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'Failing mental health'

Wormwood scrubs prison - C wing
Law In Action
Tuesday 10 November 2009
BBC Radio 4 1600 GMT

Ninety percent of people in prison in England and Wales have a mental health problem.

That is according to figures from the Office of National Statistics.

Although it is ten years old it is a widely quoted number and is still backed up by smaller, more recent studies.

That begs the question whether the courts are identifying people early enough and dealing with them appropriately.

Lack of progress

A man sat on a bed in a psychiatric ward
With high numbers of prisoners with mental health problems, are they being identified early enough?

A recent report commissioned by the government from Lord Bradley, illustrates a lack of progress in diverting people with mental health problems from prison, leaving them in danger of self harm and suicide.

Even if problems are identified early this is not the end of the issue.

There are still serious delays in deciding what to do when people actually get to court. Shane Cutts from Exeter is one such case.

He is currently serving a two year community order for arson which requires him to have treatment for his mental health problems.

Shane Cutts
Shane Cutts is serving a community order and receives treatment for his mental health problems.

'Passed around like a rugby ball'

He spent 14 months on remand in prison while psychiatrists decided on the most appropriate treatment.

His solicitor is Warren Robinson. He says they were hampered by a difference of opinion between the psychiatrists in the local NHS Trust area and those outside it.

'All were suggesting that he was treatable when I went out of the area. Then we sought opinions of psychiatrists within the area and it became clear that they were maintaining that his condition was untreatable. '

The Judge in the case said the NHS Trust was treating prison like a 'rubbish bin' for people with mental health problems and that Shane had been passed around 'like a rugby ball'.

The Devon Partnership Trust apologised for not communicating properly with the court but said it was not about 'a failure to find support or to attend to Mr Cutt's needs'.

A new approach

Law Court at Brighton
A new mental health pilot scheme that assesses mental health is being tried out in Brighton.

These problems are being addressed by a new pilot scheme. Hailed as a new criminal justice approach to the treatment of those with mental health issues, the pilots are being run at Stratford in East London and in Brighton.

On arrival at court anyone who is thought to have mental health problems is assessed.

Donna Beard is the Community Psychiatric Nurse at Brighton. She says that most of the people she sees have problems that are 'less acute'.

'Pleased to be asked'

But one of the more common problems she sees are people in an acute phase of depression.

'Quite often people I see are really pleased that somebody is asking questions at this level.'

Mental Health Service fact sheets from Brighton Magistrates' Courts
At the pilot scheme in Brighton, people are given leaflets explaining how to get help.

So far the pilot in Brighton has identified more than 700 people for assessment and found 178 with mental health problems that need further attention.

Surprisingly perhaps, only 29 have been given community orders with a mental health element.

An awful mess?

Neil Ashton the Legal Team Manager says that the pilot shouldn't be judged on this basis.

He says those who did not get a community order have not been ignored.

'They have been served very well. They have had their mental health needs assessed and they have been given advice and signposting onto local services'.

Interior of Whitemoor prison in Cambridgeshire
Theodore Dalrymple thinks the criminal justice system should be kept separate from therapy.

So, is the Mental Health Court Pilot the way forward in dealing with those with mental health issues who pass through the criminal justice system? Not everyone thinks so.

Theodore Dalrymple, a former prison doctor and Consultant psychiatrist, says 'It is not a therapeutic institution and once you start muddling the two up you get into an awful mess'.

But Sean Duggan the Joint Chief Executive of the Sainsbury's Centre for Mental Health disagrees. He says that the evidence shows 'the earlier you intervene on mental health issues then you are likely to prevent more chronic continuous problems further down the line.'

Contact the programme

If you have thoughts on any of the topics we have covered, or any other legal issues, you can contact us by email at, or by post at Law In Action, BBC White City, Wood Lane, London W12 7TS.

BBC Radio 4's Law In Action was broadcast on Tuesday 10 November 2009 at 1600 GMT and repeated on Thursday 12 November at 2002 GMT.

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