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This study aims to explore service users’ experience of psychological therapy as part of a community sentence with a Mental Health Treatment Requirement (MHTR) in Birmingham Courts between January and December 2018.

All service users that had therapy in this period were telephoned a month after ending and offered a semi-structured telephone interview. Seven service users agreed to be recorded. This data was then transcribed and analysed using thematic analysis to gain a richer understanding of their lived experience.

Themes identified were: Is the MHTR for me? Opening up, enlightening connections and personal change. Service users initially questioned the relevance and burden of the order for them; the experience of therapy allowed them to trust and talk about things unsaid in the past; this helped them to review and reconsider their understanding of themselves and their life choices and what further support they might need.

Interviews were not completed by an independent interviewer. Experience of working with offender manager supervision additionally available throughout the sentence was not explored.

What is included in the MHTR information and support needs to be informed by the service user’s perspective, including this can improve engagement.

Therapy was seen as a “a cog in the machine” and wider social inequalities may need to be addressed within the sentence.

This report focusses on experience of a therapeutic intervention – a key part of a community sentence with an MHTR.

Many violent and sexual offenders are mentally disordered or will develop mental disorders while serving their sentence. The Criminal Justice Act 2003 introduced major changes to the sentencing of 'dangerous offenders'. The disposal given to these offenders has implications for subsequent clinical management in secure mental health units, prison and, ultimately, in the community, particularly when it is an indeterminate sentence. This paper argues that the Act also has implications for psychiatric evidence submitted to the courts in such cases. The changes appear to carry significant resource implications too, especially for community forensic psychiatry.

The purpose of this paper is to discuss five domains impacted by the transformation of correctional mental health care in the USA: public health, public safety, legal obligations, fiscal responsibility and ethical standards, as well as critical issues such as administrative segregation, suicide prevention and reentry planning.

In the last four decades, the USA has seen a sizable growth in its criminal justice system and corrections population. It has also seen reductions in civil and community-based mental health care. Persons with mental disabilities have come to represent a highly disproportional segment of the corrections population. The paper discusses the implications and underlying causes of these developments as well as recent responses to them.

This set of circumstances is starting to change the mission of correctional health services from crisis intervention and suicide prevention to include preparation for the inmate's almost inevitable return to the community.

Such changes have led to further developments in correctional mental health care, in particular, policy designed to treat mental illness, reduce its destructive outcomes such as suicide, and facilitate successful reentry into the community in attempts to reduce recidivism and improve clinical outcomes. Mental health care professionals working within corrections have likewise faced ethical challenges in effectuating treatment.

In the UK, the mental health treatment requirement (MHTR) order for offenders on probation has been underused. A MHTR service was established to assess the effectiveness of a partnership between a probation service, a link worker charity and an independent mental healthcare provider. Short-term structured cognitive behavioural interventions were delivered by psychology graduates with relevant work experience and training. Training for the judiciary on the MHTR and the new service led to a significant increase in the use of MHTR orders. The paper aims to discuss these issues.

A total of 56 (of 76 MHTR offenders) completed treatment in the first 12 months. A single cohort pre-post follow-up design was used to evaluate change in the following domains: mental health and wellbeing; coping skills; social adjustment; and criminal justice outcomes. Mental health treatment interventions were delivered under supervision by two psychology graduates who had relevant work experience and who were trained in short term, structured, cognitive behavioural (CBT) interventions.

Clinically significant changes were obtained on measures of anxiety and depression, and on measures of social problem solving, emotional regulation and self-efficacy. Ratings of work and social adjustment and pre-post ratings of dynamic criminogenic risk factors also improved. This new initiative has addressed the moral argument for equality of access to mental health services for offenders given a community order.

While the current initiative represents one of a number of models designed to increase the collaboration between the criminal justice and the mental health systems, this is the first within the UK to deliver a therapeutic response at the point of sentencing for offenders with mental health problems. The significant increase in the provision of MHTR community orders in the first year of the project has been associated with a decrease in the number of psychiatric reports requested that are time consuming and do not lead to a rapid treatment.

Prisoners are at greater risk of developing mental health problems compared with people of a similar age and gender in the community. They are less likely to have their mental health needs recognised, are less likely to receive psychiatric help or treatment, and are at an increased risk of suicide. Prison mental health in‐reach services have been developed in the UK to address these problems. An organisational case study method was used to generate theory about the links between the aims, processes and impacts of the introduction of mental health in‐reach teams to prison contexts. Case studies were undertaken on six sites and included interviews and focus groups with in‐reach team staff, prison healthcare staff, and discipline staff. The aims of prison mental health in‐reach were related to providing an equivalent service to a Community Mental Health Team, with a primary focus on serious mental illness, but a widening role. Achievement of these aims was mediated by the organisational context, active relationship development and leadership. Overall effects were positively reported by all stakeholders. Successful development was not just a function of time in post, but also a function of the effectiveness of leadership within the in‐reach teams. The more effective teams were having a wide impact on the response to mental health problems in the prison setting

This paper aims to determine any barriers and gaps within one community Forensic Child and Adolescent Mental Health Service (FCAMHS) provision for young people presenting with risk of harm to others or involvement with the youth justice system, from Black, Asian and Minority Ethnic (BAME) backgrounds.

This study presents a systematic review of literature into the barriers and gaps within community FCAMHS, which showed little research in the area. Because of this, referral numbers for five major cities within the Yorkshire and Humber community FCAMHS region were compared to population statistics and youth justice caution and sentencing data.

Comparison suggests that BAME young people are under-represented across referrals to community FCAMHS. Also, there were differences in the representation of BAME young people when compared to youth justice data across the five major cities.

The lack of literature, combined with disparities in proportional representation of BAME young people within the Yorkshire and Humber FCAMHS, shows the need for a detailed study and analysis within national community FCAMHS.

More needs to be done within community FCAMHS to ensure that services are meeting the needs of young people at risk of criminalisation.

To the best of the author’s knowledge, there is currently no published literature that explores ethnic representation and access to community-based FCAMH services. Exploration within one regional service suggests that young people from BAME backgrounds may be under-represented within such services, whilst at the same time being over-represented within formal criminal justice.

The purpose of this chapter is to discuss the impact of COVID-19 on the invisible incarcerated women population who are convicted of a crime and serving a sentence in a residential correctional facility in the United States (US). Even though correctional populations have been declining in the past years, the extent of mass incarceration has been a significant public health concern even before the pandemic. Moreover, the global spread of COVID-19 continues to have devastating effects in all the world's societies, and it has exacerbated existing social inequalities within the US carceral complex.

We base our findings on data collection from two comparative clinical sociological garden interventions in a large Southeastern women's prison and a Midwestern residential community correctional facility for women. Both are residential correctional facilities for residents convicted of a crime. In contrast, in prison, women are serving longer-term sentences, and in the community corrections facility, women typically are housed for six months. We have developed and carried out educational garden programming and related research on both sites over the past two years and observe more closely the impact of COVID-19 on incarcerated women and their communities, which has aggravated the invisibility and marginalization of incarcerated women who suffered a lack of programming and insufficient research attention already before the pandemic.

We argue that prison gardens' educational programming has provided some respite from the hardships of the pandemic and is a promising avenue of correctional rehabilitation and programming that fosters sustainability, healthier nutrition, and mental health among participants.

Residential correctional facilities are distinctively sited to advance health equity and community health within a framework of sustainability, especially during a pandemic. We focus on two residential settings for convicted women serving a sentence in a prison or a residential community corrections facility that offers rehabilitation and educational programming. Women are an underserved population within the US carceral system, and it is thus essential to develop more programming and research for their benefit.

Imprisonment for public protection (IPP) has been the subject of much attention and some controversy since its implementation in April 2005. High numbers of IPP prisoners, combined with a low release rate, have meant that IPP has had a significant impact on the prison population. This paper charts the genesis of IPP and its historical antecedents. It also explores IPP as an exemplar of the ‘rise of risk’ and focuses on its links to the ‘dangerous severe personality disorder’ pilots. It presents two hypotheses on the mental health implications of IPP.

There is a dissonance between the purposes and services of the justice system compared to the needs of suicidal people or those with mental health problems. Correctional authorities are faced with sometimes difficult responsibilities when they have to incarcerate those who fall through the gaps in the social safety net. Correctional Service Canada’s (CSC) mandate is to carry out the sentences of two or more years imposed by the Court; consequently that federal authority may have more time and means than its provincial counterparts receive for inmates on remand or serving shorter sentences. CSC developed strategies for inmates with mental health problems and, specifically, an exhaustive suicide prevention program. The implementation of all the components of the mental health strategy is not completed but it is based on good planning. With respect to suicide prevention activities, these are mainly based on screening the most vulnerable inmates at the time of intake, but they cover a larger spectrum.