Part 3 of the 1983 Act is concerned with the care and treatment of offenders with a ‘relevant disorder’ (a psychiatric disorder, autism or learning disability which has serious behavioural consequences) who are involved in criminal proceedings or under sentence. There are two categories of Part 3 patients – unrestricted or restricted:
Restricted patients are offenders with a relevant disorder who are detained under Part 3 of the 1983 Act in hospital for treatment and who are subject to special controls by the Secretary of State for Justice. Restrictions are imposed either by a Court or the Secretary of State, for offenders who present a risk to the public. They can take the form of a restriction order, limitation direction or a restriction direction, depending on the type and status of patient within the criminal justice system. The aim of the restricted patient regime is to protect the public from serious harm while at the same time recognising patients’ right to access treatment in an appropriate setting.
Unrestricted patients are defendants or offenders without a restriction order who receive a hospital order or transfer direction. This includes patients who were originally subject to restrictions, but whose restrictions have since ended or been lifted. The Secretary of State for Justice does not have involvement in these cases, unless the patient falls into their ambit in another way, for example multi agency public protection cases.
	Individuals in contact with the criminal justice system may need to be admitted to hospital for assessment or treatment if they exhibit a relevant disorder. This could be at the point they enter the criminal justice system. In such situations, the Court may issue an order to divert an offender from punishment in the criminal justice system to ensure they receive the appropriate treatment for their needs. On sentencing, a Court may give a section 45A sentence of imprisonment with a hospital component, or a section 37 hospital order, as an alternative to a custodial sentence. A hospital order authorises detention under the1983 Act for as long as this is required by the offender’s mental health needs; there is no minimum term to be served for the purpose of punishment.
	The Court may also add a restriction order under section 41 of the 1983 Act, if it considers this to be necessary for the protection of others from serious harm. The patient’s management will still be determined by a clinical assessment of the patient’s need and the risks arising from it, but the restriction order gives the Secretary of State for Justice responsibility for certain key decisions, rather than the responsible clinician. For example, the responsible clinician must ask the Secretary of State for consent to transfer a patient from one hospital to another, or to allow the patient leave in the community, or to discharge the patient from hospital into the community.
	If a prisoner or other detainee develops mental disorder whilst in custody, in prison or another place of detention, they can be transferred to hospital for treatment under Part 3 of the 1983 Act by warrant issued by the Secretary of State Justice. This is known as a transfer direction. These patients can also be made subject to restrictions.
	Part 3 of the 1983 Act is guided by the principle that those who have been accused or convicted of a criminal offence should be able to access equivalent medical care and treatment to civil patients detained under Part 2. There are, however, some areas where reform brought about by the Act will differ, due to the nature of the different provisions under Part 3 of the 1983 Act. The need to protect the public from those who have been convicted of serious offences and the need to ensure care and treatment is appropriate for the person it serves must be carefully balanced. In some cases, public safety concerns necessitate a higher degree of restriction and compulsion for patients detained under Part 3 of the 1983 Act, when compared to those detained under Part 2 of the 1983 Act. These areas have been set out in relation to specific sections in the Commentary on provisions of the Act section below.
The Mental Health Act 1983 (the 1983 Act) Part 3 of the 1983 Act