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Posts tagged public health
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.

Recreational Cannabis Legalization and Immigration Enforcement: A State-Level Analysis of Arrests and Deportations in the United States, 2009–2020

By Emilie Bruzelius and Silvia S. Martins

Recreational cannabis laws (RCL) in the United States (US) can have important implications for people who are non-citizens, including those with and without formal documentation, and those who are refugees or seeking asylum. For these groups, committing a cannabis-related infraction, even a misdemeanor, can constitute grounds for status ineligibility, including arrest and deportation under federal immigration policy—regardless of state law. Despite interconnections between immigration and drug policy, the potential impacts of increasing state cannabis legalization on immigration enforcement are unexplored.

Methods

In this repeated cross-sectional analysis, we tested the association between state-level RCL adoption and monthly, state-level prevalence of immigration arrests and deportations related to cannabis possession. Data were from the Transactional Records Access Clearinghouse. Immigration arrest information was available from Oct-2014 to May-2018 and immigration deportation information were available from Jan-2009 to Jun-2020 for. To test associations with RCLs, we fit Poisson fixed effects models that controlled for pre-existing differences between states, secular trends, and potential sociodemographic, sociopolitical, and setting-related confounders. Sensitivity analyses explored potential violations to assumptions and sensitivity to modeling specifications.

Results

Over the observation period, there were 7,739 immigration arrests and 48,015 deportations referencing cannabis possession. By 2020, 12 stated adopted recreational legalization and on average immigration enforcement was lower among RCL compared to non-RCL states. In primary adjusted models, we found no meaningful changes in arrest prevalence, either immediately following RCL adoption (Prevalence Ratio [PR]: 0.84; [95% Confidence Interval [CI]: 0.57, 1.11]), or 1-year after the law was effective (PR: 0.88 [CI: 0.56, 1.20]). For the

deportation outcome, however, RCL adoption was associated with a moderate relative decrease in deportation prevalence in RCL versus non-RCL states (PR: 0.68 [CI: 0.56, 0.80]; PR 1-year lag: 0.68 [CI: 0.54, 0.82]). Additional analyses were mostly consistent by suggested some sensitivities to modeling specification.

Conclusions

Our findings suggest that decreasing penalties for cannabis possession through state RCLs may reduce some aspects of immigration enforcement related to cannabis possession. Greater attention to the immigration-related consequences of current drug control policies is warranted, particularly as more states weigh the public health benefits and drawbacks of legalizing cannabis.

BMC Public Health volume 24, Article number: 936 (2024)

“No Penalties. No Arrests. No Jails”: Perspectives on Drug Decriminalization Among People Who Inject Drugs in Sydney

By

George Christopher Dertadian and Vicki Sentas

The decriminalization of drug possession in varied forms is gaining some traction around the world. Yet prospects for people with lived and living experience of drug use to influence the direction of drug law and policy reform remains bound by stigma and exclusion. This study considers the aspirations for decriminalization of people who inject drugs through 20 semi-structured qualitative interviews with the clients of the Sydney injecting centre. What does decriminalization mean for those most criminalised by drug law and policy? The study found that participants’ views of what is possible for decriminalization are mediated by the same structures and experiences of criminalization, incarceration and exclusion that has disrupted their lives. Participants anticipate the need to mobilise incremental and partial changes associated with de facto models, including fines, increased police discretion (and therefore power) and treatment

orders. At the same time, participants collective imaginary also exceeds the limits of a police-controlled depenalization. We document people’s claims on a future drug policy that speaks to a world without criminal drug offences, punitive controls and the exclusion of people who use drugs from the policy table

International Journal of Drug Policy Volume 135, January 2025, 104657