Author:DREWETT Alison
Title: A literature review of services for mentally disordered offenders
Publisher: University of Leicester. Nuffield Community Care Studies Unit, 1995
Summary
This review is chiefly concerned with the overall pattern of services which should be available for mentally disordered offenders (MDOs), and does not include material specific to the technical skills of the various professionals who provide help for MDOs. For example, there is no discussion of the sorts of therapies which can be used for different sorts of offenders. It is assumed that such information will form part of individual professionals' own skills. Information is not given on specific client categories, such as women, ethnic minorities and people with learning disabilities, or on consumer views.
Context
The Health of the Nation document (1992) identified services for mentally disordered offenders (MDOs) as a priority problem. It is against this background that Leicestershire Health asked for a literature review of services for this client category in order to inform the commissioning process.
Contents
The introduction gives the background and explains how the review was carried out, concentrating chiefly on collecting unpublished and less readily available information (‘grey literature') from the varied agencies which purchase and provide services for this client category. Section 2 discusses numbers of mentally disordered offenders and the psychiatric needs of prisoners, those in contact with the probation service, those taken to police stations, and all offenders. Section 3 is about multi-agency working, discussing the problems and concluding that many agencies are now engaging in a multi-disciplinary approach and authorities are beginning to try to identify what works. The following chapters examine some of the services being put in place. Section 4 is on diverting MDOs, asking why this is done, describing where diversion takes place and the numbers identified and diversion schemes, and discussing effectiveness. Secure accommodation for mentally disordered offenders is discussed in Section 5: prisons, special hospitals, regional secure units, and psychiatric wards, ending with service developments in providing a coherent secure service and assessing risk. Section 6 covers community care for MDOs, with sections on training and service problems. The publication concludes that although the principle of providing health care instead of punishment for MDOs is not new, coherent health and social care is not available for all in the UK , and the level depends very much on where they live. Agencies must work together. The comparatively few offenders presenting serious danger tend to distort responses, with the risk of resources being concentrated on them at the expense of the far more numerous others. Some psychopaths may not receive any health care because they are considered untreatable. All parts are interdependent and repercussions of neglect will be felt elsewhere. While, in theory, there is a push towards helping all types of clients have access to generic services, there is nevertheless some call for specific services staffed by for generic professionals.those trained to help MDOs – as if, in practice, generic services were not answering. Given the scale of need, services are unlikely to be able to given all the help all MDOs need, so there must be a balance between providing highly specialised services on the one hand and, on the other, educating staff in generic services so that they are able to respond to the needs of MDOs. Specialist staff should be available in an advisory capacity
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