Only long-term work will succeed

It is approaching 10 years since the Reed review tried to
co-ordinate government policy for offenders with mental disorders.
Jointly commissioned by the Home Office and the Department of
Health, the review made more than 250 recommendations on how these
people should be treated and adopted several key
principles.¹

Today those principles are the cornerstones of good practice. Care
and attention are given to individuals’ needs, which, where
possible, are met in the community rather than in institutions.
Above all, there is a respect of individuals’ rights as citizens.

The Reed review set the ball rolling. It sparked off local
voluntary and public sector activity. Experimental schemes were set
up to look at ways to identify, assess and support people with
mental health problems who end up embroiled in the criminal justice
system.

In recent years, many organisations have generated a wealth of new
ideas and excellent pockets of good practice. There is now a high
level of agreement about what works for offenders with mental
health, substance misuse and housing problems.

But the principles of the Reed review will never be fully realised
until a national approach to providing a service to mentally
vulnerable offenders, including those with multiple needs, is
developed. If the lessons of the Reed review are truly to be
learned, the government must draw together all the experience of
recent years to develop a sustainable service.

So often the quest for help fails at the first hurdle. At the
crisis point of arrest or returning to the community from prison,
vulnerable offenders need access to front-line services such as GP
surgeries, social services and homeless persons’ units. Left to the
criminal justice system, offenders’ problems will only get
worse.

Court, police and prison staff also need to be involved, with
training and support to enable them to identify mentally vulnerable
people and to refer them directly to multi-disciplinary
teams.

For many individuals there are no immediate solutions. Services
will only achieve results if they can work with clients in the long
term. If preventive, community-based schemes were established
across the country by the time we reached the 20th anniversary of
the Reed review, real progress would have been made.

1 J Reed, Review of Health and Social Services for Mentally
Disordered Offenders and Others Requiring Similar Services, The
Stationery Office, 1994

Crispin Truman is director of mental health and criminal justice
charity Revolving Doors Agency