Thousands of people with a mental illness were coming into the criminal justice system each year but their needs were being ‘missed at every stage’, according to a major report from four criminal justice and healthcare inspectorates. The damning study claims that the criminal justice system is ‘broken’ for people with mental health difficulties which represent around a third of individuals in police custody.
The report collates data from the four watchdogs with inspectors examining more than 300 cases across six regions, as well as interviewing 550 professionals and 67 people with mental health issues who had been through the criminal justice system.
As a result of lockdown and prisoners spending 23 hours a day in their cells, there has been a significant impact on the quality of mental health services in prisons with longer waits and availability for acute and urgent cases only. The report illustrated that the full effects are ‘yet to be fully realised’. One individual surveyed described it as ‘the lowest point of my prison mental health life’ and that it ‘felt like I had been denied air to breath’. Others echoed such comments calling their experiences ‘unbearable’ and ‘frightening’.
‘The criminal justice system is failing people with a mental illness. At every stage, their needs are being missed and they face unacceptable delays in getting support,’ said chief inspector of probation, Justin Russell. ‘Not enough progress has been made since our last joint inspection 12 years ago to put right these critical shortfalls.’ He highlighted ‘significant problems’ in the exchange of information in ‘every agency and at every stage of an individual’s journey in the criminal justice system’. ‘This part of the system is broken and needs to be fixed urgently,’ he added.
The report highlighted challenges in accessing inpatient beds for individuals assessed for detention under the Mental Health Act and ‘unacceptable delays’. In one case, transfer to a secure hospital took 375 days; the national guidance is 14 days. Due to these challenges, inspectors found evidence of patients being remanded in prison as a ‘place of safety’. Senior managers at one women’s prison counted 24 such incidents in the previous 12 months. Inspectors stated this was ‘inappropriate and inhumane’.
The exchange of information was raised as a significant issue, described as ‘broken’ and needing ‘urgent’ improvement. The report stated: ‘The transfer of mental health information, where available, by the police to the CPS to support charging decisions is generally weak. Officers often do not include relevant material and, when the CPS asks for further information, this inevitably causes delay. This then has a negative knock-on effect in court.’
Inspectors found that police officers were often unclear about GDPR confidentiality in the disclosure of information, leading to timely delays. In only 25% of cases had the police provided the relevant material to the CPS. Not one of the six areas visited in the inspection had the memorandum of understanding for information-sharing despite recommendations made in 2009.
It was found that police were ‘not routinely providing defence lawyers with full custody records’. The MG5 form, used to summarise cases by police, did not make it ‘sufficiently clear’ if an individual had mental health issues. There was also ‘no specific document’ to alert the CPS to the mental health needs of a suspect, meaning ‘they must search through the file for relevant “clues”’. Such information was often ‘minimal’ and ‘insufficient’. Particularly given the significant number of unrepresented defendants who have mental ill-health in the criminal justice system, the report felt it was a ‘growing concern’.
The National Liaison and Diversion Model (L&D) was used to varying degrees of success across police forces. The L&D Model was designed to identity individuals who have mental health, aiming to ensure that the right support is put in place. Of 183 custody cases, only 45% had been referred to L&D and there were ‘very notable’ variations between police forces described as ‘concerning’, varying from 20% in eligible cases for one force to 70% in two others.