NCJ Number
194703
Date Published
2002
Length
143 pages
Annotation
This report presents the methodology and findings of the evaluation of two of Great Britain's largest court-based psychiatric assessment schemes, whose responsibility is to identify and treat offenders with mental disorders.
Abstract
In the United Kingdom, mentally ill persons who are charged with or convicted of a criminal offense may be diverted to a hospital for assessment or treatment in lieu of a sentence. This involves the placement of psychiatric teams in magistrates' courts to facilitate the identification of and diversion of mentally ill persons appearing before the court. This report reviews all published reports about court diversion schemes, published relevant editorials, the details of previously published surveys, and all audits of such schemes for the years 1994 to 1997. The outcome evaluation examined 214 admissions through court schemes in central London. These were compared with 214 compulsory admissions to mental health facilities from the community, matched for admitting hospital, month of admission, and compulsory status. Case notes and computerized hospital databases were used to determine details of previous and subsequent admissions. Criminal records were reviewed to ascertain previous offending and recidivism after discharge. Follow-up was for a minimum of 2 years. Admissions and convictions in the 2 years before admission were compared with the 2 years after discharge. Paired statistical tests were used. The study concluded that there was clear evidence that court diversion schemes could improve the identification of mental illness four-fold, could decrease the time from arrest to admission for treatment by a factor of seven, could achieve admission to a hospital when needed, could deal effectively with both minor and serious offenses, could supplant the remand prisons as the focus of diversion from custody, and could function effectively inside and outside the inner city. Still, many schemes are currently ineffective because of poor planning, inadequate case identification and referral procedures, a lack of commitment from local psychiatric services, the failure to incorporate schemes into the mainstream psychiatric service, inadequate staffing and resources, and lack of access to beds. 80 references and appended list of characteristics of effective schemes