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I will now describe the new model of liaison and diversion services in Criminal Justice Mental Health Teams, their component functions and how they will form the mechanism for current and future change to services.

Development of liaison and diversion services

A constant thread throughout the offender pathway chapters of this report has been the potential improvements that better coverage of liaison and diversion services can bring. Although currently not without their problems, what liaison and diversion schemes can offer is a framework on which a more effective model can be built. This framework, if properly developed, could carry many of the functions currently needed to support improvements for people with mental health problems or learning disabilities across the criminal justice system.

Recommendations

- The National Programme Board will oversee the development of a national model of Criminal Justice Mental Health Teams with agreed common elements, and its roll-out across the country. The core elements of this work will be the development of the following:

- Core minimum standards for each team - National network

- Reporting structure - National minimum dataset - Performance monitoring - Local development plans - Key personnel.

Recommendations

- The development of Criminal Justice Mental Health Teams will be informed by the recent Mental Health Effective Practice – Audit Checklist recommendations in addition to further evaluation work. It is anticipated that some of the core elements will include: - Liaison with local community services

- Screening and assessment

- Coverage of police custody and courts, with links to prison mental health in-reach services and resettlement to ensure continuity of care

- Management of information concerning an individual’s needs throughout the criminal justice system and back into the community

- Direct involvement and input to Multi Agency Public Protection Arrangements (MAPPA)

- Standardised assessment processes

- Joint training for criminal justice and health and social care staff - Active service user involvement

- Access to learning disability expertise.

- Schemes should also consider how they can best serve the interests of particular groups within the offender population, for example:

- People with learning disabilities - Women

- Children and young people

- People from black and minority ethnic groups.

The requirement for Criminal Justice Mental Health Teams is currently included in the standard NHS contract for mental health and learning disabilities on a non-mandated basis. This should be included in the contract as a mandated item and reflected in the next edition of the NHS Operating Framework.

Roles and responsibilities

Although the detail of how liaison and diversion services function will obviously need to be determined at a local level, according to local circumstances, there are some specific areas that have clearly emerged that require a focus for development. These include:

- Focusing liaison and diversion services at the police station

- Managing continuity of care across the offender pathway

- Information sharing

- Data collection.

Focusing liaison and diversion services at the police station

As we know from the liaison and diversion scheme audit report,199 _{discussed in}

Chapter 3, schemes serving only courts represent the majority, despite the fact that police station-only teams and teams that operate on multiple sites scored more highly in terms of effectiveness. As we also know, the police are the first point of contact and so provide a great opportunity for early assessment and engagement of appropriate services.

If we look back at Chapter 2, there is a strong case for ensuring that screening and assessment take place at the earliest possible opportunity – at the police station. This is not only to inform the police in their risk assessment and handling of an individual, but also to inform charging and prosecution decisions by the police and Crown Prosecution Service (CPS) and further decisions at subsequent stages of the criminal justice system.

A study undertaken in 2000200 _{looked at a scheme set up at a police station in}

London and compared it with similar schemes based at court. The report argued that a service at a police station was not duplicating that of existing court diversion schemes but tended to identify those accused of more minor offences, which may never even reach the court stage. The police-based scheme allowed offenders to be signposted to local services, with a view to supporting them at an early stage in their offending career, rather than merely dropping out of the criminal justice system with no further support. The report concluded that intervention at the police station may contribute to the prevention of more serious offending in the future.

Another issue that this report explored is the role of the Forensic Medical Examiner (FME) in relation to assessing individuals for mental health problems at the police station. In Chapter 2, I touched on the issue of how well equipped FMEs are for coping with the high prevalence of mental health problems in offenders at police stations. This report found that the role of the FME, which has traditionally provided health services in police stations, tended to be focused on making judgements in terms of ‘fitness to be detained’ and ‘fitness to be interviewed’. In contrast, where community psychiatric nurses were based at police stations they were attached to the local community mental health and social services teams, and had immediate access to the local forensic service for advice and support. It concluded that a full assessment by an experienced community psychiatric nurse, with their links to mainstream mental health services, may be more effective at identifying need for hospital admission than a brief interview by an FME.

Court diversion