Manjunath Abigail, Gillham Rebecca, Samele Chiara, Taylor Pamela J
Fromeside, Blackberry Hill Hospital, Bristol, United Kingdom.
Adult Forensic Services, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom.
Crim Behav Ment Health. 2018 Dec;28(6):492-502. doi: 10.1002/cbm.2096. Epub 2018 Nov 6.
Safe alternatives to custody for offenders with mental disorder are vital, not least as self-harm, and violence rates are rising among them in prisons. In England and Wales, the Criminal Justice Act 2003 allows a mental health treatment requirement (MHTR) to supplement a community or suspended prison sentence, but this combination is poorly understood and rarely sought.
To explore offenders' perspectives on the MHTR.
We interviewed all 25 consenting offenders under an MHTR in two probation areas. Verbatim transcripts of their audio-taped narratives were analysed using grounded theory methods.
Their core concern was "instability," characterised by many health and social difficulties and resolved by achieving stability, which included not reoffending as well as becoming healthy, substance free, and "having a life." Most considered that the MHTR helped their motivation and service provision, but some cited poor supervisor accessibility, supervisor role confusion, and sense of stigma under the order as stressful and threatening good outcomes.
This first account of offenders' perspectives on the MHTR suggests a model in which, under it, offenders see themselves making progress as courts require. They understand the risk of return to court and imprisonment if in breach. This model of understanding how MHTRs work could provide for professional guidance and evaluation of their effectiveness.
为患有精神障碍的罪犯提供安全的替代监禁措施至关重要，尤其是鉴于他们在监狱中的自残和暴力发生率不断上升。在英格兰和威尔士，2003年《刑事司法法》允许心理健康治疗要求（MHTR）作为社区刑罚或缓刑的补充，但这种组合的情况鲜为人知，也很少有人寻求。
探讨罪犯对心理健康治疗要求的看法。
我们采访了两个缓刑区所有25名同意接受心理健康治疗要求的罪犯。使用扎根理论方法对他们录音叙述的逐字记录进行了分析。
他们最核心的担忧是“不稳定”，其特点是存在许多健康和社会方面的困难，而实现稳定可以解决这些问题，稳定包括不再重新犯罪以及变得健康、戒除毒品和“拥有生活”。大多数人认为心理健康治疗要求有助于激发他们的积极性并提供服务，但也有人指出，监管人员难以接触、监管人员角色混乱以及该命令下的耻辱感会给良好结果带来压力和威胁。
这是首次对罪犯对心理健康治疗要求的看法进行阐述，它提出了一个模式，在该模式下，罪犯认为自己在按照法庭要求取得进步。他们明白如果违反规定就有被送回法庭和监禁的风险。这种理解心理健康治疗要求如何发挥作用的模式可为专业指导和对其有效性的评估提供依据。
