There is a range of types of sentence the courts can use for adult offenders who have mental disorders, developmental disorders or neurological impairments. The type of sentence (or disposal) will depend on the facts of the case, the nature of the offence and other factors, including the offender’s behaviour when they are unwell. The court will also consider the need to protect the public.

Hospital order – the offender is detained in a hospital for treatment.

Guardianship order – the offender is placed under the guardianship of local social services or an approved person.

Restriction order – if making a hospital order, the Crown Court may also make a restriction order if it appears that it is necessary to do so to protect the public from serious harm. A restriction order means that aspects of an offender’s sentence, such as transfer to another hospital or discharge into the community, become subject to the consent of the Secretary of State.

Imprisonment with hospital direction and limitation direction – if the crown Court decides the criteria are met for a hospital order (offenders aged 21 or over only) the court must then also consider if it would be more appropriate to pass a sentence of imprisonment with a direction that the offender is detained in hospital (a “hospital direction”) rather than in prison. A hospital direction will always be accompanied by a limitation direction, which has the same effect as a restriction order.

Secretary of State transfer powers – if a sentenced prisoner becomes mentally unwell, a prison can ask the Secretary of State to give permission to transfer the prisoner to hospital.

Which sentence?

The criteria for making these orders and which courts can impose them are set out in Annex C of Sentencing offenders with mental disorders, developmental disorders, or neurological impairments.

When sentencing offenders under the age of 18 with mental disorders and related issues the courts will refer to Sentencing children and young people.