It has been announced recently, the government will look to change the law around the payment of Universal Credit to certain mental health patients in hospital and it’s causing a considerable debate, especially in psychiatry.
First things first: this proposal (£) does not affect patients “sectioned” under the Mental Health Act 1983 (MHA) who have not gone through the criminal justice process – it affects criminal justice patients only, so-called “Part III” MHA patients.
Even then, it’s only some Part III patients so we need some clarity as soon as possible as to what the precise idea is. This all came about after the Nottingham victims’ families learned the offender was receiving benefits. He pleaded guilty and was criminally convicted of x3 manslaughter and x3 attempted murder offences, before being given a restricted hospital order under s37/41 MHA and is currently in Ashworth Hospital where his UC benefits are likely to be around £800pcm, totalling around £10,000 since his conviction.
I provide these estimated numbers just to demonstrate what we’re talking about here – not to imply any point about it, I’m sure you can form your own view. The post is essentially about what’s missing from the debate I’ve seen on this and is just attempting to throw in some legal information after a quick tour through some of the issues and the all-too-vague Government press release!
POPULTION OF THE SECURE ESTATE
First things first, so the rest makes sense – if you were to do a population “head-count” in Broadmoor, Ashworth or Rampton – the three “high secure” hospitals in England (Ashworth serves Wales as well), you will find patients there who have had various kinds of legal journey to their admission via a criminal court under the MHA –
- Convicted – restricted hospital order under s37/41 or hybrid order under s45A.
- Insanity – not convicted because of an insanity defence, then given a restricted hospital order.
- Unfit to plead – did not stand trial, then restricted hospital order.
Only the first category are “convicted criminals”, technically speaking, albeit all there will be prima facie evidence all three have engaged in conduct which, aside from their mental illness, would like have seen a conviction for those offences. All three groups were then hospitalised as patients and it is here the attention on benefits is falling.
It is also worth remembering this debate is not specific to high secure hospitals, it seems it would apply to anyone made subject to a s37/41 restricted hospital order, including those held in conditions of medium or low security. And I can’t stress this enough: these proposals are for criminal justice MHA patients only and seemingly only to those on s37/41 MHA.
CONVICTED PATIENTS
What we do not yet know, is whether the desire to end benefits for “convicted criminals”, the language used in the government’s press release, literally just means those with a criminal conviction. The Nottingham offender was charged with three counts of murder but pleaded guilty to three counts of manslaughter (diminished responsibility) as well as the three of attempted murder which covered six victims from his spree of attacks.
By way of contrast, think about someone like Alexander Lewis-Ranwell who was prosecuted for three counts of murder after killing elderly men in Exeter in 2019 and did stand trial for murder, only to be found not guilty, by reason of insanity.
Valdo Calocane is reported to be in Ashworth hospital in Merseyside; Lewis-Ranwell in Broadmoor – both high secure hospitals and both are detained under a s37/41 order. The difference between these two men is simply that Calocane’s route there was as a convicted criminal with a mental illness – Lewis-Ranwell is not. He was found not guilty of the murders because legal and psychiatric assessment of his mental state meant it was shown he “did not know what he was doing or did not know what he was doing was wrong”.
These are simple summaries of complex matters so of course, I’ve gone light on detail here because the reasons behind those assessments and the differing conclusions about criminal culpability is not what I’m trying to emphasise. My point is merely that some patients are charged and found to have committed serious offences, notwithstanding their mental illness; others are fully exonerated because of the extent of theirs.
PSYCHIATRIC OBJECTION
On social media, a number of psychiatrists have entered this debate and all those I’ve seen so far have been against the proposal, some of them quite angry about it, in fairness. One objection has been that it would “criminalise” patients in the high secure estate – I don’t think this objection gets off the ground, even if I knew what “criminalise” meant in that kind of usage. Almost everybody in the high secure estate has been “criminalised” to some extent – with some very rare exceptions, patients in high security have arrived their via extensive contact with the criminal justice system, usually a whole process of arrest, prosecution, court and trial.
What this argument also misses however, are the other patients who can arrive in high or even medium security via the criminal justice system. There was consideration in Calocane’s case about whether he should be given a s45A so-called “hybrid order” under the Mental Health Act. This would mean imprisonment for a specified time, but hospital treatment first and transfer to prison later. Such patients in hospital, many of whom are there for years, do not receive benefits. Prison also sometimes transfer convicted prisoners to hospital for treatment under s47/49 MHA and despite being in hospital and achieving the legal status of patient, they also do not receive benefits.
This is not as simple as “in hospital = patient therefore benefits”
The debate essentially, that convicted criminals do not receive benefits, so why should that change for some convicted criminals who are in hospital, instead of prison and only for some convicted criminals in hospital? The argument is also about what such benefits would be needed for. Patients in secure hospitals have all their essentials provided for them and access to facilities there. Upon discharge from hospital there are then process for aftercare and yes, benefits.
Hopefully the process will be clarified in the forthcoming consultation and everyone can then have their say. I will update you when the consultation is announced.
Awarded the President’s Medal, by
the Royal College of Psychiatrists.
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All opinions expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2026
I am not a police officer.
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – www.legislation.gov.uk
Mental Health Cop 