Part 1: The framework for Section 117 Aftercare

Section 117 aftercare arises automatically when a person ceases to be detained under a qualifying section of the Mental Health Act 1983. It is a legal duty owed by the Local Authority and the Integrated Care Board, not a discretionary service.
It is not dependent on:

• Care Act eligibility
• a request being made by the person
• the person demonstrating need through advocacy or challenge
• Local Authority or ICB discretion
• agreement between organisations about funding responsibility; or
• the resolution of disputes between a Local Authority and an Integrated Care Board.

The duty to provide or arrange Section 117 aftercare rests with the statutory bodies. It is their responsibility to identify when Section 117 applies, assess aftercare needs, agree provision, and resolve any funding or ordinary residence disputes without delay. People should not be required to “fight” for Section 117 aftercare, nor should disputes between organisations result in gaps, delays or withdrawal of support.

Where there is disagreement between statutory partners about responsibility or funding, interim arrangements must be put in place to ensure continuity of aftercare pending formal resolution. In accordance with Section 117, any dispute between a Local Authority and an Integrated Care Board as to their respective responsibilities is to be determined by the Secretary of State but must not affect the provision of after-care services to the person concerned.

Section 117 exists to ensure that people who have been detained under qualifying provisions of the Act receive the aftercare they need once detention ends. Its application must therefore be proactive, lawful and centred on the person’s rights, needs and continuity of support, rather than organisational boundaries.

Section 117 aftercare is a statutory duty designed to ensure that people who have been detained in a mental health hospital under qualifying sections of the Mental Health Act 1983 receive the support they need when they leave hospital or are otherwise discharged from detention (including where a person is remitted to custody and later released from prison).

The duty requires the Local Authority and the Integrated Care Board to provide or arrange aftercare services that:

• meet needs arising from or related to the person’s mental disorder; and 
• have the purpose of reducing the risk of a deterioration in the person’s mental condition and, accordingly, reducing the risk of readmission to hospital for treatment.

Section 117 aftercare is provided free at the point of delivery and must be planned, delivered and reviewed in a way that reflects the person’s individual needs, circumstances and goals.

It recognises that recovery and wellbeing are influenced by a wide range of factors, not only clinical treatment. Aftercare should therefore take a holistic approach, considering areas such as social connection, housing, employment, relationships and wider determinants of health and wellbeing.

While housing may form part of Section 117 aftercare where it is necessary to meet needs arising from or related to the person’s mental disorder, not all housing needs fall within the scope of Section 117. Decisions should be based on the purpose and criteria of aftercare, rather than assumptions about service responsibility.

Entitlement to Section 117 aftercare, irrespective of age, depends on the reason for the person’s detention in a mental health hospital under the Mental Health Act 1983.

✔ A person is entitled to Section 117 aftercare on discharge from a mental health hospital if they have been detained under one of the following sections:

• Section 3 (Treatment Order): Used when someone requires treatment in a mental health hospital for a mental disorder and cannot agree to admission. 
• Section 37 (Hospital Order): Used where a court decides a person should receive treatment in a mental health hospital rather than a custodial sentence. This includes Section 37 with or without a Section 41 restriction order. 
• Section 45A (Hybrid Order): Used where a court directs that a person is admitted to a mental health hospital for treatment and may later be returned to prison. 
• Section 47 (Transfer from Prison): Used when a sentenced person in prison requires treatment in a mental health hospital. 
• Section 48 (Transfer from Prison on Remand): Used when a person on remand requires treatment in a mental health hospital. 
• Section 17A (Community Treatment Order – CTO): Used for some people who can be supported in the community but remain liable to be recalled to a mental health hospital if necessary. People on a CTO remain entitled to Section 117 aftercare.

✘ A person is not eligible for Section 117 aftercare solely by virtue of being discharged from hospital where they are admitted under one of the following sections of the Mental Health Act:

Important: This does not affect the Section 117 aftercare eligibility of a person who has previously been detained under Section 3, Section 37, or another qualifying section. In such cases, Section 117 eligibility continues unless and until it is lawfully ended, even if the person is later detained under Section 2, Section 136, or admitted informally.

Every Section 117 aftercare plan should be developed with the person in a holistic and person-centred way. Carers should be involved where appropriate and with the person’s consent. Consideration may also be given to involving others who have a relevant role in the person’s care or support, where appropriate and in line with the person’s wishes, legal rights and best interests.

The scope of Section 117 aftercare is defined by the Mental Health Act 1983 and informed by case law. Section 117(2) requires local authorities and Integrated Care Boards to provide or arrange aftercare services that:

• meet needs arising from or related to the person’s mental disorder; and
• have the purpose of reducing the risk of deterioration in the person’s mental condition and, accordingly, reducing the risk of readmission to hospital.

This reflects the statutory wording of Section 117. Case law, including R v Manchester City Council ex p Stennett [2002] UKHL 34, has confirmed that Section 117 imposes a free-standing duty to provide aftercare services without charge.
For practical purposes, this means that, to fall within Section 117, a service or form of support must satisfy both of the following:

Test 1: Does it meet a need arising from or related to the person’s mental disorder?
Test 2: Is it provided for the purpose of reducing the risk of deterioration in the person’s mental condition or reducing the likelihood of readmission to hospital?

Both elements must be satisfied.

Where those criteria are met, Section 117 aftercare plans may properly include a wide and flexible range of support, tailored to the person’s circumstances and recovery goals, and developed in collaboration with the person and relevant professionals and partners involved in their care, in line with the Mental Health Act Code of Practice (see, for example, paragraph 34.12 on consultation in aftercare planning).

Below are examples of the types of support that may be considered within a Section 117 aftercare plan.

Section 117 aftercare is a distinct statutory duty. Aftercare provision must be based on the person’s assessed needs and must not be limited solely to services that are routinely available or already commissioned within the local area.

Section 117 aftercare can include services that go beyond existing provision where this is necessary to meet the person’s needs. Equally, where appropriate services are already in place and meet those needs, the duty may be fulfilled through existing provision.

Providers and commissioners must not refuse to meet an assessed aftercare need on the basis that a particular service or type of support is “not offered” or “not commissioned locally”.

Where a need has been identified as necessary to meet the purpose of Section 117 aftercare — to reduce the risk of relapse or readmission — that need should be interpreted broadly and applied flexibly. This may include adapting existing services, commissioning of new provision, or purchasing tailored support on an individual basis.

The focus should remain on what the person needs to stay well and live a meaningful life, rather than on organisational or market constraints.

Section 117 aftercare does not have a fixed time limit. It continues for as long as the person has needs arising from their mental disorder that require aftercare services to prevent deterioration or readmission.

Section 117 aftercare can only end when the Local Authority and the Integrated Care Board (ICB) are satisfied, following a proper joint assessment and review, that the person no longer requires aftercare. This reflects established case law, including R (Mwanza) v London Borough of Greenwich [2010] EWHC 1462 (Admin), which confirms that decisions must be based on assessed need and future risk, not convenience or cost.

Review of Section 117 aftercare

Section 117 aftercare must be regularly reviewed to ensure that support remains appropriate, proportionate and responsive to the person’s needs.

• Reviews should take place at appropriate intervals based on need and risk
• Aftercare provision may be increased, reduced or amended following review
• Any changes must be:
  • jointly agreed by the Local Authority and the ICB
  • clearly recorded
  • made in collaboration with the person, and where appropriate their carer or advocate

When can Section 117 end?

Section 117 aftercare can only end when all of the following conditions are met:

1. A joint review has taken place
A formal review is undertaken involving both the Local Authority and the ICB.

2. A full assessment confirms aftercare is no longer required
The decision must be based on a comprehensive assessment of the person’s current and future needs, including the risk of deterioration or relapse.

3. The decision is jointly agreed
The Local Authority and the ICB must agree the decision. One organisation cannot end Section 117 aftercare unilaterally.

4. The decision is clearly recorded
The outcome of the review, including the rationale for ending aftercare, must be clearly documented.

In line with the Mental Health Act Code of Practice (33.20), every effort should be made to involve the person in decisions about ending Section 117 aftercare, and where appropriate their carer, family member or advocate.

This includes:

• using preferred communication methods and making reasonable adjustments
• offering opportunities to participate in review discussions
  ensuring the person has the opportunity to express their views

Where the person does not engage, this should not be taken as evidence that aftercare is no longer required. Records should demonstrate that reasonable and proportionate efforts have been made to support engagement.

Ending Section 117 must not occur:

• ❌ Without a clear, jointly agreed decision by the Local Authority and the ICB based on a current assessment of need and risk
• ❌ Solely on the basis that the person appears stable, where that stability is being maintained through ongoing support
• ❌ Because of reduced service contact alone

Where needs continue to exist but are being effectively met, this should be recorded as evidence of effective Section 117 aftercare, not used as a justification for ending it.

Good practice when ending Section 117

Although not a statutory requirement, it is good practice to:

• explain the decision to the person
• provide reasons for the decision
• ensure clarity about how to access support in the future

This helps to avoid a “cliff edge” and supports continuity of care.

In summary

• The Local Authority and the Integrated Care Board have a joint duty to provide or arrange Section 117 aftercare free at the point of delivery
• A person becomes entitled to Section 117 aftercare when they meet the statutory criteria following qualifying detention
• Aftercare must continue for as long as it is required to meet needs arising from the person’s mental disorder
• It can only end following a joint decision based on a proper assessment of need

Nine pillars for effective partnership Section 117 aftercare include clear joint policy; person-centred and strength based; services supported to work in an integrated way; a focus on early intervention and mental health; reducing risk of hospital readmission through effective discharge; inclusive and responsive planning; there is clarity on funding, roles and responsibilities; effective information sharing and governance; monitoring, quality assurance and continuous improvement seen as business as usual.