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	TX: 23.09.09 - Mental Health Courts PRESENTER: JULIAN WORRICKER

	Downloaded from www.bbc.co.uk/radio4 THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 91훑괵 CANNOT VOUCH FOR ITS COMPLETE ACCURACY. WORRICKER Now two pilot schemes of so called Mental Health Courts were launched by the Ministry of Justice in January. The aim was to give people with mental health problems who are going through the criminal justice system a more supportive journey. However, up to the end of July, official figures that we've been given show that of the 1,450 people screened, of those only 346 went on to be assessed and just 39 actually received extra support. Lord Keith Bradley wrote a review of the criminal justice system and mental health, and as result of his recommendations, the government made changes - including the introduction of the Mental Health Courts... I asked him what he thought of those figures. BRADLEY That does seem a very small number because from my examination of the issue there were at least 80% of people who may end up in prison who have some form of mental illness or dual diagnosis problem, that being drug and alcohol related issues. Now clearly these are only pilots and therefore don't have the comprehensive coverage that I would like to see where all courts have access to information about mental health problems so that people can be more effectively assessed and properly identified as they go through the criminal justice system. WORRICKER Is it fair to say if you are surprised by those figures that something is not happening that should be happening? BRADLEY I think the problem with mental health courts is that they only sit on certain days, only those people who appear before the courts for those particular sessions may be properly assessed. And from my examination of the issue all courts, and more importantly even earlier in the criminal justice system - at the police station - there needs to be that identification of assessment of people with mental health, learning disabilities or dual diagnosis problems, so that they can all benefit from early assessment and then the courts making a more timely decision about their eventual disposal. WORRICKER For those who don't know the system can you give us a sense of what is supposed to happen and what indeed does happen between the moment of arrest and the moment that the individual actually appears in court? BRADLEY Currently people are arrested, the police may or may not know that they have a mental health or learning disability and then people are passported through to the courts who then will take a decision about what sentence, depending on the nature of the offence, should be applied. Now for people with mental health problems that identification of their needs must be done at the earliest opportunity. If they appear in court without any information about the mental illness then too often the magistrates or the judges will remand someone into custody whilst that information is collected. The Mental Health Court is an attempt to make that assessment at the court stage but I believe that assessment will be better done when they first hit against the criminal justice system in police custody so that information about their illness may be passed to the courts at that first appearance to ensure that people are not unnecessarily remanded into custody, so delaying the process and not connecting people to the appropriate services. WORRICKER In which case is the Ministry of Justice doing enough here, bearing in mind that we hear a figure, don't we, frequently from charities, groups, in this field that as many as nine out of every 10 people in the system have mental health problems? BRADLEY Well those are the figures that I've been given and clearly the Mental Health Courts are an attempt to address that. But I firmly believe that because these courts only sit maybe on half a day or one day a week and only those people who are passed to those particular courts get proper assessment and psychiatric care then we're missing a huge opportunity to look more widely at those numbers. WORRICKER So this is a trial, do you think this scheme should be rolled out across the country? BRADLEY I think there should be more identification of mental illness and the courts play a part in that. What I don't want to see is a siloing of response to mental illness away from drugs and alcohol. We're currently badging courts in that way and I think a more comprehensive approach needs to be introduced that will save money on remands, it'll save money on unnecessary psychiatric reports being commissioned late in the process and ensure that those people who need to be committed into custody are doing so because that information needs to be enhanced rather than gathered at that point. WORRICKER We can make an international comparison here because a system of mental health courts has been operating in the United States for around a decade. The latest study from the US Department of Justice suggests up to half of all people locked up suffer from a mental health problem. Our reporter Tom Lane has been to a mental health court in Brooklyn in New York to find out more. ACTUALITY Did you see this - straight As, excellent report, perfect as a matter of fact. LANE It's an exchange you'd expect to hear in a classroom not a courtroom but then this isn't just any court, it's Brooklyn's mental health court, one of the growing number of experimental chambers that are challenging America's approach to prisoners with mental illness. Judge Matthew Denmick is in charge. DENMICK Fifty, 40 years ago when new medications came about and governors decided to close institutions and to have the least restrictive environment for people suffering from mental illness sufficient monies were not put into the community to address the problems of people suffering from mental illness. Unfortunately because of that discrepancy jails and prisons in the United States have become the largest mental institutions in the country. People who would ordinarily have been in a mental institution wind up in jail and prisons. LANE Each week about a hundred defendants appear before the judge, it's part of the court's system where in exchange for getting to stay out of prison they have to enter mental and social treatment programmes and come to the court for regular check ups. ACTUALITY How are you? Well that's a good report and everything's going okay, so come up, I have your [indistinct words]... Oh thank you. Congratulations. LANE This defendant is nearing the end of her treatment. She gets a certificate to mark her progress and is invited up to the bench to chat with the judge. ACTUALITY Everything is fine. Everything is so good. LANE It's an unusual style for a court to take but Judge Denmick says it's an effective one. DENMICK If somebody engages you your natural instinct is to engage back. And once that happens and a relationship develops then I don't want to disappoint them but more importantly they don't want to disappoint me. LANE This court was one of America's first to offer a new deal for some mentally ill prisoners. For public safety reasons it mainly deals with defendants who've committed relatively minor misdemeanours, such as shoplifting or creating a public disturbance. Most of them suffer from bipolar disorder, depression or some form of schizophrenia. The court's main social worker, Lucille Jackson, says these are all highly treatable by putting people on the right medication and working with them in intensive programmes. JACKSON People stay with us for a very long time, you know, even for a misdemeanour the minimum treatment mandate is 12 months and we have some people with us for as long as five years. So you know there's a familiarity here, this is not like a fast turnstile - like you come in and you're gone. LANE Back in the waiting room this man had nothing but praise for the system. OFFENDER They've got it pretty much good because it's helping me out a lot. LANE His lawyers wouldn't let us use his name but he was happy to talk. He'd been in and out of jail for 20 years before finally being diagnosed and coming to this court. He said he finally believed the cycle could be broken. OFFENDER So they've been a real great help, my family's real happy about it, my wife and my kids and everything that's been going on so, so good. LANE However, the courts do have their critics. One of these is Rutgers University's Dr Nancy Wolff who says focusing on mental health can distract from other factors behind crime. WOLFF Their evidence shows that people with mental illness who engage in criminal behaviour have some of the same characteristics that people without mental illness have who engage in criminal behaviour. So with all of the characteristics of their lives to just select the mental illness and say if we provide treatment then we will expect to see less social or criminal deviance, there is not evidence that really suggests that. LANE Nonetheless interest is growing. There are now about a 150 such courts in the US. Although no studies have been done to prove how successful they are Judge Denmick says of the 600 people who've successfully graduated his court only about a hundred have relapsed. ACTUALITY Come on up I have your graduation certificate. LANE The hope is that this latest graduate will be yet another positive statistic for those studies that are yet to come. WORRICKER That was Tom Lane reporting. Keith Bradley you went to the United States to see how they operate, what do you think of their system? BRADLEY I did, I went to the Bronx in New York which had a very similar set up to the Brooklyn experience that we've just heard about. Now I think there's some very positive aspects which the trails in this country are following but I do feel, as I found in the Bronx, that they were taking a very small number, they were looking at where services were available to meet the needs of the individual and whilst I support entirely the continuity of the judge who hears the case following through that case I think the reality is that we need to have a more comprehensive system to ensure that everyone who may have mental health or dual diagnosis problems are assessed and have access to that support during the criminal justice procedures and in the court process. WORRICKER What about re-offending rates, because research from the think tank Policy Exchange suggested certainly that in San Francisco rates of re-offending dropped by as much as 40% and we heard some similarly quite positive stories in that report from Brooklyn, do we know enough in that specific area at the moment? BRADLEY I think there is huge scope to address the re-offending agenda. But that'll only happen if there's a continuity of management of an individual who has gone into the criminal justice system, if they need to follow through into the prison system then they need to be collected and supported again when they come out of that prison system, so that the services they required in the community are matched to them, so that they're not left alone to fend when they come out of the secure system, particularly prison, to re-offend again. And I think if we have a proper continuity care case management model, as they do in America, then we have a far better chance of addressing re-offending figures. WORRICKER That was Keith, now Lord, Bradley. And the Ministry of Justice told us that just under half of those 346 assessed had no mental health issues and that the number of community orders imposed was just one indicator of any potential success. Those people attending mental health courts are now able to access services at an earlier stage. When the pilot's results are published in full next spring, they anticipate they will show an increase in the volume of cases progressing through the courts. Back to the Transcripts homepage Back to the You and Yours homepage The 91훑괵 is not responsible for external websites

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