The importance of increasing public understanding of mental health cannot be overstated -as a criminal defence solicitor I have seen first-hand the devastation a failure to identify and adequately respond to mental illness can wreak on a vulnerable person's life.
When I am called to a police station, the custody sergeant responsible for my client will have carried out a risk assessment, taking into account their presentation, conduct and any other information relating to health. If the offender is under 18 or found to be mentally vulnerable, the sergeant will call in an appropriate adult to accompany and assist them.
Mental health problems can make it difficult for people to effectively communicate during interview, or sufficiently comprehend the possible consequences of what is said. Alone and unsupported, they could fail to take advantage of legal advice and find themselves swiftly remanded in custody.
Early intervention measures are really important for reducing time that vulnerable people spend in custody and ensuring that they receive the right care. This information can be shared with the court for the first appearance, making significant headway in rectifying the notoriously ineffectual network of information-sharing.
More than once I have been called to represent an individual when the proceedings are well underway and immediately had to file for an adjournment for a psychological assessment. The red flags should have been waved much sooner and not by me. By then, the defendant might have really disadvantaged their case due to their difficulties comprehending aspects of the allegations and the case against them. It is imperative that such individuals receive adequate support.
However, police officers are not mental health experts, and in the pressure cooker that is an understaffed police station, there is doubt as to whether people can be adequately assessed. The Appropriate Adults network espouses that up to 22% detained by police are mentally vulnerable, but, per police data, only 3% of detainees are assigned an appropriate adult.
Nevertheless, some positive moves are being made to address the glaring lack of support. Established in 2010, the Liaison and Diversion Program is a government initiative which aims to identify potential vulnerabilities in suspects and defendants as early as possible in their contact with the criminal justice system.
This service, provided by NHS professionals and currently covering 53% of the English population is integrated into police custody suites. A concerned custody sergeant can call the Liaison and Diversion officer to carry out a detailed assessment. If vulnerabilities are found, the L&D officer may then make a referral for appropriate treatment or support.
Hopefully as these initiatives expand, understanding and cooperation across the entire system will be improved.
This could result in halting criminal justice proceedings at any stage, with the offender being diverted to a treatment facility, particularly if the offence in question is relatively minor. If the offence is serious, the offender can be given the necessary support while remaining in police custody and awaiting trial.
Accordingly, as the program continues to be rolled-out, demand for appropriate adults in police custody suites across the nation could skyrocket. So too could the urgent need for beds in mental health facilities -services that continue to be ravaged by spending cuts.
It's clear, then, that awareness is simply not enough. As crucial as it is to identify mental health issues early on so that people are dealt with appropriately for the duration of criminal proceedings, whether this system will be able to successfully divert them into treatment and rehabilitation is more uncertain. As the L&D program, currently embedded in police and magistrates and youth courts and soon-to-be extended to the crown courts, is rolled out further, the strain on NHS resources, already pushed to breaking point, will only increase.
We need only look at the state of mentally unwell individuals in prison to fully appreciate this. With hospital places in such short supply, prisoners who are experiencing severe mental health problems are often left in limbo, waiting for a bed to become available so that they can be sectioned. Far too many vulnerable people deemed a danger to themselves are being incarcerated simply for their own protection. Yet prison can in fact exacerbate the very problems that landed them there in the first place.
With already-vulnerable people forced to contend with overcrowded conditions, stripped of their support network and with ample opportunities for substance abuse, it's tragic yet unsurprising that the prison suicide rate has dramatically increased. In 2016, a record 119 people died by suicide while in prison -the equivalent to one death every three days.
Given these awful statistics I can only hope that fewer people will be imprisoned for want of anywhere else to go. More alternative places of safety for vulnerable people are needed, and better still, preventative measures that reduces the likelihood of any police intervention whatsoever.
The public policy failures which we are facing up to in this mental health crisis are twofold: an ill-equipped justice system and woefully inadequate health provision. Though surely well-intentioned, when what is really needed is an overhaul in health and social care, all the criminal justice initiatives in the world cannot fix a broken system.