Centre for Mental Health

Centre for Mental Health welcomes justice green paper and calls for investment in effective diversion services

8 December 2010

"The Government's pledge to divert more people with mental health difficulties from the courts and police stations is a welcome step that could improve the health of many of the most vulnerable people in our society, make communities safer and save public money," Centre for Mental Health associate director Dr Graham Durcan said today.

Responding to the Green Paper, Breaking the Cycle, Graham Durcan said: "At least a quarter of adult prisoners in England have mental health problems that require treatment from specialist services. Children and young people in the youth justice system are three times as likely as their peers to have diagnosable mental health problems. Many more have emerging mental health problems that are less easy to identify.

"We welcome the pledge to implement Lord Bradley's call for a national liaison and diversion service by 2014. It is vital that this includes a distinct approach for children and young people and that national quality standards are set to ensure consistent quality and coverage across the country.

"We welcome the greater flexibility in relation to decision making about prosecution for children and the commitment to allow the police and CPS to use greater discretion in putting their trust in the clinical assessment of the professionals supporting these decisions.

"We welcome the greater focus on parenting issues in Youth Offending Teams but would reinforce the importance of using evidence-based parenting approaches to maximise the chances of change. We would also stress the pivotal importance of making parenting interventions available as early as possible (and at the very least at the very earliest point of contact with the youth justice system) for those children who have early stage conduct disorders and who have risk factors for the poorest life chances.

"We welcome the proposal to create a new 'health treatment requirement' as part of a community sentence and for more flexible use of the mental health treatment requirement. It is vital that the courts can divert offenders with mental health problems to community orders with the assurance that health services will be there to support them.

"We also welcome the pledge to reform the Dangerous and Severe Personality Disorder pilots, which have been very expensive and worked with only a small number of offenders. There are many thousands of people in the prison system with untreated personality disorders. We hope that funds will be reinvested from DSPD to support many more people more effectively.

"We agree that more prisons should provide work opportunities. It is vital that employers are encouraged to recruit from the prison population, including those with mental health problems, and that employment support reaches 'through the gate' to help prisoners get paid work after release.

"The Green Paper under-estimates the prevalence of mental ill health among the prison population. The most reliable figures suggest that nine out of ten adult prisoners have at least one mental health problem and that one in ten has a severe mental illness.

"We are concerned that the Green Paper mentions little about alcohol misuse. Treatment and support for offenders who misuse alcohol is often poor and given much less priority than drug treatment and we would be concerned if this gap grows further.

"We welcome the proposal to test payment by results in the criminal justice system. Most offenders need support from a range of services, including health, social care, housing and employment. It is therefore crucial that all these agencies are held accountable for doing their part to rehabilitate offenders, reduce crime and narrow inequalities in health and life chances."

Graham Durcan concluded: "Imprisoning people with mental health problems, even for short periods on remand, damages their health, creates additional costs to the public purse and increases the likelihood they will offend again.

"We need to be able to identify children and adults with mental health difficulties at any stage of their journey through the criminal justice system. We need to be able to offer them the treatment and support they require alongside any sanction that is needed for offences they commit. And we need to hold criminal justice, health and social services accountable for making a difference in people's lives and in their communities."