Nigel Turner's HyperGUIDE to the Mental Health Act

Sections 18 and 21

Unauthorised Absence: Being Absent Without Leave, and Returning

A person who is liable to be detained in hospital under the Act is absent without leave if he/she:

• goes away from the hospital without leave being granted under Section 17
• fails to return when a period of authorised leave comes to an end, or when recalled from authorised leave
• goes away from a place where he/she is required to reside as part of the conditions for authorised leave

In the above circumstances, the person can be taken into custody and returned to the hospital (or other place where he/she is required to reside) by:

• any Approved Social Worker
• any police constable
• any officer on the staff of the hospital
• any person authorised (in writing by the Mental Health Act Managers) to do so

With regard to someone subject to Guardianship who is absent without leave from the place where the Guardianship order says he/she should reside, that person may be taken into custody and taken to the proper place by:

• any Approved Social Worker
• any police constable
• any officer on the staff of a local social services authority
• any person authorised (in writing by the guardian or the local social services authority) to do so

Time Limits

Overall Time Limits

A person who is detained for treatment, or subject to Guardianship, and is absent without leave, can be taken into custody and returned at any time up to the later of:

• six months from the date he/she went absent
• the expiry date of the current Section / Guardianship order

The consequence of returning or being brought back from unauthorised leave is set out at Section 21 and is different according to whether the person returns within 28 days or after 28 days.

Return within 28 Days

If the person returns, or is brought back, within 28 days of going absent, the current Section stands and will run its normal course.

However, if that Section has expired, or has less than 7 days to run, the person can nevertheless be detained for up to 7 days and the appropriate medical officer may examine the person and consider whether to make a Section 20 renewal report. Any new period of detention or Guardianship will run from the date that the former period ended. If no renewal report is made during this 7-day period, the liability to be detained will lapse.

Return after 28 Days

If the person returns, or is brought back, more than 28 days after going absent but within the overall time limits given above, the appropriate medical officer must examine the person within 7 days of his/her return. The person can be detained for up to 7 days following return, even if the previous Section had expired or had less than 7 days to run at the time of return.

The doctor has to decide if the conditions for continuing detention or guardianship are met. If no Section 20 renewal report is made, the original Section lapses, even if, had the patient not absconded, the original Section would have still been in force. In the case of people detained in hospital, the RMO must consult:

• one or more professionals who have been concerned with the person's treatment
• an approved social worker

If a renewal report is made, this may have the following effect:

• If the last day of the original/previous period of detention has passed, the Section is renewed with effect from that day
• If the last day of the original/previous period of detention has not yet passed, then the original detention period is restored, and
  • if that previous period has more than two months to run, then a further report would have to be provided within the last two months, as usual, for any extension beyond the end of the original period, but
  • if that original period has less than two months to run, then the report may, if it states this, have the effect of an ordinary Section 20 renewal, thus renewing / extending the Section from the end of the previous period (just as for any patient who had never been absent without leave).