No abstract

In a cohort of young people referred to an Australian mental health court diversion service over a 7-year period, 46.5% of those deemed eligible ( n = 523) were granted diversion and the following were identified as barriers to being granted diversion: identifying as Aboriginal and/or Torres Strait Islander, having substance use problems, prior offending, and no record of prior diversion. Young people granted diversion were significantly less likely to reoffend, even after adjustment for a range of other covariates. This study highlights the need to address barriers to mental health court diversion for young people, particularly in light of the evidence of its effectiveness in reducing risk of reoffending.

Risk of contact with the criminal justice system (CJS) is greater among those with mental illness, including severe mental illness—an observation that many argue reflects a process of “criminalizing” mental illness. Forensic patients represent a subgroup at one end of a spectrum of such criminalization, typically with histories of serious violence and psychotic illness. Strategies for decriminalizing mental illness in this context should consider a range of approaches, including intervening to prevent CJS contact in those with severe mental illness, particularly in the early or emerging stages of psychosis. However, it may be that even gold standard mental healthcare applied universally is insufficient to address CJS contact risks. While there is now an extensive literature documenting the relatively low rates of repeat CJS contact for forensic patients released from secure care, appropriate comparison groups are lacking and the key ingredients of any benefits of treatment are unknown. The CJS may well have something to learn from forensic mental health systems and services given the abject failure to stem rates of prison-release reoffending internationally. Understanding how to best identify risk and effectively intervene to prevent CJS contact in those with mental illness, whether early in the course of psychosis or following release from secure care, remains a priority for those seeking to address the criminalization of mentally illness in our communities.