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.

By Ashley N. Muchow, Agustina Laurito

In 2012, Chicago closed half of its public mental health clinics, which provide services to those in need regardless of their insurance status or ability to pay. Critics of the closures argued that they would result in service shortages and divert untreated patients to the criminal justice system. We explore this claim by examining whether and to what extent the closures increased criminal justice contact. Using a difference-in-differences framework, we compare arrests and mental health transports in block groups located within a half mile of clinics that closed to those equi-distant from clinics that remained open. While we find evidence that police-initiated mental health transports increased following the closures, we do not observe similar changes in arrests.

Policy implications

Chicago's mental health clinic closures remain a contentious issue to this day. Our results suggest that the shuttered clinics were meeting a need that, when left unmet, created conditions for mental health emergencies. While the closures do not appear to have routed untreated patients to the county jail, they increased police contact and, subsequently, transportation to less specialized emergency care facilities. Our findings demonstrate the need to strengthen health care access, crisis prevention, and the mental health safety net to preclude police from acting as mental health responders of last resort.

Criminology & Public Policy Volume 24, Issue 1 Feb 2025

By User Voice

This report brings forth the experiences of people who are diagnosed and self-diagnose as neurodivergent. As the health and criminal justice sectors are learning more about the experiences of neurodivergent service users, User Voice wants to bring their voices front and centre, and to give them real agency. Their quotes are unedited and based on their personal experiences. As part of this study User Voice interviewed 104 service users across 11 prisons nationwide between September 2022 and February 2023. To gain as full a picture as possible, User Voice additionally surveyed 250 neurodivergent service users about their experiences in the criminal justice system. All interviewed or surveyed service users were either diagnosed or self-diagnosed as neurodivergent. To provide as holistic a picture as possible, User Voice spoke to service users about their lives before they were involved in the criminal justice system. In early life, most service users we spoke to came from lower socio-economic backgrounds, over half had experienced abuse and neglect, and one third had been in care. At a crisis point, service users often found that they did not have the needed support networks, and therefore as a result, many had turned to alcohol and drugs which then had led to a life of criminality. Many told us that due to their neurodiversity, they are easily manipulated, coerced, groomed, or susceptible to peer pressure. This report shines a light on the lack of support for people who end up in the criminal justice system. Half of the service users who took part in this report told us they had been diagnosed before they turned 17 years old. Nine had been diagnosed between ages 17 – 26, and 17 when they were older than 27 years. None of them had been told how to live with their conditions. This study finds a criminal justice system ill-prepared to help neurodivergent people. In police custody, only 2 service users had adjustments made around their neurodiversity, whereas in prison, 15 said adjustments had been made. Because of lack of assessments and screening in prisons, we found that only few were receiving the support they needed. We believe that lived experience has a crucial part to play in the formulation of policy and practice in every sector, whether it be criminal justice, health, or education. To benefit those who are neurodivergent, we advocate for more peer support as well employing staff with lived experience in neurodiversity. This would guarantee that services and resources are tailored to the needs of neurodivergent service users. As prison populations grow, a commitment to more neurodiversity qualified health care staff is a must. The prison population would benefit from clinical psychologists in prison as well as better management of medication. This report is a snapshot of people’s lived experience. To drive true reform, we hope that more resources are given to projects that share the voices and experiences of neurodivergent people. To stop neurodivergent people ending up in the criminal justice system, we need to learn from those who have been there.

London: User Voice, 2023. 41p

By Andrew Galley,  Frank Sirotich, and Sara Rodrigues  

This report is based on a scoping review by a team of researchers at the Canadian Mental Health Association (CMHA), who analyzed existing research and policy documents on the mental health care needs of justice-involved persons in Canada’s criminal justice system and in peer jurisdictions. It aims to guide future research and policy development by highlighting what is currently known about this topic and what knowledge gaps may exist in the literature on mental health in the criminal justice system. While it highlights research on the prevalence of mental health problems and mental illness in the criminal justice system, experiences of justice-involved persons with mental health problems and mental illness, and promising practices and principles for mental health care, it is not intended to be a comprehensive review of the literature.   

Ottawa: Mental Health Commission of Canada , 2020. 124p.

ByNational Center for State Courts

A mindfulness program offered through a free, mobile app and weekly webinar meetings showed promise for increasing mindfulness and well-being and reducing stress among a convenience sample of individuals who work in and with courts. Because of the high attrition rates, common to these types of studies, the findings are promising but should be interpreted with caution. Additional research to build the evidence on mindfulness programs for the court community is encouraged. Among those who participated, feedback about the program was largely positive. Participants found the mobile app userfriendly and engaging, and the half-hour weekly webinars with a mindfulness instructor useful and engaging. Results suggest that building a judicial education mindfulness program around a mobile app is a cost-effective approach that is flexible to implement and helps some in the court community enhance their mindfulness and well-being and reduce their stress. Future mindfulness programs should include evaluations to further our knowledge on which features of the programs are of greatest benefit to participants and whether the programs are more likely to affect well-being and stress in distinct subsets of the court community

Williamsburg, VA: National Center for State Courts, 2023. 7p.

By Steering Committee on Justice Efficiencies and Access to the Justice System

A sub-committee of the Steering Committee on Justice Efficiencies and Access to the Criminal Justice System was formed to examine therapeutic courts in Canada, ascertain how well they were functioning, and identify best practices. A plan was formed to conduct a jurisdictional scan focused on mental health and drug treatment courts. (Other therapeutic courts, such as domestic violence courts and “Gladue” courts for Indigenous offenders, were outside the scope of the scan due to the constraints of time and the need to focus the inquiries.) Group interviews were arranged with judges, lawyers, and treatment providers from across Canada who work in these courts. The general topics that were covered in the interviews were: 1) Barriers to access and success; 2) Best practices; and 3) Evaluation methods. The authors of this report hope that this report can, in some way, serve to support, enhance, and contribute to the extensive body of knowledge held by the dedicated professionals who serve in these courts and who are passionately committed to improving the well-being of their communities.

Vancouver, BC: ICCLR, 2021. 142p.