the following.
If you would like to talk to an IMHA you can contact the service yourself or ask someone else to do it for you. You could ask your:
Use an internet search engine to find an IMHA service. Use search terms like ‘Independent mental health advocacy Leicestershire.’
See our webpage on Advocacy for more information.
If you break a condition, you may not go back to hospital immediately. Your responsible clinician (RC) should only recall you back to hospital if: ,
You might not be recalled if you have a good reason for not going to an appointment.
Your RC may recall you if you stop taking your medication. But your RC will only recall you if they think that you will become unwell again. You may be able to stop a recall if you:
If your responsible clinician (RC) recalls you to hospital, they will give you a written recall notice.
Anyone from your mental health team can give you the written notice. Your team should try and give you the notice in person, but they can send the notice in the post.
When you get the recall notice you will have to go back to hospital.
You may be able to go to hospital on your own. You may have time to make personal arrangements. For example, get someone to look after your pet.
Your care coordinator can go to hospital with you. An ambulance or the police can take you to hospital if you are very unwell or aggressive.
Going back to hospital should be as stress free as possible. You can ask for a relative, carer or friend to go with you.
A psychiatrist will assess your mental health when arrive. They should do this within 72 hours. This will help the team to decide what the next step should be.
Appropriate treatment will be provided. Clinicians should ask for your consent before they treat you. But you can usually be given treatment even if you don’t want it.
Your RC can keep you in hospital for up to 72 hours while they decide what to do.
Your RC and AMHP will end your CTO if they decide to keep you in hospital for more than 72 hours. This is called revoking the CTO.
They will put you back onto the section of the Mental Health Act you were on before you had your CTO.
An AMHP must agree with your RC before they can revoke your CTO. If the AMHP doesn’t agree with your RC, your CTO won’t be revoked. This means that you will stay on your CTO.
If your CTO is revoked the hospital managers will refer your case to a First-tier Tribunal. The Tribunal will decide if it was the correct decision to revoke your CTO.
Your CTO may be revoked if:
If you don’t go back to hospital when asked, you may be treated as absent without leave (AWOL).
Your hospital will have a policy on what happens when someone is AWOL. You can ask to see this.
Being AWOL means that you can be taken back to hospital by:
The hospital should ask the police to get involved if they think you particularly vulnerable or dangerous.
The local magistrate’s court can allow the police to go into your house and take you to hospital. The police should have a warrant to go into your house without your permission. You may hear this warrant called section 135(2) warrant.
For more information see our webpages on the following:
Your first community treatment order (CTO) can last up to 6 months.
Your responsible clinician (RC) will review your CTO and decide to discharge you or extend it. Your CTO can be extended for a further 6 months and then for 1 year at a time.
Each time your RC renews your CTO, they must make sure you meet the criteria for a CTO.
You should have a review 2 months before your CTO is due to end. The criteria for a CTO are explained in the section at the top of this page.
An approved mental health professional (AMHP) must agree to continue the CTO.
The hospital managers must arrange for you to be told if your CTO is extended.
If your CTO comes to an end without being renewed, it will end. This means you are no longer under the CTO. You don’t have to follow the conditions any longer and you can’t be recalled to hospital.
Your community treatment order (CTO) can end in different ways.
Your CTO will end when you don’t meet the criteria anymore, you’re discharged, it’s revoked, or it runs out.
Your RC should discharge you from your CTO and the Mental Health Act if you no longer fit the CTO criteria. The criteria for a CTO are explained in the section at the top of this page.
This means you’ll no longer be under the Mental Health Act, and you don’t need to stick to the CTO conditions. But you should listen to and think about your mental health team’s advice on recommended treatment and support.
You can also be discharged from your CTO by:
See below for more information.
A CTO will also end if it is revoked. This is explained in more detail in the section above.
If your CTO is revoked the hospital managers will refer your case to a First-tier Tribunal. The Tribunal will decide if it was the correct decision to revoke your CTO.
Your nearest relative (NR) can write to the hospital managers to discharge you from your CTO. But only if you were detained under section 3 of the Mental Health Act before your CTO was made.
Your NR must give the hospital managers 72 hours’ notice to discharge you.
Your RC can stop you from being discharged if they think you are likely to be dangerous to yourself or other people.
NR is a term that is defined under the Mental Health Act. The NR has certain rights under the Mental Health Act. Most people will have an NR. The NR and the ‘next of kin’ can be the same person or 2 different people.
The First-tier Tribunal is also known as the Mental Health Review Tribunal.
They are an independent panel that can discharge you from your CTO. The tribunal hearings take place at the hospital.
The tribunal must decide if you fit the criteria for being under a CTO or not.
You have the right to apply to apply to the tribunal one time in the first 6 months of your CTO. After this you can apply once in each renewal period.
The same rules apply if you want to appeal your CTO being revoked.
You can ask the hospital managers to review your community treatment order (CTO). They have the power to discharge you from your CTO.
You can apply to the hospital managers at any time. But there may be a local policy to explain how often you are allowed to apply.
The name ‘managers’ can be confusing because it does not mean the people who run the hospital. Hospital managers make sure that the Mental Health Act is used properly.
The decision is made by 3 or more people called ‘associate managers’ or ‘Mental Health Act managers.’
If you want to apply to the hospital managers to get discharged from your CTO you can:
See our webpage on Discharge from the Mental Health Act for more information.
You are entitled to free legal support through the Legal Aid scheme If you appeal to the First-tier Tribunal. A solicitor who understands the Mental Health Act will come to the tribunal with you.
You can get a list of mental health solicitors from the ward staff. Or you can look on the law society website. They have a database of solicitors that you can search. You can find this at www.solicitors.lawsociety.org.uk
You can also contact Civil Legal Advice. Their contact details are in the Useful contacts section at the bottom of this page.
You can also get help from an Independent Mental Health Advocate (IMHA).
See the previous sections for more information about IMHA’s.
For more information see our webpages on the following:
Care Quality Commission (CQC)
If you have concerns or a complaint about the way the Mental Health Act has been used, you can contact the CQC.
Telephone: 03000 616161
Email: enquiries@cqc.org.uk
Website: www.cqc.org.uk
Civil Legal Advice
You might be able to get free and confidential advice from Civil Legal Advice (CLA) as part of legal aid if you’re in England or Wales.
Telephone: 0345 345 4 345
Minicom: 0345 609 6677
Website: www.gov.uk/civil-legal-advice
Law Society
The Law Society maintains a list of practising solicitors in England and Wales. You can use their website to find a local solicitor.
Phone: 020 7320 5650
Email: via contact form on website - www.lawsociety.org.uk/get-in-touch/
Website: www.solicitors.lawsociety.org.uk
POhWER
Provides advocacy services in over 50 different areas across the country.
Telephone: 0300 456 2370
Address: PO Box 17943, Birmingham, B9 9PB
Email: pohwer@pohwer.net
Text: send the word ‘pohwer’ with your name and number to 81025
Website: www.pohwer.net
The Advocacy People
An independent charity providing free, confidential advocacy services across England.
Telephone: 0330 440 9000
Address: PO Box 375 Hastings, East Sussex, TN34 9HU
Email: info@theadvocacypeople.org.uk
Text: send the word ‘PEOPLE’ then your message to 80800
Website: www.theadvocacypeople.org.uk
Voiceability
Provides advocacy services in different areas across England.
Telephone: 0300 303 1660
Address: VoiceAbility, c/o Sayer Vincent, Invicta House, 108-114 Golden Lane, London EC1Y 0TL
Email: helpline@voiceability.org
Website: www.voiceability.org
© Rethink Mental Illness 2022
Last updated November 2022
Next update November 2025
Version number 5
You can access a fully referenced version of this information by downloading the PDF factsheet by using the link at the top of this page.
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