Liaison and diversion services in South East London: Referral patterns over a 25-year period

Criminal justice liaison and diversion services identify people with mental health needs and ensure they receive appropriate support. We describe a 25-year period of one such service that deals with a population of 864,540 in South East London that was set up in 1991. We used data from three time periods. A diagnosis of a mental illness was recorded in 70.0–80.3% of court liaison and diversion referrals. The proportion receiving a hospital order declined from 15.4% in 1991/1992 to 1.1% in 2015/2016; 54/199 (27.1%) of referrals to the police liaison and diversion service were detained in hospital. Although the service is designed to support any individual with a mental health issue, these results suggest that it has dealt mainly with people who have severe mental illness. Further research is required to understand how best to benefit a wider range of people with mental health issues who attend the lower (Magistrates’) courts, and whether screening for mental disorders can be applied in liaison and diversion settings to aid the implementation of national policy. We also need to understand how disposal decisions are made, and which are most effective.

Admissions to the Western Australian state forensic hospital from court on hospital orders over a 10-year period from 2007 to 2016

Objective: To investigate trends in admissions to the state forensic hospital (Western Australia (WA)) from court on hospital orders from 2007 to 2016. Method: A retrospective survey was undertaken. Demographic, clinical and legal data were obtained from hospital records. Hospital orders referred on less serious charges or without a primary diagnosis of major mental illness were identified as ‘non-forensic’. Results: There were 890 hospital orders representing 40% of total admissions. Eighty-one per cent were male and 50% had a diagnosis of schizophrenia; 22% were Indigenous; 421 (47%) were admitted on less serious (non-Schedule 1) charges; 199 (22%) did not have a primary diagnosis of a major mental illness recorded on the discharge summary; 82 (9%) had neither major mental illness nor serious charges. Overall, 539 hospital orders (60%) were identified as non-forensic; 243 (45%) of these were made with no input from the Court Liaison Service (CLS). Conclusions: Hospital orders make up a significant proportion of admissions to the forensic unit in WA. Many do not require secure forensic care. Developing alternative diversion pathways is essential.

A literature review about the prevalence and identification of people with an intellectual disability within court Liaison and Diversion services

Purpose Expert consensus is that people with an intellectual disability are over represented across the criminal justice setting (CJS). Primary research studies have been conducted in police stations and prisons, but little is known about the prevalence of this population in the court setting. The purpose of this paper is to conduct a literature review to find out more about the prevalence of defendants with an intellectual disability in court. Design/methodology/approach A literature review was conducted using standard systematic review methodology (Julian et al., 2011) and the PRISMA reporting guidelines (Moher et al., 2009). Findings Two papers met the inclusion criteria and were critically appraised. The papers reported prevalence findings ranging from 10%–20%. Research limitations/implications Differences in study design, sampling, recruitment and diagnostic criteria affect the ability to make comparisons or synthesise findings. Practical implications It is important that future primary and secondary research studies standardise operational terms to enable true comparison between studies, systematic reviews and evidence syntheses. Social implications Defendants with an intellectual disability need to be identified to enable criminal justice professionals to make reasonable adjustments to proceedings and consider diversion and alternative disposal options. This will likely improve outcomes for this population and reduce recidivism. Originality/value This literature review contributes to the growing evidence base about meeting the criminal justice needs of people with a learning disability and recognition of the increased prevalence across the CJS and specifically within the court setting.

Forensic psychiatry

Covering the role of the psychiatrist in forensic situations, from participation in the criminal justice system and legal definitions of crime (including homicide, violence, and sexual offences) to the relationship between mental disorders and offending, this chapter addresses secure hospitals and units, police and court liaison, and the role of the prison psychiatry. Legal provisions and how to give evidence in court are described, and an overview of pathways through the criminal health and justice system for mentally disordered offenders is provided. Fitness to plead and criminal responsibility are both explained.

Defendants with autism spectrum disorders: what is the role of court liaison and diversion?

Purpose The purpose of this paper is to examine the role of liaison and diversion services working in the lower courts (also known as Magistrates’ courts) with regard to autism spectrum disorders (ASDs) and their assessment, in particular, the role of pre-sentence and psychiatric reports and interviews. Design/methodology/approach Current practice is described in the lower courts in the context of current legislation and procedures. Findings When writing reports, there is a need for expertise to offer an opinion on future risk, disposal and what needs to be in place to support people with ASDs. No assumptions should be made when reporting on the basis of an ASD diagnosis alone and each case must be assessed on its individual merits while ensuring that individual human rights are protected. Originality/value There is currently a sparse literature examining ASD in court settings. This paper seeks to clarify the current practice.

Key performance indicators for Australian mental health court liaison services

Objectives: The aim of this paper is to describe the development and technical specifications of a framework and national key performance indicators (KPIs) for Australian mental health Court Liaison Services (CLSs) by the National Mental Health Court Liaison Performance Working Group (Working Group). Methods: Representatives from each Australian State and Territory were invited to form a Working Group. Through a series of national workshops and meetings, a framework and set of performance indicators were developed using a review of literature and expert opinion. Results: A total of six KPIs for CLSs have been identified and a set of technical specifications have been formed. Conclusions: This paper describes the process and outcomes of a national collaboration to develop a framework and KPIs. The measures have been developed to support future benchmarking activities and to assist services to identify best practice in this area of mental health service delivery.

Evaluation of a court liaison and diversion service in London over a quarter of a century

IntroductionOxleas NHS Foundation Trust has run a Court Diversion Service in South East London since 1991. It provides services for people within the earlier stages of the Criminal Justice System.ObjectivesThis evaluation aims to combine data from across the 25-year period since the introduction of the diversion scheme. It seeks to provide a longitudinal picture to elucidate the impact of service changes during this time.MethodsThe evaluation uses data obtained from a variety of sources for four points in time: 2015/2016, 2011, 1999 and 1991. Data across domains was collated to allow longitudinal analysis.ResultsAfter the initial introduction of the scheme in 1991, the total mean time on remand was noted to drop from 67.1 days to 49.5 days (P < 0.001). There were 280 referrals over 18 months in 1991, 210 per year in 1999, 190 in 2011 and 174 between April 2015 and March 2016. Violent crimes increased from 29% in 1991 to 47% in 2011. The proportion with schizophrenia decreased from 31% in 1991 to 18% in 1999, before increasing again to 25% in 2011. The use of Section 37 hospital order disposal decreased from 15% in 1991 to just 4% in 2011.ConclusionsThe court diversion scheme has produced significant benefits since it was introduced in 1991, despite a rise in the proportion of violent alleged offences. Changes to the service have seen decreased use of hospital orders.Disclosure of interestThe authors have not supplied their declaration of competing interest.