If people, especially those from chaotic backgrounds, experience the symptoms of a mental health problem, they may not know how to articulate what they are going through. Yet symptoms, such as emotional distress and anxiety, can lead to all sorts of offending behaviours. Self-medicating with drugs or alcohol, for example, can numb the pain of trauma temporarily, but it can also influence people to behave in ways that they would not normally. This might involve stealing to fund a habit or not being able to control a temper when drunk.
Mental health difficulties in the prison and probation populations far exceed those in the general population both in frequency, intensity and in complexity (Martin, Lang & Olafsdottir, 2008). Approximately 70% of a given prison population has a ‘dual diagnosis’, characterised by at least two diagnoses of mental health difficulty (e.g. personality disorder and generalised anxiety disorder, or depression); and 70% of the probation population are considered vulnerable due to symptoms of mental health difficulty.
Despite the prevalence of mental health difficulties with this population and its clear relationship to forensic risk, research by Brooker, Denny & Sirdifield (2014) and Long, Dolley & Hollin (2018) both found significant gaps in understanding, training and a lack of adequate services to support people in the criminal justice system.
Many people who are on probation and living with a debilitating mental health problem have not ever been treated for their mental health. One example is Chris, who was 50 years old before anyone even asked him about his mental health and yet, as an 11 year-old boy, he experienced significant trauma when his baby brother died in his arms from Cot death. This led to repeated criminal acts and many suicide attempts over the years.
Probation services, such as the use of a Mental Health Treatment Requirement (MHTR) has been proven unsuccessful, largely through underuse of the requirement or lack of available services within the courts probation services. Instead, third sector psychology services are now working in partnerships with courts to offer manualised cognitive-behavioural therapy (CBT) to service users on licence or community orders, without the use of an MHRT, with many service users voluntarily seeking mental health treatment to help stop them reoffending. A service based in Greater London, between St Andrew’s Healthcare and London Community Rehabilitation Company (CRC) found that 74% of individuals who accessed its voluntary mental health support during probation committed no further offence in the following 12 months, whilst also showing significant impacts 6 months after treatment in symptomology across depression, anxiety, general distress and social functioning.
Society is often quick to judge those who have committed crimes and stigmatise those with mental health, however the statistics show what an impact investment in these areas can have on reducing crime and helping people to turn their lives around.
Based on blog post by Ellie Burch, Clinical and Forensic Psychologist, St Andrew’s Community Partnerships Team and research by James C. Fowler, Consultant Forensic Psychologist, St Andrew’s Community Partnerships Team
Fowler, J.C., Price, R.C., Burger, K., Mattei, A.J., McCarthy, A.M., Lowe, F. and Sathiyaseelan, T. (2019), "Embedding third sector psychology services within the probation environment: an alternative to MHTRs", Journal of Criminal Psychology, Vol. 10 No. 1, pp. 16-29.
Click here to find out more about the services St Andrew’s Healthcare offer to people in the Criminal Justice System.