Mwanza, R (on the application of) v London Borough of Greenwich & Anor

After-care under section 117 of the Mental Health Act 1983 is confined to services necessary to meet a need arising from the former patient’s mental disorder and aimed at reducing the risk of readmission. It does not impose a general duty to provide ordinary housing or income merely because homelessness may worsen mental health. Ordinary accommodation may fall within section 117 in an unusual case if it is necessary to meet a need arising from mental disorder.

Local authorities retain a broad discretion to assess needs and determine appropriate services. Under section 21 of the National Assistance Act 1948, accommodation requires an unsatisfied need for care and attention, meaning more than accommodation alone. Care supplied by family members may satisfy that requirement.

Michael Mwanza, a Zambian national, challenged decisions by Greenwich and Bromley Councils refusing accommodation and financial support. He had been detained under section 3 of the Mental Health Act 1983 and claimed that Greenwich’s section 117 after-care duty remained extant and included accommodation.

Alternatively, he claimed accommodation from Bromley under section 21 of the National Assistance Act 1948. The issues were whether ordinary accommodation fell within section 117, whether Greenwich had lawfully terminated its responsibility, and whether Michael had an unmet need for care and attention or was excluded from section 21 assistance by his immigration status.

1. Section 117. The claim against Greenwich failed. Section 117 requires services necessary to meet a need arising from the patient’s mental disorder and directed towards reducing the risk of readmission. It does not require the provision of any service which might prevent deterioration. Ordinary housing and financial support meet common human needs and do not ordinarily arise from mental disorder.
2. The exclusion of bare accommodation is not absolute. In an exceptional factual situation, ordinary accommodation could be necessary to meet a need arising from mental disorder. The question is fact-sensitive and falls within the authorities’ professional assessment and discretion.
3. On the evidence, Michael’s need for accommodation arose from the family’s destitution and immigration position, not from his mental disorder. Greenwich’s assessment that no section 117 accommodation need existed was professionally rational and could not arguably be impugned.
4. Greenwich and Oxleas had also lawfully discharged their section 117 responsibilities in November 2001. The contemporaneous records showed a decision to discharge him from allocated cases while retaining out-patient contact. His condition was sufficiently stable and the decision was based on a proper conclusion that he no longer required after-care services. Any challenge would in any event have been defeated by the very substantial delay and prejudice caused by it.
5. Section 21. Permission was granted, but the substantive claim against Bromley was dismissed. “Care and attention” requires more than accommodation and means being looked after in a way that the person cannot or should not be expected to undertake himself. Bromley was entitled to conclude that Michael’s care needs were met by Prudence and, to a lesser extent, his son. The identified risk to Prudence was serious but not immediate and did not make that assessment irrational.
6. On the alternative immigration issue, the court treated the evidence as showing no extant immigration claim. Schedule 3 to the Nationality, Immigration and Asylum Act 2002 therefore excluded section 21 assistance, subject to human-rights obligations. Any Article 8 claim was unarguable on the evidence.

The section 117 claim was refused permission. The section 21 claim was dismissed on the merits.

First-instance judicial review decision. No earlier decision is stated in the judgment.