Kane Eddie, Evans Emily, Mitsch Jurgen, Jilani Tahseen
Institute of Mental Health, University of Nottingham, Nottingham, UK.
Business School, University of Birmingham, Birmingham, UK.
Crim Behav Ment Health. 2020 Oct;30(5):256-267. doi: 10.1002/cbm.2166. Epub 2020 Sep 8.
Liaison and Diversion (L&D) has twin objectives: improving mental health outcomes and reducing re-offending. Early diversion from police custody seems promising, but evidence of benefit is required to sustain such programmes. To test the hypothesis that contact with L&D services while in police custody would lead to improved mental health outcomes and a reduction in type and level of offending, we used a pre-post service use design. National Health Service (NHS) records in two counties were searched for evidence that patients had been involved with L&D services while in police custody during the period July 2009-December 2017. We defined January 2009-July 2014 as the pre-intervention period and any time after contact as the post-intervention period. Data from the Police National Computer were gathered for each period for these individuals, to assess their pre-post L&D contact offending histories. NHS Trust data were similarly gathered to assess their pre-post use of mental health legislation. 4,462 individuals were identified who had used L&D services in police custody. There were statistically significant reductions in the amount of offending following contact with the L&D service (whether one or two contacts), regardless of offence type. Statistically significant reductions were also observed in use of the four most commonly used legislative powers for detaining patients in hospital on mental disorder grounds, regardless of offending status (prolific/non-prolific). Our results indicate positive associations between the L&D interventions and change in offending and use of compulsory hospital detention. Whilst our research does not allow a direct causal relationship to be established in either area, the findings go beyond other impact assessments of L&D which have either been with small samples or relied only on qualitative data or expert opinion.
联络与分流(L&D)有两个目标:改善心理健康状况并减少再次犯罪。尽早从警方拘留中分流似乎很有前景,但需要有受益证据才能维持此类项目。为了检验在警方拘留期间与L&D服务接触会改善心理健康状况并减少犯罪类型和程度这一假设,我们采用了服务使用前后设计。在两个县搜索了国民医疗服务体系(NHS)记录,以寻找患者在2009年7月至2017年12月期间被警方拘留时参与L&D服务的证据。我们将2009年1月至2014年7月定义为干预前期,接触后的任何时间定义为干预后期。为这些人在每个时期收集了警方国家计算机的数据,以评估他们在L&D接触前后的犯罪历史。同样收集了NHS信托数据,以评估他们在心理健康立法方面的使用前后情况。共识别出4462名在警方拘留期间使用过L&D服务的人。与L&D服务接触后(无论是一次还是两次接触),无论犯罪类型如何,犯罪数量都有统计学上的显著减少。无论犯罪状况(频繁犯罪/非频繁犯罪)如何,在基于精神障碍理由将患者拘留住院的四项最常用立法权力的使用方面也观察到了统计学上的显著减少。我们的结果表明,L&D干预与犯罪变化以及强制住院拘留的使用之间存在正相关。虽然我们的研究不允许在这两个领域中直接建立因果关系,但这些发现超越了L&D的其他影响评估,后者要么样本量小,要么仅依赖定性数据或专家意见。