Sainsbury Centre for Mental Health

Community sentences better than prison for offenders with mental health problems, says Sainsbury Centre report

26 March 2009

Community sentences are not meeting their potential to keep offenders with mental health problems out of prison, says a report published today by Sainsbury Centre for Mental Health.

A Missed Opportunity?, by Husnara Khanom, Chiara Samele and Max Rutherford, shows that few people are given a Mental Health Treatment Requirement (MHTR) by the courts because it is poorly understood and is prone to long delays.

The MHTR is one of 12 possible requirements for all people given a community sentence in England and Wales. It is rarely used in practice, even though more than two-fifths of people on community sentences have mental health problems.

A Missed Opportunity? looks at why the courts, probation and health services rarely use the MHTR. It finds that the purpose of the MHTR and the group of people to whom it can be given are not clear to sentencers, probation staff or health professionals.

Long delays in the production of court psychiatric reports are a major barrier to the use of the MHTR. Yet without an offer of treatment from local services the courts cannot make an MHTR.

There is also widespread confusion among health, probation and court staff about how an MHTR can be breached and what should be the consequence. In some cases, breach of a Community Order can lead to imprisonment.

Sainsbury Centre head of research Dr Chiara Samele said: "We have found that the MHTR is poorly understood by the very people who are needed to make it work. A lack of communication between health, probation and court staff is leaving people who could be diverted from prison languishing in custody. Without clear guidance about how and when to use the MHTR, staff lack the confidence they need to offer it as an alternative to prison."

A Missed Opportunity? calls on the Government to issue clear guidance on the use of the MHTR. It says that court diversion teams should take an active role in identifying people who could benefit from the MHTR and that primary care trusts should make services available to support people on the MHTR.

Sainsbury Centre chief executive Angela Greatley said: "Every year, some 70,000 people go to prison on short sentences. The majority of these people have mental health problems. Many could safely be diverted from prison and offered mental health treatment, if necessary alongside other requirements to make amends for their offences.

"Community Orders can be just as robust as short prison sentences, and they have much lower reconviction rates. We believe that the MHTR has unfulfilled potential as a form of diversion from custody. We hope that the forthcoming review of mental health and criminal justice by Lord Bradley will pave the way for investment in diversion from prison towards more effective alternatives outside."