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

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Criminal justice liaison and diversion schemes: A focus on women offenderswith all the other service programmes, likecancer, like heart diseases, all the other bitsand pieces… They all get dealt with first.Mental health comes way down thecommissioning list and within mentalhealth you have all those targets that youare performance-managed… Court diversionhas not appeared in that. It barely got amention in the criminal justice carepathway… never mind a target.’CJLD schemes’ datafindingsData qualityWe collated local police arrest and sentencingdata and scheme monitoring data from 2005 toprovide an indication of the need for CJLDschemes for women offenders in different areas.From the outset it was clear that the extent andquality of routine monitoring data would vary. Anearlier Nacro survey 22 found that one in fiveschemes did not collect service level activity data,while two-fifths did not record details of clients’gender. As anticipated, much of this activity datawas paper-based.The quality and consistency of activity data wasgenerally poor and monitoring systems wereinadequate. The minimum data set proposed forthis study (see Box 2, page 11) representedcommon core data that were available across theschemes, according to screening and assessmenttools. However, only four schemes routinelytransferred these data onto an electronicdatabase, three had no electronic data at all, twogave us partial electronic data and one schemecould provide no activity data. As a result, theproportion of missing data was high, particularlyon items such as primary diagnosis and referralrecommendations. Criminal justice outcomeswere not easily available at eight of the schemes.Likewise, the outcome of referrals to communityservices were not recorded routinely.This meant that we were unable to draw anyconclusions about the recommendations made tothe court by CJLD schemes for women offendersand the proportion of recommendations taken upby courts, or the proportion of successfulreferrals from CJLD of women to hospital andcommunity-based mental health services andcriminal justice system interventions. Thesekinds of outcome data were not recordedroutinely by most schemes, making it very hardto judge the effectiveness of the schemes. Whatwe can say about the CJLD contacts and referralsources is limited. This dearth of monitoring datais an important finding in its own right.Nature and extent of contact byCJLD schemesWe can say that the schemes were seeing onaverage 2% to 3% of the total number of offenderspassing through the police station and courts.This suggests a considerable level of unmet need.Surveys of the offender population haveconsistently found a high proportion with mentalhealth problems. 15There were 2,155 adult referrals to the nine CJLDschemes between January and December 2005,ranging from 16 to 688 referrals per scheme (themean was 239). Around three-quarters of referralsduring this period were made via police custody(n=1,123; 52%), probation (n=289; 13%) or thecourts (n=192; 9%).Four schemes operated at the police station. *Between January and December 2005 these policeforce areas came into contact with a total of49,666 arrestees. During the same period theCJLD schemes received 1,492 referrals, but notsolely from custody suites – equivalent to 3% ofthe arrestee population at these sites. The rate ofcontact was similar for female suspects (3.5%).The level of contact with the arrestee populationvaried by area from 4.7% in Scheme 9 to 1.4% inScheme 10.At all nine CJLD sites it was possible to gathercomparable data on court activity (though onlysix operated as court-based schemes). During2005, 85,893 defendants were sentenced by thecourts. The schemes in these areas received 2,155referrals – equivalent to 2.5% of the populationprocessed by the courts. As with the arresteedata, the rate of contact was almost identical forfemale defendants (2.6%), but with the level ofcontact varying considerably between areas, from0.8% in Scheme 1 to 4.9% in Scheme 7, thisscheme also engaged the highest proportion offemale defendants (7.7%).The most common reasons for making a referralwere unspecified mental health concerns (n=500),* Two schemes operated both at the police station and at the court stage.8
Mental health briefing 2008Table 2 Primary diagnosis for CJLD referrals requiring furtherintervention (%) (n=1146)35 32%16%3025201513%11% 11%1056%5%3%2% 2%1%0Substance useSerious and enduringmental illnessDepressionOtherPersonality disorderNo diagnosisLow level mentalhealth needsDual diagnosisLearning disabilityMissingSelf-harmself-harming (n=355), substance use (n=28) orother reasons (n=184). * The available activitydata from the nine sites suggests that less thanone-third (n=648) of those referred to CJLDschemes during 2005 had previous contact withpsychiatric services. ** In some cases CJLDworkers completed a full assessment with thereferrals they saw (n=820; 38%); however, wecannot be certain of the extent to which thishappened, as details on the type of assessmentundertaken were often missing.Over half the adults referred to the CJLD schemeswere assessed as requiring further intervention(n=1146; 53%). *** Table 2 illustrates how substanceuse (n=362), SEMI (serious and enduring mentalillness, such as schizophrenia and bipolar/manicdepressive psychosis) (n=187) and depression(n=142) were the most common forms of primary* The reason for referral was not recorded in 51% of cases (n=1089).** Data on previous contact with psychiatric services was not recorded in 44%of cases (n=956).*** Data on referral recommendations were missing (including not known andnot assessed) in 25% of cases (n=545).diagnosis made by CJLD workers followingassessment of need. The high rate of CJLDreferrals being identified with substance misuseproblems indicates some duplication of effort orthe potential for dual diagnosis of substancemisuse and mental health problems. Thisreinforces the need to establish links betweenCJLD schemes and DARS.How did the women seen by theCJLD schemes differ from the men?It is important to consider whether women’sexperiences of the CJLD schemes differed frommen’s and to understand what factors wereimportant in shaping these experiences. Therewere a limited number of variables, for which wehad reasonable data, which we could hypothesiseas being potentially important factors (see Table 3overleaf).The women seen by the schemes were more likelythan men to be white; to have beenarrested/charged with a public order or violentoffence (but not section 136 detainees); and, to9
Page 1 and 2: Mental health briefing September 20
Page 7: Mental health briefing 2008Linking
Page 11 and 12: Mental health briefing 2008Box 2Rec

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