Serving a community sentence with a mental health treatment requirement: Offenders' perspectives

Abstract

Background: Safe alternatives to custody for offenders with mental disorder are vital, not least as self-harm, and violence rates are rising among them in prisons. In England and Wales, the Criminal Justice Act 2003 allows a mental health treatment requirement (MHTR) to supplement a community or suspended prison sentence, but this combination is poorly understood and rarely sought.Aim: To explore offenders' perspectives on the MHTR. Methods:We interviewed all 25 consenting offenders under an MHTR in two probation areas. Verbatim transcripts of their audio-taped narratives were analysed using grounded theory methods.Results: Their core concern was "instability," characterised by many health and social difficulties and resolved by achieving stability, which included not reoffending as well as becoming healthy, substance free, and "having a life." Most considered that the MHTR helped their motivation and service provision, but some cited poor supervisor accessibility, supervisor role confusion, and sense of stigma under the order as stressful and threatening good outcomes. Conclusions: This first account of offenders' perspectives on the MHTR suggests a model in which, under it, offenders see themselves making progress as courts require. They understand the risk of return to court and imprisonment if in breach. This model of understanding how MHTRs work could provide for professional guidance and evaluation of their effectiveness.

Mental health in the criminal justice system: A pathways approach to service and research design

“…Of the three community health treatment requirements, which include alcohol and drug treatment requirements, the mental health treatment requirement has not only been underused, but its use was falling; the court, in essence, makes a form of contract between the probation officer, the clinician, and the prospective patient, who must agree to the order (Scott & Moffatt, ). It is reassuring that the offender patients involved appear to understand these orders (Manjunath, Gillham, Samele, & Taylor, ), but empirical research on their effectiveness is lacking. A similar kind of community order in New York, to which patients must also give consent, has proved highly effective in reducing rearrest and incarceration (Steadman, Redlich, Callahan, Robbins, & Vesselinov, ) as well as inpatient hospitalisation, among other benefits (Swartz, Swanson, Steadman, Robbins, & Monahan, ).…”

Sentencing offenders with mental disorders, developmental disorders or neurological impairments: what does the new Sentencing Council Guideline mean for psychiatrists?

“…Offender-patients appear to understand them, and there is a theoretical model of how they may work. 4 A Ministry of Justice analysis found MHTRs were associated with significantly less reoffending for people with 'significant psychiatric problems' than short prison sentences (https://www.gov. uk/government/publications/do-offender-characteristics-affect-theimpact-of-short-custodial-sentences-and-court-orders-on-reoffending).…”

“…Offender–patients appear to understand them, and there is a theoretical model of how they may work. 4 A Ministry of Justice analysis found MHTRs were associated with significantly less reoffending for people with ‘significant psychiatric problems’ than short prison sentences (.…”

Mental disorder in people convicted of homicide: long-term national trends in rates and court outcome

“…18 However, one form of Community Treatment Orders for offenders with mental disorder that remains underused is the Mental Health Treatment 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Requirement, with fewer than 400 orders made in 2016 (0.3% of all community orders). 19 Nonetheless, there has been an increase in comorbid substance misuse, with 43% of patients having a secondary diagnosis of substance dependence/misuse. Prevention of patient homicide therefore is strongly linked to clinical measures in reducing substance misuse and maintaining treatment and engagement with services.…”