National survey of current arrangements for diversion from custody in England and Wales.
OBJECTIVE
To assess the extent and nature of psychiatric assessment schemes based at magistrates' courts in England and Wales for the early diversion of mentally disordered offenders from custody and to determine the response of the NHS to new initiatives concerning alternatives to custody for this group.


METHODS
Postal survey of the probation service, petty sessional divisions, mental health provider units, and district purchasing authorities in England and Wales.


METHODS
All chief probation officers (n = 55), clerks to the justices (n = 284), managers of mental health provider units (n = 190), and purchasers of mental health services (n = 190) in each of the district health authorities.


METHODS
Number of psychiatric assessment schemes, practical difficulties in their operation, extent of regular liaison with health and social services; current and future intentions to purchase or provide services for diversion from custody.


RESULTS
Data were obtained from every magistrates' court. Forty eight psychiatric assessment schemes were identified with another 34 under development. Particular problems were lack of adequate transport arrangements, difficulties with hospital admissions, and overdependence on key people. There was little liaison between health, social services, and members of the criminal justice system. Twenty five of the 106 purchasers who responded had a policy dealing with diversion, and 39 had a scheme under development; 56 purchasers had no current or future plans about diversion. Sixty nine of the 150 providers who responded reported that diversion was included in their current or next business plan.


CONCLUSIONS
Schemes to divert mentally disordered offenders from the criminal justice system are often hampered by lack of adequate transport arrangements, difficulties in hospital admissions, and overdependence on key people.
Blumenthal
S
S
Department of Psychological Medicine, King's College Hospital School of Medicine, London.
Wessely
S
S
D003134:Commitment of Persons with Psychiatric Disorders; D003258:Consumer Behavior; D003416:Criminal Law; D005555:Forensic Psychiatry; D006291:Health Policy; D006801:Humans; D007400:Interprofessional Relations; D008605:Mental Health Services / Q000458:organization & administration*; D010343:Patient Admission; D010347:Patient Care Planning; D010360:Patient Transfer; D006113:United Kingdom