Editorial
| Date | 01 June 1996 |
| DOI | https://doi.org/10.1108/13619322199600011 |
| Published date | 01 June 1996 |
| Pages | 4-4 |
| Author | Helen Smith |
| Subject Matter | Health & social care |
Editorial
This issue addresses the complexity of
meeting needs associated with a mental
illness and offending behaviour: a challenge
to even the best services. Part of the difficulty is the
breadth of tertiary care, spanning special hospitals,
medium and low secure-units in both the statutory
and private sectors. Linking these services with
secondary-care mainstream and specialist forensic
services can cause a mesh of holes through which
people can — and do — fall.
Mike Lindsay reminds us that service responses
and labels may have changed over the years, but the
needs of highly-vulnerable people at risk of, or in
contact with, the criminal justice system, remain the
same. All groups of service-users have had to fight
against their invisibility within services, but mentally
disordered offenders even more so.
Despite this, care, rather than containment, does
work. Peter Oates, a patient in Broadmoor, describes
how he needed help which would not be forthcoming
in prison, although he clearly expresses his concerns
about the burgeoning bureaucracy that prevents staff/
patient contact. Simon Keyes, writing from a
voluntary-sector perspective, presents a powerful
reminder that people in this client group often
have multiple social problems. Concentrating only
on health problems will rarely be of much use to
individuals who may face enormous difficulties in
getting ordinary needs for adequate housing, welfare
benefits, access to a GP
,friends and so on, met.
It is now more widely recognised that people with
mental health problems increasingly come into
contact with the criminal justice system for minor
offences associated with obtaining food or shelter.
David Etherington describes how he diverts
people from police stations into mental health
services: an attempt to offer people a morerapidly-
responsive service than diversion from court. This
case study clearly demonstrates the value of projects
which seek to identify people in need of careat the
earliest possible stage. Martin Cherrett describes
how the Metropolitan Police are seeking to deal
with offenders or people detained by the police in
need of treatment. He highlights the potential scale
of the problem and draws attention to the need for
Appropriate Adults for people who, in London
alone, number about 10,000 per year with a recog-
nisable mental illness.
Jennifer McCabe, later in the Review,describes
the situation for women in special hospitals and
medium-secure units. The difficulties faced by
women having to cope in these overwhelmingly male
conditions and the evidence that few actually require
the level of security of these services, presents a clear
imperative for local services to treat and contain
women where they live, and for courts to recognise
the necessity of choosing local, low-security options.
Partof the difficulty in providing multi-agency
services to this sometimes challenging group of
clients, is the lack of inter/multi-agency training.
Dorothy Tonak describes some existing initiatives
but they arestill too few in number to bring about
aradical change in the care offered to people.
However, there are now Patient Councils in all
three special hospitals and the work of WISH has
bought women’s voices to the fore. Many services
are starting to get to grips with the complexity of
an adequate local service for mentally disordered
offenders. I hope the articles in this issue assist in
this task.
Therewill, perhaps, be a justifiable criticism that
many of the articles are London-based. This is partly
due to the prominence of this issue in the capital;
however, this is not to downplay the size of the
problem, or decry the excellent initiatives that exist
in other areas. The articles have been chosen for
their applicability elsewhere and it is hoped that,
despite a London bias in some of them, readers can
draw lessons and information for their own services.
A reminder that the next issue, in September
1996, is on the links between primarycareand
secondary mental health services.
EDITORIAL
Helen Smith
EDITOR
4 The Mental Health Review 1:2 ©Pavilion Publishing (Brighton) 1996
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