Blumenthal S, Wessely S
Department of Psychological Medicine, King's College Hospital School of Medicine, London.
BMJ. 1992 Nov 28;305(6865):1322-5. doi: 10.1136/bmj.305.6865.1322.
To assess the extent and nature of psychiatric assessment schemes based at magistrates' courts in England and Wales for the early diversion of mentally disordered offenders from custody and to determine the response of the NHS to new initiatives concerning alternatives to custody for this group.
Postal survey of the probation service, petty sessional divisions, mental health provider units, and district purchasing authorities in England and Wales.
All chief probation officers (n = 55), clerks to the justices (n = 284), managers of mental health provider units (n = 190), and purchasers of mental health services (n = 190) in each of the district health authorities.
Number of psychiatric assessment schemes, practical difficulties in their operation, extent of regular liaison with health and social services; current and future intentions to purchase or provide services for diversion from custody.
Data were obtained from every magistrates' court. Forty eight psychiatric assessment schemes were identified with another 34 under development. Particular problems were lack of adequate transport arrangements, difficulties with hospital admissions, and overdependence on key people. There was little liaison between health, social services, and members of the criminal justice system. Twenty five of the 106 purchasers who responded had a policy dealing with diversion, and 39 had a scheme under development; 56 purchasers had no current or future plans about diversion. Sixty nine of the 150 providers who responded reported that diversion was included in their current or next business plan.
Schemes to divert mentally disordered offenders from the criminal justice system are often hampered by lack of adequate transport arrangements, difficulties in hospital admissions, and overdependence on key people.
评估英格兰和威尔士治安法庭实施的精神病学评估方案的范围和性质,以便将精神错乱罪犯尽早从羁押中分流出来,并确定国民保健服务体系(NHS)对针对该群体替代羁押措施的新举措的反应。
对英格兰和威尔士的缓刑服务机构、治安法庭分庭、精神健康服务提供单位及地区采购当局进行邮政调查。
每个地区卫生当局的所有首席缓刑监督官(n = 55)、治安法官书记官(n = 284)、精神健康服务提供单位经理(n = 190)以及精神健康服务采购者(n = 190)。
精神病学评估方案的数量、其运作中的实际困难、与卫生和社会服务机构定期联络的程度;当前及未来购买或提供羁押替代服务的意向。
从每个治安法庭获取了数据。确定了48个精神病学评估方案,另有34个正在制定中。具体问题包括缺乏适当的交通安排、住院困难以及过度依赖关键人员。卫生、社会服务机构与刑事司法系统成员之间几乎没有联络。106名做出回应的采购者中有25名有处理分流问题的政策,39名有正在制定的方案;56名采购者目前或未来没有关于分流的计划。150名做出回应的服务提供者中有69名报告称分流已纳入其当前或下一个业务计划。
将精神错乱罪犯从刑事司法系统中分流出来的方案常常因缺乏适当的交通安排、住院困难以及过度依赖关键人员而受阻。