1. Manchester Offenders: Diversion Engagement and Liaison (MO:DEL) Chris Martin Butler Trust Workshop September 2013

2. WHO ARE WE?  NHS funded mental health team  Work across CJS  Focus is improving health and social care outcomes  Service developed from Pilot project, Bradley Report recommendations

3. MO:DEL M anchester - Cover city of Manchester O ffenders - In contact with CJS D iversion – Police diversion, Diversion panels, Magistrates Court diversion E ngagement - Case management (brief intervention) L iaison - Advice, navigation, access

4. Who can ACCESS MO:DEL?  Residents of Manchester, including NFA who consider themselves Manchester residents  16 +  Currently involved in CJS  Diagnosed or probable diagnosis of mental disorder  Complex co-morbidities e.g. personality disorder, homelessness, substance misuse  History of exclusion from services/poor engagement

5. Aims of the Service  Provide inclusive service to client group, targeting those who would otherwise be excluded  Work within “Recovery Model” to support and encourage clients back into mainstream services  Reduce criminal activity by addressing underlying mental health issues  Improve clients mental health  Assess and reduce risk to self and others  Support clients to make significant lifestyle changes breaking the cycle of offending behaviour

6. MO:DEL Team Structure Clinical Lead Administrator Mental Health Nurses Mental Health Social Worker Consultant Psychiatrist (x 0.1) Adjunct recovery service (personal recovery) led by Probation Officer

7. Vision & Philosophy  To promote equality of access to the Health and Social Care Services to which mentally disordered offenders are entitled.  We promote equivalence by providing equitable access to Health and Social Care Agencies, working within a socially inclusive framework. We facilitate multi-agency working to bridge the gaps between Mental Health, Criminal Justice and Social Care Agencies.  We are flexible to meeting the multiple needs of the service user, balancing the recovery goals of the individual and the need to reduce risk to self and others. We apply best evidenced practice sharing a culture of lifelong learning, education and research.

8. What we do  Mental health assessment and intervention  Risk assessment  Case management - up to 6 months  Facilitate access to mainstream mental health services  Mental health screening at Court  Engagement Services in Police Custody Cells  Facilitating “Mental Health Activity Requirement” for Probation Service  Engage with Targetted Services Court

9. CASE STUDY - DIVERSION  Client A – 38 yr old female  Arrested for Public Order Act Offence  Concerns around mental health, safeguarding of children  Arrest/assessment made more difficult by language barrier  Arranged assessment/interpreter  Charge held until assessment had been completed  Longer term referrals completed, Criminal Justice action ceased

10. Case Study – ENGAGEMENT/RECOVERY  Client B - 48 year old male  Referred by drugs worker.  Referral reason - low mood, hearing voices, panic attacks and memory loss. Client A had additional substance misuse needs and was on a Methadone prescription  Following assessment, client was referred to:  Bereavement Counselling  CMHT  HOPE

11. Client’s areas of need  Social isolation/institutionalised (7 years prison)  Long history of substance misuse (heroin)  Difficulty in engaging with healthcare professionals i.e. G.P  Unresolved bereavement and grief (mother)  Supporting responsibilities with caring for pets (budgie)  Low Mood/Depression  Hearing Voices  Dental problems (contributing factor to client’s low self esteem)

12. Intervention  The focus was on encouraging Client B to attend appointments, build a daily structure, develop caring responsibilities, build a social network and to improve clients health  Supported client when attending GP, Dentist to obtain dentures and other additional appointments  Supported client to maintain caring responsibility for pet by regularly visiting vet  Supported client when attending his appointments at with drug services, and liaised with drugs worker  Encouraged involvement with HOPE recovery service to improve social skills and to reduce social isolation  During the intervention, Client B was referred and accepted to CMHT for longer term care coordination