Mental health review tribunal decisions in restricted hospital order cases at one medium secure unit, 1992–1996

Abstract We examined the outcome of 80 consecutive English mental health review tribunals (MHRTs) considering applications from restricted hospital order (section 37/41 Mental Health Act 1983) patients from January 1992. There was a high level of agreement between the RMO's recommendation and the tribunal decision, irrespective of whether the recommendation was for continued detention or conditional discharge. There was some indication that patients transferred from special hospitals were more likely to be discharged by a tribunal than those admitted from other sources. Although for black Caribbean patients conditional discharge was more likely than continued detention, overall there was no statistically significant association between ethnic group and tribunal outcome. There were no discharges against the RMO's advice on the patient's first application to the tribunal. These associations were weak in comparison with the overall 86% concordance of MHRT decision with RMO recommendation. Whilst the measures used should be reproducible at other medium secure units, it may well be that local factors such as availability of a hostel place or quality of the patient's legal representation at the tribunal, which it was not possible to assess in a retrospective case note study, also had a major bearing on tribunal outcome. Given current concern regarding the function of MHRTs in relation to the most serious offender‐patients, this may be an area for further study. Copyright © 1998 Whurr Publishers Ltd.