UK health policy in relation to mentally disordered offenders in the community

Author(s):  
Jane Senior ◽  
Adrian Hayes ◽  
Jenny Shaw

The majority of mentally disordered offenders are never treated within forensic mental health services. Instead, they remain within the criminal justice system, where care and treatment for complex and co-morbid mental health, substance-misuse, and personality disorder issues remain secondary to justice and punishment. In this chapter, we explore the policy, practice, and legislative drivers influencing healthcare delivery throughout the criminal justice pathway. Firstly, we consider the current liaison and diversion programme in England, which aims to identify people with mental health issues at the point of entry into the criminal justice system. Secondly, we review the state of mental healthcare in prisons, a quarter of a century after the clinical improvement partnership between the National Health Service and HM Prison Service. Thirdly, we discuss issues around court mandated mental health treatment in the community. Finally, we consider initiatives designed to meet the discrete needs of offenders with personality disorders.

Author(s):  
Frank Holloway ◽  
Tony Davies

There is a long-standing policy of diversion of mentally disordered offenders (MDOs) from the criminal justice system to care by mental health services. Care of the MDO presents specific challenges to the non-forensic practitioner. These include the need to understand the workings of the criminal justice system and the specific legal issues presented by an offender, the salience of risk, and its management in the mind of the courts and novel additional ethical dilemmas that arise. The importance of substance misuse as a factor in offending behaviour is emphasized, and its implications are explored. In addition, the MDO may present with clinical problems that are unfamiliar. Key principles of management are set out. These include developing a clear understanding of the patient and their world, excellent communication between all those involved, and rapid intervention when there is cause for concern. Staff working with an MDO require adequate supervision and support.


1969 ◽  
pp. 788
Author(s):  
Julian V. Roberts ◽  
Simon Verdun-Jones

The issue of conditional sentencing in relation to mentally disordered offenders was recently addressed by the Supreme Court of Canada in R. v. Knoblauch. This article examines the context in which the Knoblauch decision was made by reviewing the incidence of mental disorders in correctional populations and the criminal justice system s response. The authors explore Knoblauch's implications on the conditional sentencing regime as a whole and its use as a sentencing tool for dealing with mentally disordered offenders.


Author(s):  
Thomas L. Hafemeister

Chapter 2 presents an overview of forensic mental health assessments and their deployment within the criminal justice system. This chapter describes how forensic mental health assessments are conducted, the multiple steps taken in the course of these assessments, and the challenges and tensions associated with providing them within the criminal justice system. In addition, it delineates their distinctive nature and how they differ from clinical evaluations and mental health treatment. This chapter also discusses a key question that frequently arises in conjunction with these assessments, namely, distinguishing a genuine report of a mental disorder and its impact from malingering (i.e., the faking of an illness), and strategies for making this distinction.


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