A Joint Thematic Inspection of the Criminal Justice Journey for Individuals with Mental Health Needs and Disorders

By HM Prison and Probation Service and Ministry of Justice (UK)

Why should the Criminal Justice System be concerned with the mental health of those passing through the system? We know that rates of mental ill-health are high among those who pass through the CJS. Around a third of people11 who find themselves in police custody have some form of mental health difficulty, as do 48 per cent of men and 70 percent of women in prison. Some 38 per cent: of people on probation supervision are recorded as having a mental health issue. But why does this matter? First, because people with a mental illness need and deserve treatment. Entry into the CJS can provide a second chance for people who have been missed by other services to access that treatment and an incentive for them to take up that offer. Second, because mental illness and the symptoms associated with it can trigger criminal behaviour and therefore bring a person into contact with the CJS. Decisions then need to be made on whether a criminal charge is in the public interest or whether an alternative disposal (such as diversion into mental health treatment) would be more appropriate. Third, mental illness, particularly the more severe forms, can affect an individual’s ability to understand and participate in the criminal justice process. They may need additional support to understand the questions put to them during an investigation or at trial or they may lack the mental capacity to plead or stand trial. Fourth, the criminal justice process itself, for example the experience of custody, can have a severe and negative impact on someone’s mental health, particularly if they are already suffering a mental illness. In these circumstances, there is a duty of care to try to mitigate these wherever possible. This includes a duty to reduce the risks of suicide and self-harm, which we know to be high in criminal justice populations. For all these reasons, it is essential that those with a mental health condition or disorder are identified as early as possible in their journey through the CJS, particularly where that problem is severe. Once the mental health issue is identified, information relevant to that issue must be shared between agencies so that appropriate support and treatment can be offered, and the right decisions made at each step of the journey from arrest to sentence and post-sentence supervision in custody or in the community. This inspection, the first on this topic to involve all of the criminal justice inspectorates, and to consider post-sentence supervision, as well as the period leading up to trial, focuses on these critical issues: • Are people with a mental illness identified when they first come into the CJS? • Is this information passed on through the rest of the system from the police and defence lawyers to the Crown Prosecution Service (CPS) and the courts or from the courts to the probation and prison services so that the right decisions can be made about next steps? • Are people with a mental illness entering the CJS being properly assessed and then referred for help or treatment where this is identified as necessary? • What is the quality of support they are getting? Is it timely and adequately resourced or are people having to wait many months to get it? • Are the most seriously mentally ill people being looked after in appropriate settings and places of safety, or is custody still having to be used?

Manchester, UK: Her Majesty’s Inspectorate of Probation November 2021 117p.