Primary Care Mental Health Treatment Requirements - PowerPoint Presentation

1. Primary Care Mental Health Treatment RequirementsNHS England and NHS ImprovementMignon French Mental Health Treatment Requirement (MHTR) Programme Manager Health and Justice Non Custodial Team. NHS England and NHS Improvement

2. Treatment requirements have been a sentencing option since being introduced in the Criminal Justice Act, 2003. Alcohol Treatment Requirements (ATRs)Drug Rehabilitation Requirements (DRRs)Mental Health Treatment Requirements (MHTRs)Despite high numbers of individuals with mental health and substance misuse issues, use of treatment requirements remains low. In 2019, only 4% of commenced requirements as part of a community order or suspended sentence order were DRRs, 3% ATRs and less than 1% MHTR.Partnership approach to increase the use of all three treatment requirements introduced in Oct 2017 Aims: reduce re-offending and use alternatives to short custodial sentences, directly addressing underlying mental health and substance misuse issues which contribute towards offending behaviour. Community Sentence Treatment Requirements

3. Primary Care Mental Health Treatment Requirement (PC MHTR)MHTRs are the least used Community Sentence Treatment Requirements (CSTRs) some reasons include: Clinical service availability and lack of dual diagnosis provisionClinical oversightLack of a clinical model/interventions for this complex vulnerable cohort of individuals Probation have reported:Increasing caseloads of individuals with high levels of complexitiesCustodial sentences for those who have underlying mental health/substance misuse issuesBreaching due to the underlying issues not being addressed. Improved partnership with substance misuse providers is vital to enable the sentencing to combined orders (MHTR/DRR, MHTR/ATR), if appropriate. The MHTR service will include an overseeing Clinical Lead who holds the requirement and provides clinical supervision. primary care practitioners assess the individual and provide the interventions. NHS England and NHS Improvement have developed the primary care (PC) MHTR model to directly address these issues. The model includes Evidence based clinical interventions and are inclusive for all individuals who meet the clinical criteria, including those with dual diagnosis/personality disorder/neurodiversity. Criteria for acceptance is based on the mental health assessments, offence (community order or higher threshold) and age.

4. A CSTR Site Pre-sentence (Court Duty Officer-CDO)Referral e.g. from CDO/Liaison & Diversion/Legal RepresentativeMHTR primary care trigger screen: Indicates high levels of psychological distress If guilty plea: MHTR assessment by MH Practitioner ATR/DRR screen by CDO or provider] If suitable for MHTR/DRR/ATR and client consents, clinical lead (MHTR) or substance misuse provider (ATR/DRR) contactedVerbal report from CDO for recommendation into Pre sentence report CDO makes recommendations to court Date for first appt agreed. Individualised care plan agreed with Providers, Client and Clinical Lead CDO assesses level of risk to self and othersSentenceCourt impose community order or SSO to include CSTR. Judiciary to check (if not already covered in PSR):- Individual has given consent- Clinical responsibility agreed- CSTR court review timetableTo be eligible individuals must:Enter a guilty plea or have been found guilty after trial18+ years oldConsentCharged with committing an offence which falls into Community or Suspended Sentence Order (SSO) Where possible, on the day sentencing is encouraged – 80% of CSTRs sentenced on day in Programme sitesMental Health Treatment requirements (MHTR):Primary care and secondary careAny MH issues and personality disorder problemsRange of evidence-based screening tools and assessments used throughout the process, depending on the specific site and individual in question.DRR= Drug Rehabilitation Requirement ATR= Alcohol Treatment Requirements

5. Thank youmignon.french@nhs.netNHS England and NHS Improvement