Abstract

This article describes how one community healthcare trust in England introduced a referral procedure to support risk management for patients detained under Mental Health Act Hospital Orders, with and without restriction, who had been assessed as requiring management under MAPPA Level 1. In the Trust, it was routine for MAPPA referrals to be made for individuals who were assessed as falling under Level 2 or Level 3, but not Level 1, there being no requirement to do so. This article sets out the background to, and justifications for, the introduction of the process and gives information about the number of referrals and patient characteristics since the procedure was introduced in 2021. The referral process is illustrated with two case studies. The article includes reflections on the information gathered and makes recommendations for future research including the need for an empirical assessment of the impact, if any, of the process on offending and re-offending. It makes recommendations for future policy, practice, and research so as to support detained patients at Level 1 and enhance victim safety planning and public protection.