Abstract

The majority of mentally disordered offenders are never treated within forensic mental health services. Instead, they remain within the criminal justice system, where care and treatment for complex and co-morbid mental health, substance-misuse, and personality disorder issues remain secondary to justice and punishment. In this chapter, we explore the policy, practice, and legislative drivers influencing healthcare delivery throughout the criminal justice pathway. Firstly, we consider the current liaison and diversion programme in England, which aims to identify people with mental health issues at the point of entry into the criminal justice system. Secondly, we review the state of mental healthcare in prisons, a quarter of a century after the clinical improvement partnership between the National Health Service and HM Prison Service. Thirdly, we discuss issues around court mandated mental health treatment in the community. Finally, we consider initiatives designed to meet the discrete needs of offenders with personality disorders.

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