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Russell Webster

Russell Webster

Criminal Justice & substance misuse expert and author of this blog.

Modernising offender healthcare

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The 10th anniversary of the Bradley Report finds we are slowly starting to make progress on the justice and health agenda.

Thursday (20 June 2019) was the 10 year anniversary of Lord Bradley’s ground-breaking report on mental ill-health in the criminal justice system and the date did not go unnoticed.

The Ministry of Justice  issued a press release which shows that it is beginning to deliver on the health justice agenda that it has spent so much time talking about. The press release focuses on three distinct initiatives.

Firstly, the MoJ announced that its Community Sentence Treatment pilots are to be rolled out to 9 more courts in two new areas. CSTRs, as they are inevitably known, are designed to increase the number of offenders with drug, alcohol and mental health needs who receive treatment as part of a community sentence. The sentencing option recognises that many people experience both substance misuse and mental health issues together and enables a joined up treatment package to be delivered. So far, pilots have been successful because they have resolved the tension between thorough pre-sentence assessment and the needs of “speedy justice”. In the pilot areas, psychiatrists are paid to be on standby in order to provide on the day assessments of those awaiting sentence. Of course, this approach requires proper investment, not only in funding psychiatrists’ time, but in ensuring that there is sufficient treatment capacity locally and in promoting the new orders to local magistrates. This may be the reason why the rollout is so slow and limited to just two new areas.

The second part of the press release relates to prisoner health technology pilots which are underpinned by better information sharing between NHS staff working in custody and the rest of the health system. Prisoners in 35 establishments now have access to consultations with expert clinicians over video link. This “Telehealth” programme saves resources all round, but particularly by ruling out the need for lengthy prison escorts to hospitals, and, more importantly, allows prisoners to access specialist help without long, possibly very damaging delays. Other prison technology developments include a similar virtual consultation scheme in 10 Midlands prisons with prisoners talking to a GP on video link and an automatic drug dispensing unit at HMP Isle of Wight which uses secure fingerprint technology to automatically deliver medication to prisoners. Again, the benefits are reduced costs, better prisoner access to medicines and overcoming the security challenges of a large number of prisoners queueing up to get their medication at the same time.

Finally, the MoJ and Department of Health are committed to publishing the first ever Health and Justice Plan in the Autumn.

© Andy Aitchison

In 10 Years’ Time

The MoJ were not the only people celebrating Bradley. Thursday also marked a new call for the government to strengthen the law so that anyone being considered for a prison sentence must have a relevant and up-to-date pre-sentence report before a court can imprison them. This call, made jointly by the Revolving Doors Agency, the Centre for Mental Health, the Prison Reform Trust, the Disabilities Trust and Transform Justice, is designed to make sure that sentencers are fully aware of individual offenders’ substance misuse or mental health problems before deciding whether to imprison them or sentence them to a community alternative. The court forms part of a new report entitled In Ten Years Time which argues that far too many people are still being sent to prison despite significant vulnerabilities.

The charities’ campaign is strengthened by independent poll findings that show that:

  • 76% of people think that magistrates should know whether someone has a mental health condition before sentencing them
  • 68% of people think that magistrates should know whether someone has a learning disability before sentencing them.

Lord Bradley must be proud to know that his report continues to have such ongoing influence a full decade after it was first published.

Thanks to Andy Aitchison for kind permission to use the images in this post. You can see Andy’s work here.

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