Sainsbury Centre for Mental Health

Diversion works,
says Sainsbury Centre report

23 February 2009

Diverting people with mental health problems from prison is good value for taxpayers money but existing diversion arrangements are not achieving their potential, says a report published today by Sainsbury Centre for Mental Health.

Diversion: A better way for criminal justice and mental health finds that court diversion and liaison schemes in England only work with one in five of the people with mental health problems who go through the criminal justice system. Many opportunities for diversion are being missed and too little is being done to ensure that offenders with mental health problems make continuing use of community mental health services.

The report concludes that good quality diversion offers excellent value for money to the taxpayer. It can reduce the costs of expensive court proceedings and unnecessary imprisonment of people on remand or sentence. It can reduce the risk of re-offending among people who get mental health treatment in the community instead of being imprisoned. And it can improve people's mental health, which benefits them, their families and society as a whole.

It finds that there is an especially strong case for diverting people who commit comparatively minor offences from short prison sentences to community sentences. For each person who is diverted from a prison service and who gets good quality mental health care in their community, an average of £20,000 can be saved in crime-related costs alone.

But in the absence of a clear national policy framework, diversion services have developed in a piecemeal and haphazard way. Many schemes are insecurely funded and there is an unacceptably wide degree of variation in their ways of working.

Sainsbury Centre chief executive Angela Greatley said: "Too people with complex mental health needs end up in prison. This is extremely expensive to the taxpayer; it is inappropriate as a setting for mental health care; and it is ineffective in reducing subsequent offending.

"Mental health diversion schemes seek to ensure that people with mental health problems who come into contact with the police and courts are identified and directed towards appropriate mental health care, particularly as an alternative to imprisonment.

"Our report shows that there is a powerful value for money case for investing in diversion. Yet most diversion schemes are inadequately or insecurely funded. Most do not fulfil their potential. Diversion teams rarely make recommendations to the courts or follow up referrals to mental health services. And some areas still have no diversion teams at all nearly 20 years after a government report * called for national coverage of court diversion."

The report makes 21 recommendations to enable diversion teams to meet their potential. It calls for a diversion team to be established in every primary care trust area of England, backed up by national guidance and at least three times the level of funding as it has today.

Diversion teams should be funded jointly by the NHS and criminal justice agencies and should be able to identify people at all stages of the criminal justice system, from first contact with the police to release from prison. They should offer training for criminal justice staff in mental health and advise them on individual cases. And when they refer people to community mental health services, diversion teams should maintain contact to ensure they get access to the services they need and to help them to stay in touch.

Angela Greatley said: "The Government's independent review of mental health in the criminal justice system, led by Lord Bradley, is due to report this year **. We hope that our report will contribute to Lord Bradley's review by showing beyond doubt that diversion can make a difference, not just to the people it helps but to their families, their victims, their communities and the taxpayer."

* The Reed Report, published in 1992, recommended that all courts in England and Wales should be served by a diversion team.

** In December 2007, the Secretary of State for Justice commissioned Lord Bradley to carry out an independent review of mental health and criminal justice.