Working with restricted patients From: Contents The guidance covers work with restricted patients detained in hospital and those discharged into the community. It also covers transfers from prison to hospital under the Mental Health Act 1983. Restricted patients are mentally disordered offenders who are detained in hospital for treatment and who are subject to special controls by the Justice Secretary due to the level of risk they pose. These controls include permission for community leave, transfer to another hospital, discharge and recall to hospital. The Mental Health Casework Section takes these decisions on behalf of the Justice Secretary. Detained patients are usually treated in secure hospitals, and will be given gradual access to the community as part of their rehabilitation only when it is safe to do so. Detained patients have access to the independent First Tier Tribunal (Mental Health), which has a statutory duty to discharge patients who no longer meet the criteria for detention under the Mental Health Act 1983.