Liaison and Diversion: Meeting the Concordat Challenge Dr Vicky Hancock Coventry and Warwickshire Partnership NHS Trust

People in contact with the criminal justice system are at higher risk of suicide than the general population Prevalence rates for personality disorder, psychosis, attention disorders, post-traumatic stress disorder (PTSD) and self-harm are notably higher than in the general population. Learning disability is more common in young people in custody; a prevalence of 23-32%, compared to 2-4% of the general population Almost 50% of adult prisoners suffer from anxiety and/or depression compared with 15% of the general population Prevalence of any personality disorder was 78% for male remand prisoners, 64% for male sentenced and 50% for all female sentenced prisoners Mental Health and Criminal Justice

‘ Liaison and Diversion (L&D) services are intended to improve the health and criminal justice outcomes for children, young people and adults who come into contact with the criminal justice system, where a range of complex needs are identified as factors in their offending behaviour. Liaison and diversion services should ensure that these individuals can access appropriate interventions, in order to reduce health inequalities, improve physical and mental health, tackle offending behaviours including substance misuse, reduce crime and re- offending, and increase the efficiency and effectiveness of the criminal justice system.’ What is Liaison and Diversion?

Service Model

Background of Liaison and Diversion Outline Business Case Approved by HM Government in partnership with NHS England, Ministry of Justice, Home Office, Department of Heath, Youth Justice Board, Public Health England, HM Courts and Tribunals Service £25 million investment 10 National Trial Sites National Operating Model Initial 12 month trial with a commitment to 24 month Further trial sites to be identified to be in operation for April 2015 Development of Full Business Case by late 2015

Future of Liaison and Diversion

Why focus on offenders and those in contact with the Criminal Justice system? Mental Health has led to offending Offence is a trigger for crisis Increase in stress related to offence/arrest/court may be trigger for relapse of ongoing mental health issue Unmet need Criminal Justice and Crisis

Early Intervention – Referrals from neighbourhood, response and specialist teams – Benefits for individual and system Urgent and Emergency Access to Crisis Care – Skills and Training – Information Sharing Recovery – Substance Misuse – Ongoing contact with Criminal Justice Specific Care Concordat Principles

Challenges – Cultures – Understanding of Roles and Responsibilities – Information Sharing Lessons Learned – Build relationships – Be honest about mistakes Working Together

Case Examples Joint training Safer Services Co-location – Communication – Skills, Knowledge and Understanding Effective Partnerships