2.19 Mental health and learning disability services have a statutory supervisory/care role in relation to certain MAPPA offenders. Under section 117 of the Mental Health Act (MHA) 1983, there is a requirement on the relevant local social services authorities and Clinical Commissioning Groups (CCG) to provide after-care services to offenders subject to section 37, section 45A, section 47 and section 48 hospital orders who are discharged from hospital, until such time as the CCG and the local social services authority are satisfied that they no longer need them. What the care consists of will naturally vary but in many cases it will be co-ordinated by community mental health teams. It is essential that mental health and learning disability services:

• Identify all offenders who meet the MAPPA eligibility criteria and fall within MAPPA through a mental health outcome (both those in hospital and those in the community).
• Undertake a comprehensive risk assessment and assess the required level of MAPPA management and refer the offender for Level 2 and 3 management, where required.
• Complete the MAPPA I and send it to the MAPPA Co-ordinator.
• Provide data of the cases they manage for the MAPPA Annual Report.
• Communicate with victims of serious sexual and violent offences, when the offender is detained as an unrestricted mental health patient.

Further information can be found in Chapter 26 - Mentally Disordered Offenders.

2.20 After-care under section 117 MHA 1983 will generally be established and managed via the Care Programme Approach (CPA), which is intended to provide:

• A systematic assessment of health and social care needs.
• An agreed care plan.
• The allocation of a key worker (care co-ordinator).
• A regular review for mentally ill patients who are considered for discharge or accepted by specialist mental health services.

The after-care requirement applies in relation to both restricted and unrestricted patients. When the former are discharged, this will generally be subject to conditions and a Social Supervisor and Clinical Supervisor reporting to the Secretary of State will be appointed to monitor the patient's progress in the community (see 26.53).

2.21 CPA involves a multi-disciplinary approach to care and RA agencies may be involved. Patients should be referred to MAPPA Level 2 or 3 when it is clear that the CPA is not equipped to deal with the risks identified. Most offenders subject to hospital orders will be managed within the CPA without recourse to MAPPA Levels 2 and 3. The offender received a hospital order because the court decided that that was the appropriate way to proceed and, while the care teams may wish to consult RA agencies (and will often benefit from doing so), it is likely that the interventions available under CPA or via the supervisory regime for restricted patients will be the most appropriate. However, experience shows that this cannot be taken for granted.