The thematic review of mental health in probation in England and Wales
| Author | Laura Buckley |
| DOI | http://doi.org/10.1177/20662203221144118 |
| Published date | 01 December 2022 |
| Date | 01 December 2022 |
| Subject Matter | Original Articles |
Original Article
European Journal of Probation
2022, Vol. 14(3) 263–281
© The Author(s) 2022
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/20662203221144118
journals.sagepub.com/home/ejp
The thematic review of mental
health in probation in England
and Wales
Laura Buckley
HM Inspectorate of Probation, Manchester, UK
Abstract
While the relationship between offending and mental health is complex, research findings
indicate that those in conflict with the law have higher levels of mental illness and need
than the general population. This article considers the findings of a joint thematic in-
spection of the criminal justice journey for individuals with mental health needs, with a
particular focus on the probation stage. Inspectors from across justice and health re-
viewed cases to establish the extent to which needs were identified and met. Interviews
were also undertaken with 67 individuals who had lived experience of mental illness while
in the criminal justice system. Findings are considered in relation to the identification of
mental health needs; the role of trauma; probation practitioners’skills, knowledge and
support; case management; and access to required services. This inspection led to
identified effective practice and key agencies agreeing to a number of actions in response
to inspectors’recommendations.
Keywords
Mental health, criminal justice, healthcare, probation, inspection, lived experience
Introduction
The relationship between offending and mental illness is complex (Brooker et al., 2012).
Due to data not being routinely gathered, it is not possible to make an accurate assessment
on the number of people in conflict with the law who have mental health needs. However,
evidence suggests that levels of mental illness amongst those in the criminal justice
system (CJS) are higher than in the general population.
Corresponding author:
Laura Buckley, HM Inspectorate of Probation, Civil Justice Centre, Manchester M3 3FX, UK.
Email: laura.buckley@hmiprobation.gov.uk
A recent study by Samele et al. (2021) which looked at a 2-week sample of people
entering custody in one South London police station (n= 134) noted that 29% had a
current mental illness, while 40% were believed to have had mental health needs at some
point in their life. Leese and Russell (2017) had similar findings where they reported that
more than a third of people entering police custody have some form of mental illness. An
evaluation of the Liaison and Diversion
1
(L&D) service (Disley et al., 2021) found that
72% of the almost 37,000 people referred had mental health needs, a fifth of whom had
two or more specific needs. In addition, 62% of the overall sample had previously utilised
mental health services. And for those individuals in prison, research has widely indicated
that levels of mental illness amongst this population are consistently higher than the
general population (National Audit Office, 2017), and indeed that over 90% of those
incarcerated may have at least one mental health need (NICE, 2017). In addition, the
prison environment itself can be a trigger for developing or exacerbating mental illness
(Schnittker et al., 2012).
Levels of mental health needs have also unsurprisingly been found to be high amongst
those individuals under probation supervision. A study from 2012 (Brooker et al., 2012)
found that in a random sample taken from one probation trust (n= 173), almost four in ten
had a current mental illness, whereas almost half had a past/lifetime mental health
condition. Similar levels of mental health need have been seen in HM Inspectorate of
Probation data. Findings from 2016–2017 inspection data (n= 1066) revealed that in
almost four in ten of the inspected cases, emotional well-being was a factor that the
inspector judged to be a priority for supporting an individual’s desistance
2
(HM
Inspectorate of Probation, 2019). Furthermore, unpublished analysis of HM Inspector-
ate of Probation data on more recent inspections (2018–2019) revealed that in just over a
third of cases (n= 3308), mental health was recorded by inspectors as a disability.
It is equally challenging in getting a true estimate of the levels of mental illness in the
general population to allow for comparison. However, to give an approximation, the
Adult Psychiatric Morbidity Survey 2014 (McManus et al., 2016) estimated that ap-
proximately one in six people report symptoms of common mental health problems,
around four per cent screen positive for post-traumatic stress disorder, three per cent for
personality disorders, two per cent screened positive for bipolar disorder and less than one
in a hundred for psychotic disorder.
The link with trauma
Although it is not possible to say with certainty why there is such a significant amount of
mental health need in the CJS, it should be borne in mind that high levels of trauma and
experiences of adversity have been found amongst people in conflict with the law. For
example, the Welsh Adverse Childhood Experience Study (Bellis et al., 2016), which
compared people with four or more of the listed incidences of childhood adversity
3
with
those who had none, found that those with multiple experiences of trauma were:
·fourteen times more likely to be a victim of violence in the last 12 months;
·fifteen times more likely to be a perpetrator of violence in the last 12 months; and
264 European Journal of Probation 14(3)
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