61. Section 117 requires the relevant authorities to provide a patient on discharge from section 3 with ‘after-care services’. ‘After-care services’ are not defined in the statute. Mr Armstrong submitted that the term was wide in scope: the authorities were bound to provide any service that prevented possible deterioration in the former patient’s mental condition, and reduced the chance of relapse and readmission. Ms Richards for Greenwich Council submitted that the services required to be provided under section 117 were restricted to those that addressed a need deriving from or related to the patient’s mental disorder and, consequently, the provision of ‘ordinary accommodation’ (ie housing without any care element) and the provision of financial support to cover basic living costs (eg food) was incapable of falling within its scope.

62. I do not accept Mr Armstrong’s submission that section 117 requires the relevant authorities to provide a former section 3 patient with any and all services simply because those services do or may prevent deterioration or relapse of a mental condition, or require readmission, for the following reasons.

63. In relation to the scope of section 117 services, the respected commentary on the 1983 Act by Richard Jones says (Mental Health Act Manual, 12th Edition, at paragraph 1–1053)

‘It is suggested that an after-care service is a service which is (1) provided in order to meet an assessed need that arises from a person’s mental disorder; and (2) aimed at reducing that person’s chance of being re-admitted to hospital for treatment for that disorder.’

64. Mr Armstrong sought to persuade me that the relevant service was defined in terms of Mr Jones’ second limb only – but I do not agree. The duty derives from a provision in mental health legislation; and it is described as a duty to provide ‘after-care services’. As Ms Richards submitted, section 117 is not concerned with the provision of support and accommodation at large, but rather with the provision, to the specified category of patients who have been detained on account of their mental disorder, of services tailored to meet needs arising from that disorder. An after-care service must, in my judgment, be a service that is necessary to meet a need arising from a person’s mental disorder.

65. It may be that, if a former patient were unemployed or homeless, that would increase the chance of deterioration in his mental condition – but, in my judgment, that would not require an authority under section 171 to provide employment or housing, as Mr Armstrong’s submission suggested. The need for work or the need for a roof over one’s head simpliciter are common needs, and do not arise from mental disorder. Section 171 does not impose a general responsibility on the relevant authorities to house or provide an income to a former patient. Of course, a patient’s mental disorder may make it more difficult for him to look for housing or employment on discharge from section 3 – and it may therefore give rise to a need for assistance in doing so. But that is a different need and a different issue.

66. That, it seems to me, is the principle. In practice, the assessment of needs that do arise from a mental disorder may of course give rise to difficult issues. It is for the relevant authorities – the local authority and the health authority – to reach their own view as to what need the person has, and, in making an assessment under section 47 of the 1990 Act, they enjoy a discretion as to what if any services are required to meet such needs. As Lord Phillips MR said in R (K) v Camden and Islington Health Authority [2001] EWCA Civ 240 at [29]:

‘The nature and extent of those [after-care] facilities must, to a degree, fall within the discretion of the [authorities] which must have regard to other demands in [their] budget.’The reference to ‘nature’, as well as ‘extent’, of the services in my view emphasises both the potential broad scope of section 117 and the wide discretion of the authorities within that scope. They are The recognition of this discretion, given to the authorities by Parliament, appears to me to be vital.

67. Therefore, I agree with Mr Jones’ suggested criteria for after-care services quoted above. However, I do not agree when later in the same paragraph he says:

‘The provision of accommodation meets a basic human need that relates to all individuals, irrespective of their mental health. Ordinary accommodation cannot therefore be said to constitute a service that is provided to meet a need that arises from a person’s mental disorder’

insofar as that suggests that, as a matter of law, ordinary accommodation can never fall within the scope of section 117, a submission also made by Ms Richards before me. As a proposition, that goes too far – although I accept that it is difficult readily to envisage in practice circumstances in which a mere roof over the head would, on the facts of a particular case, be necessary to meet a need arising from a person’s mental disorder. That difficulty, it seems to me, explains why, in the legal authorities to which I was referred, where there is discussion of the scope section 117 services, bare accommodation is not mentioned. In my view, that reflects a dearth of practical examples, rather than a principle of law.