Court outcomes for clients referred to a community mental health court liaison service.

This paper begins with a brief review of recent literature about relationships between offending behaviour and mental illness, classifying studies by the settings within which they occurred. The establishment and role of a mental health court liaison (MHCL) service is then described, together with findings from a 3-year service audit, including an examination of relationships between clients' characteristics and offence profiles, and comparisons with regional offence data. During the audit period, 971 clients (767 males, 204 females) were referred to the service, comprising 1139 service episodes, 35.5% of which involved a comorbid substance use diagnosis. The pattern of offences for MHCL clients was reasonably similar to the regional offence data, except that among MHCL clients there were proportionately more offences against justice procedures (e.g., breaches of apprehended violence orders [AVOs]) and fewer driving offences and “other offences”. Additionally, male MHCL clients had proportionately more ma...

Offending Behaviour and Mental Illness: Characteristics of a Mental Health Court Liaison Service

ii Acknowledgements iv Table of contents vi Table of figures xiv Table of legislation xv Table of tables xvi Attestation of authorship xvii Chapter One: Introducing the thesis 1 A note on terminology and focus 2 Court liaison nursing 3 Researcher positioning and rationale for the research 4 Thesis structure 6 Chapter Two: Review of the literature 8 Introduction 8 The literature search 8 Section One: Background to development of services for people with mental illness involved with criminal justice services 9 Evolution of a growing population of people with mental health concerns in justice populations 10 Contemporary responses to the needs of mentally unwell people at the front end of the interface with the law 11 Court diversion and court liaison 11 Point of arrest and police diversion schemes 15 Referral pathways to and from court diversion and court liaison schemes 16 Responding to an increasing population of people with mental health concerns interfacing with the law in New Zealand 17 Recovery in Forensic mental health services 18 Evolution of mental health nurses in criminal courts in New Zealand 19 Scholarship surrounding mental health nursing within court and prison settings ... 20 Section two: Progression of forensic mental health nursing 26 Key concepts drawn from forensic mental health nursing scholarship 29 Educational preparation for forensic mental health nursing 29 Standards and competencies 31 Forensic mental health nursing and role ambiguity 32 Consent and information sharing in a multiagency context 34 Lack of professional support 34 Cultural awareness in the criminal justice sector 35

An exploration of the role of the court liaison nurse within the New Zealand criminal courts

This paper begins with a brief review of recent literature about relationships between offending behaviour and mental illness, classifying studies by the settings within which they occurred. The establishment and role of a mental health court liaison (MHCL) service is then described, together with findings from a 3-year service audit, including an examination of relationships between clients’ characteristics and offence profiles, and comparisons with regional offence data. During the audit period, 971 clients (767 males, 204 females) were referred to the service, comprising 1139 service episodes, 35.5% of which involved a comorbid substance use diagnosis. The pattern of offences for MHCL clients was reasonably similar to the regional offence data, except that among MHCL clients there were proportionately more offences against justice procedures (e.g., breaches of apprehended violence orders [AVOs]) and fewer driving offences and “other offences”. Additionally, male MHCL clients had proportionately more malicious damage and robbery offences and lower rates of offensive behaviour and drug offences. A range of service and research issues is also discussed. Overall, the new service appears to have forged more effective links between the mental health and criminal justice systems.

Offending behaviour and mental illness : characteristics of a mental health court liaison service

This paper describes the socio-demographic and clinical characteristics of a sample of criminal defendants who were referred to the Court Liaison Service for psychiatric screening Data has been extracted from the records of the Court Liaison Service and the psychiatric reports prepared for the courts Most defendants were male, Pakeha, and facing serious charges They had high rates of both previous psychiatric contact and criminal conviction Defendants who received the usual correctional sanctions are compared with those who were admitted to a psychiatric hospital as an outcome of their court appearance More defendants who received correctional sanctions were referred because of concerns about dangerousness and they had high rates of depression Most defendants who were hospitalised had diagnoses of schizophrenia or bipolar affective disorder There are four ways in which criminal defendants can be compulsorily hospitalised due to a mental disorder in New Zealand Each of these options has distinctly different theoretical justifications, historical origins and developments over time They functionally lead however to the same outcome for the defendant who becomes compulsorily confined in a psychiatric hospital The admission criteria do not directly equate with any diagnostic classification The legal standard for insanity, based on the McNaughten rules, requires the presence of `natural imbecility or disease of the mind' that impacts on the person's understanding of the nature or quality of the act or that it was morally wrong (section 23(2) Crimes Act, 1961) While there are definitional issues, disability in New Zealand equates with fitness to plead in other jurisdictions It necessitates mental disorder that interferes with the defendant's ability to plead, to understand the court proceedings or to communicate with counsel (section 108 Criminal Justice Act, 1985) A defendant convicted of a criminal offence can be sentenced to a psychiatric hospital if the court is satisfied that the person is mentally disordered and that detention in a hospital is necessary for the safety of the public or is in the defendant's own interests (section 118 Criminal Justice Act, 1985) When a defendant faces charges that are not serious, there may be negotiation which results in the police prosecutor agreeing to drop charges and proceedings being commenced under the Mental Health (Compulsory Assessment and Treatment) Act, 1992 International studies of the characteristics of criminal defendants who receive a psychiatric disposition have often employed samples of either insanity acquittees or those found unfit to plea or both There are differences in legal standards and in the consequences of these findings across jurisdictions which makes comparisons difficult Approximately 10% of American criminal defendants who receive a psychiatric disposition are female, (Callahan, Steadman, McGreevy, & Robbins, 1991; Zonana, Bartel, Wells, Buchanan, & Getz, 1990) Most studies have found that these defendants are older than other criminal defendants and prison populations (Jeffrey, Pasewark, & Bieber, 1988; Pasewark, Jeffrey, & Bieber, 1987; Rice & Harris, 1990) Generally no association has been found between the race of the defendant and an adjudication of insanity (Callahan et al, 1991; Pasewark et al, 1987); however a meta-analytic review found that members of minority ethnic groups were more likely to be judged incompetent (Nicholson & Kugler, 1991) Marital status does not discriminate between insanity acquittees and comparison groups (Pasewark et al, 1987) Most acquittees are unemployed (Boehnert, 1988; Jeffrey et al, 1988; Pasewark et al, 1987) and employment is less frequent than in comparison groups (Rice & Harris, 1990) Over 70% of defendants who receive a psychiatric disposition have been previously arrested (Jeffrey et al, 1988; Pasewark et al, 1987) Some researchers have found that many insanity acquittees faced charges for minor nonviolent and nuisance offences (Boehnert 1988; Golding, Eaves, & Kowaz, 1989) …

Joan M. Roberts

Papers

Characteristics of Criminal Defendants Referred for Psychiatric Evaluation