Extra Funding For Mental Health Nurses
The majority of people who end up in prison have a mental health problem, a substance misuse problem or a learning disability and one in four has a severe mental health illness, such as depression or psychosis. The money announced today will be invested over the next year in joining up police and courts with mental health and other services so that people with mental health illnesses, learning disabilities and substance misuse problems receive the treatment they need at the earliest possible stage.
Care and Support Minister, Norman Lamb, said:
Too often people with mental health illnesses who come into contact with the criminal justice system are only diagnosed when they reach prison. We want to help them get the right support and treatment as early as possible. Diverting the individual away from offending and helping to reduce the risk of more victims suffering due to further offences benefits everyone.
That’s why we are investing £25 million for liaison and diversion services at police services and courts across the country. These will help identify when someone in a police station or involved in court proceedings who has mental health problems are referred to the right mental health services and are given the help and support they need.
Ten areas across the country will be testing out a new model of in Liaison and Diversion services to ensure quality of services are consistent across the board regardless of where someone is.
The ten areas receiving the funding are:
Merseyside; London; Avon and Wiltshire; Leicester;’ Sussex; Dorset; Sunderland and Middlesbrough; Coventry; South Essex; and Wakefield.
These services will be evaluated and if successful, extended to the rest of the country by 2017. This will mean people with mental health illnesses, substance misuse problems and learning disabilities who are suspected of committing an offence and come into contact with the police will have an assessment of their health needs, including mental health, which will be shared with police and the courts. This information may be shared with police and the courts to help ensure decisions made about charging and sentencing take into consideration an individual’s health needs. It will also mean treatment is given sooner which will help stop re-offending.
Policing Minister Damian Green said:
Police officers should be focused on fighting crimes and people with mental health conditions should get the care they need as early as possible.
These pilots will not only ensure that happens but in the longer term will help drive down reoffending by individuals who, with the right kind of treatment, can recover fully.
Kate Davies OBE – National Director for Health & Justice, Armed Forces and Public Health commissioning at NHS England, said:
We fully support this initiative. High quality liaison and diversion services will mean better outcomes for patients and for the criminal justice system by reducing health inequalities and re-offending.
The liaison and diversion programme is key to ensuring early help and treatment for adults and young people.
Seven day assessments from police custody and courts, often at a time of crisis, has already reduced re-offending and saved lives.
The Bradley Report, 2009, found that the majority of people who end up in prison have a mental health problem, a substance misuse problem or a learning disability.
Case studies – Liaison and Diversion – November 2013Case study from Criminal Justice Liaison and Diversion-Learning Disabilities
Mr A is 22 years old and has moderate learning disabilities and autism which impair his ability to live independently. He lives at home with his father and is not currently engaging in any form of education, training or work. His father is a highly critical and controlling individual who has minimal appreciation of his son’s needs and questions the involvement of Criminal Justice Liaison.
Mr A has no friends and relies on his immediate family. His autism is a lifelong developmental disability that affects how he communicates with and relates to others and how he makes sense of the world around him. He was also never taught to read/write or tell the time when he was a child and was never given any realistic or appropriate life goals. Mr A appears to have good communication skills however his information processing abilities require further assessment.
Mr A was arrested after he was reported to have made sexually inappropriate comments about children and made 21,000 phone calls to the NHS 111 service. The Duty Police Sergeant referred Mr A to the Criminal Justice Liaison Learning Disabilities Nurse, where a screening indicated a high probability of learning disabilities.
The police were advised about Mr A’s learning disabilities and autism and arranged for an appropriate adult to be present during his custodial hearing. Following this, Mr A was bailed. Mr A became a client of the Learning Disabilities Criminal Justice Liaison Team where he benefitted from the following services: Referred to GP for a full physical health check; referred to Social Care mental health outreach team, for access to various social activities; referred to the Forensic Learning Disabilities Psychologist for various assessments; and referred to the Community Learning Disabilities team for sex education awareness and assessment of his information processing ability.
In addition, his father was referred to Social Care for education on how to deal with people with autism and learning disabilities. Currently, Mr A is waiting to answer bail at the police station. If he is charged, he will be supported throughout the court process by the Criminal Justice Liaison Team.
Three case studies from Mersey Care Criminal Justice Mental Health Liaison Team Liverpool
Mr B is 78 years old, unknown to mental health services and of good character with no previous contact with the criminal justice system. He was arrested for assaulting several school teachers on a beach in front of schoolchildren.
He was assessed by doctors who raised concerns but considered him fit for interview and detention. However, the Custody Sergeant had a different view and liaised with Liverpool Criminal Justice Liaison Team (CJLT) who carried out a Mental Health Act assessment whilst Mr B was in custody. After being assessed under MHA 1983, he was detained subject to section 2 and then further detained under section 3 after being diagnosed with dementia with psychotic features.
Mr B was not deemed fit for interview and after high level liaison with police, criminal prosecutors and partner agencies, a decision was made to take no further action on the basis of the public interest. Mr B was discharged to 24-hour nursing care and has not come to the attention of mental health services or the police since. He is now being attended to by the older persons Community Mental Health Team (CMHT) as well as social services in the community which provides support with his health and social care needs.
Mr C is 32 years old and known to local services through the Early Intervention in Psychosis Team (EIT). His normal type of offending is alcohol-related and his engagement with services had been a cause for concern as his compliance with prescribed treatment was believed to be poor. He was deemed an escalating risk as he was homeless and increasingly chaotic in his behaviour in the community due to his heavy alcohol misuse.
The care team therefore liaised with CJLT Liverpool who facilitated a CPA risk review and consideration was given to how to best engage with Mr C. So it was decided that a silver PNC (police national computer) alert marker was placed on the PNC which flagged him to custody staff when arrested as requiring a mental health assessment by CJLT Liverpool whilst in custody.
Mr C was then arrested for stealing alcohol from a shop, the PNC alert was triggered and CJLT attended the police station to conduct as assessment with the care coordinator. It was deemed that he posed a significant risk to himself as his problems were both multiple and complex. This resulted in an informal admission to the acute services locally.
The police took no further action and he was discharged with accommodation in place and EIT supporting him at home. He was also referred to alcohol services.
Mr D is 24 and known to social services in the south of England. He was diagnosed with a possible drug-induced psychosis. He moved to Liverpool and became homeless, chaotic and a regular substance misuser, mentally unwell and unwilling to engage with local services.
He was beginning to escalate his offending behaviour from shop theft to more serious crime, such as burglary. He had been repeatedly arrested and detained under the Mental Health Act. However, upon discharge he quickly disengaged from any kind of follow-up in the community.
CJLT facilitated a multi-agency review to decide how to best manage Mr D in the community and attempt to get him to engage more with services. A silver PNC alert marker was therefore placed which flagged him to custody staff when arrested as requiring a mental health assessment by CJLT Liverpool whilst in custody.
When he was next arrested, the PNC marker was triggered, resulting in his assessment by CJLT. He was further assessed under the Act and admitted under section 3. Mr D was diagnosed with schizophrenia and comorbid drug misuse.
He is now in supported accommodation after the offence was prosecuted.