Criminal justice liaison and diversion schemes - Offender Health ...

Mental health briefing 2008Linking with women’s prisonsA common problem was the relatively poor linksschemes had with women’s prisons. Two relatedissues were noted: the geographic dispersal of thewomen’s estate meant it was often impractical toarrange visits and the infrequency of contactmade it difficult to build up workingrelationships with prison health teams. This hasimplications for transferring mental healthassessment information from the scheme to theprison and vice versa on release. Although thereare standard procedures for the notification of aprisoner’s risk of suicide and self-harm, otherinformation about mental health may be lost.Scheme 9 had appointed a prison link worker forwomen. Her role was to ensure continuity of careand access to services on leaving prison. She alsotried to help women stay in contact with familiesand carers through practical help such asarranging transport for visits.Guidance and trainingDespite the emphasis on guidance and trainingfor those working with women offenders withmental health needs, 10, 21 only two schemesreported receiving any gender-specific trainingand this was focused on self-harm. None of theschemes had received guidance on dealing witheating disorders or sexual abuse.User involvementThere is an increasing emphasis on the centralityof the service user in mental health policy 21 andregular consultation with service users isrecommended as a routine factor in serviceplanning. 23 None of the schemes in our samplehad any routine procedures for collating feedbackfrom their service users or any recent findingsfrom user consultations. Our own limitedendeavours show that it was difficult for thewomen to differentiate the service input they hadfrom different health and criminal justiceagencies, which has implications for any futuremethods schemes may use to collect serviceusers’ opinions. The interviews we undertookwith service users (11 in all) did however showthat women were generally positive about theservice provided by the schemes and gainedvaluable help and support from the receivingagencies. The following interview extracts showthe importance the women placed on havingsomeone at court or in the police station who hadtime to listen to their concerns and who hadsome understanding of what they were goingthrough:‘I thought it helped me more, because thenother people get to understand from mypoint of view, rather than just going inthere and they don’t understand everything,I mean, at least people then have, youknow, realise reasons why you get yourselfinto trouble… if I could kiss that man, Iwould, from the [CJLD scheme], you know, Iwould, he done wonders for me… and heactually sat down and he listened to me,you don’t get many people like that.’Wilma, 23 years old‘Just being able to go in and speak aboutanything really and knowing that it ain’tgoing to go any further. It’s private andconfidential. Nobody else needs to knowabout it. He’s always saying, it stays in theroom that we’re in. It’s just nice to knowthat he’s not in judgement.’Emily, 24 years oldBelow, Gale, 25 years old, describes her situationbefore and after intervention by the CJLD schemewhich led to a transfer to a mental health facility:‘I feel better here [in the secure unit]because in jail I had the voices really badand I was trying to pretend to everybody Iam all right. I was making a joke with itbecause me voices kept saying ‘out thewindow’ and I said ‘you’re telling me to goout the window’ and I was making a joke ofit. And I was making out I was all right toeveryone because I didn’t want anyonetaking the piss out of me… And I had neverbeen to jail before so I was trying to makeout I was all right when I wasn’t. Where hereI have been able to get better and tell thetruth.’ResourcesAs a general point, all the schemes talked aboutoperating with very limited resources. Thefollowing extract from an interview with asteering group chair and commissioner offorensic services is used to illustrate the issuesfaced by many schemes:‘It’s way under capacity… it’s very difficultto keep it on the commissioning agendabecause you are going through this tieringon the commissioning side. You are in there7