Court diversion for those with psychosis and its impact on re-offending rates: results from a longitudinal data-linkage study

Abstract

BackgroundWith significant numbers of individuals in the criminal justice system having mental health problems, court-based diversion programmes and liaison services have been established to address this problem.AimsTo examine the effectiveness of the New South Wales (Australia) court diversion programme in reducing re-offending among those diagnosed with psychosis by comparing the treatment order group with a comparison group who received a punitive sanction.MethodThose with psychoses were identified from New South Wales Ministry of Health records between 2001 and 2012 and linked to offending records. Cox regression models were used to identify factors associated with re-offending.ResultsA total of 7743 individuals were identified as diagnosed with a psychotic disorder prior to their court finalisation date for their first principal offence. Overall, 26% of the cohort received a treatment order and 74% received a punitive sanction. The re-offending rate in the treatment order group was 12% lower than the punitive sanction group. ‘Acts intended to cause injury’ was the most common type of the first principal offence for the treatment order group compared with the punitive sanction group (48% v. 27%). Drug-related offences were more likely to be punished with a punitive sanction than a treatment order (12% v. 2%).ConclusionsAmong those with a serious mental illness (i.e. psychosis), receiving a treatment order by the court rather than a punitive sanction was associated with reduced risk for subsequent offending. We further examined actual mental health treatment received and found that receiving no treatment following the first offence was associated with an increased risk of re-offending and, so, highlighting the importance of treatment for those with serious mental illness in the criminal justice system.

First diagnosis of psychosis in the prison: results from a data-linkage study

“…We recently reported that receiving a treatment order in the courts under the Mental Health Act had a positive impact in terms of reoffending and that an increased number of mental health treatment episodes was related to a reduced risk of reoffending. 24 This finding is consistent with a UK study of 1717 individuals in prison with psychosis that reported that treatment in prison was associated with delayed time to reoffending after release from prison. 25 Further work is needed to determine whether those with psychosis identified soon after entry to prison may have committed serious crimes precluding diversionary alternatives to custody or whether system issues such as no diversionary options available at smaller courts may be responsible for this.…”

Does mental health treatment reduce recidivism among offenders with a psychotic illness?

“…Clearly the more serious the offending, the more important will be the public interest in punishment being imposed for the protection of the community and the less likely will it be appropriate to deal with the defendant in accordance with the Act.The broad discretion open to magistrates in how they deal with mentally ill defendants opens the possibility that otherwise similar defendants with a mental illness may be dealt with in different ways by different magistrates. The average number of s32 and s33 cases dealt with by most magistrates is too small to exploit this variation in an instrumental variable analysis, but Albalawi et al. (2019) compared defendants with a diagnosed psychotic illness prior to their first NSW court appearance who had been diverted into treatment under ss.32/33 ( n = 1996) with defendants with a diagnosed psychotic illness prior to their first court appearance who were not diverted and instead received some form of criminal sanction ( n = 5747).…”

Psychosis and Criminal Offending: A Population-Based Data-Linkage Study

“…These results suggest that population-level interventions and measures targeting the health and criminogenic needs of this particular group are likely to have a significant impact on crime in the state. In another study, we also showed that court diversion under the NSW Mental Health Act for those with psychosis was associated with reduced reoffending and, importantly, increased treatment was associated with reduced reoffending (Albalawi et al, 2019). Together, these findings suggest the need for better policies that manage this group to improve justice outcomes.…”

“…This suggests that mental health services may need to be more culturally appropriate for this group to ensure they can receive equitable treatment. In another study, we identified that Aboriginal people were also less likely to be diverted into treatment by the courts than non-Aboriginal people (Albalawi et al, 2019).…”