Use of hospital and limitation directions under the Mental Health Act 1983

Last month's article on the use of the insanity defence (Griffith, 2022) highlighted that, where possible, people with a mental disorder should receive care and treatment from health and social services (Home Office, 1990). Even where there is sufficient evidence to show that a person with a mental disorder has committed a crime, prosecutors should give careful consideration to alternatives, such as admission to hospital for treatment, before deciding that a prosecution is necessary (Home Office, 1990). The diversion-into-care approach to managing people with mental disorders who commit offences has long been criticised as endangering public safety and contrary to the criminal justice system's aims of retribution and punishment (Home Office, 1996).

A decision to prosecute a person with a mental disorder is made by the Crown Prosecution Service (CPS) in accordance with guidance and a threshold test set out in its Code, focusing on the seriousness of the offence and whether it is in the public interest to prosecute (CPS, 2018). The more serious the offence, the greater the public interest in prosecution.