The Home Office Mental Health Unit and its approach to the assessment and management of risk

For a minority of offender patients in England and Wales, the court may, on convicting such a person of an imprisonable offence, set aside prison sentence in favour of a hospital order. The Crown (higher criminal) Court may also, if deemed necessary 'for the protection of the public from serious harm', add a restriction order devolving decisions on leave, transfer or discharge from hospital to the Secretary of State at the Home Office (except in the case of discharge which the Mental Health Review Tribunal may also direct). At any one time the Home Office has responsibility for in excess of 2,000 such patients resident in hospital, and over 1,000 more in the community. The Mental Health Unit of the Home Office advises the Secretary of State in the exercise of his power in this regard. The background and system for doing this are described. Similar systems operate for Scotland through the Scottish Office and Northern Ireland through the Northern Ireland Office.