Mental Health and the Criminal Justice System

Mental illness and mental health issues play a prominent role within the Criminal Justice System, not least because a significant proportion of defendants suffer with mental health issues.


What happens if somebody with a mental health condition is arrested?

There are various stages at which a suspect or defendant’s mental health can impact upon the proceedings. When a suspect is initially spoken to at the police station, if the custody staff have concerns about his or her mental health then medical staff will be contacted. An assessment will be carried out to determine if mental health issues exist and the severity of them if so.

If there are serious mental health concerns, specialist doctors will be called down with a view to a possible sectioning or detainment in hospital in accordance with the Mental Health Act.

If there are less serious mental health issues, consideration will be given to a referral to the Mental Health Diversionary Panel. Alternatively, if the suspect suffers from mental health problems but experts believe they’re still well enough to be dealt with within the Criminal Justice System, an interview will take place and a mental health approved social worker or mental health qualified appropriate adult will be in attendance. Their job will be to assist and facilitate communication between police and the suspect during the interview.

Is mental health help available at court?

If a suspect is charged with an offence, a community psychiatric nurse should be available to examine any mental health concerns, particularly if the suspect is in custody. At this stage, this intervention can take a variety of forms. It may involve referring the defendant to see community services after the court hearing has finished. Alternatively, it could bring the mental health issues to the attention of the prosecution, the defence and the court.

Depending on the severity of the mental health issues, the court may have to consider whether the defendant is fit to enter a plea. If not, then a determination of the facts hearing will follow. During this hearing, the court will take reports from psychiatrists into account before assessing whether the act was committed. The court may conclude that a Hospital Order is appropriate.

If the defendant is fit to plead, either the defence or the court can still order psychiatric reports with a view to assisting any subsequent sentencing hearing.

The procedure for more serious criminal cases that progress to the Crown Court is more formalised but nonetheless has a similar basis.

Mental health can also play a part in terms of murder charges and issues around diminished responsibility.

Government spending cuts reduce services for mental health patients

Regrettably, as with most areas of public spending following the financial crash of a few years ago, spending on mental health services within the Criminal Justice System has significantly decreased. This can mean that defendants with genuine mental health problems “slip through the net”. This can be at various stages of the process.

At the police station stage the duty “doctor” who attends is usually now simply a nurse. Often, medical staff who attend at the police station are not well versed in mental health issues and might not directly identify the defendant as having a verifiable mental health condition.

Again, even if the defendant is identified as having mental health issues, often just any appropriate adult is now contacted by the police for interview (such as an adult from the Appropriate Adult Agency) rather than a mental health approved social worker.

Due to the spending cuts, many Magistrates Courts are now without mental health nurses. As a result, such nurses tend to be called out either for a short period each day or as and when requested. This means that defendants with potential mental health issues are not always identified.

This is particularly unfortunate given that, with the increasing number of defendants who are homeless and living on the streets undetected, mental health issues are often rife and worsening. Hopefully this is something that can be addressed more appropriately in the future.

If you or a family member find yourself in trouble with the law and have a mental health issue, it is vital that you seek representation by solicitors with experience in dealing with these issues in order for you to be properly assessed by an expert psychiatrist, and get the support and treatment that you need.