From custody to community: mental health and criminal justice in Northern Ireland

Every year, World Mental Health Day provides an opportunity to reflect on the state of mental health services globally. In Northern Ireland (NI), the intersection between mental health and the criminal justice system presents a range of complex issues. From custody to community, the journey for individuals with mental ill-health also highlights the challenges faced by those who work in the system.

Funding and access to services

A 2023 report by the Northern Ireland Audit Office, estimated the cost of mental ill-health in Northern Ireland at £3.4 billion annually. The availability of psychological therapies and access to services in times of mental health crisis is a key issue in NI. Figures from December 2023 show that just over 17,500 people were waiting for their first appointment for mental health services.

Meanwhile the work of the justice system is often complicated by having to provide mental health services to the public. There are a variety of complex health and social factors that may contribute to people coming into contact with the criminal justice system. This includes adverse childhood experiences, mental ill-health, substance abuse, homelessness and lack of employment opportunities. Some will not have been in contact with community health services before. Research shows funding for those services has failed to keep pace with the demand, resulting in people struggling to access appropriate care when they need it.

Strategies have been developed across Government Departments to address these issues. One example is the Improving Health within Criminal Justice Strategy and Action Plan 2019. This is a joint initiative by the Departments of Health and Justice, highlighting the interconnection between the areas. However, funding continues to present a barrier to the full implementation of this strategy and others.

Impact on police and prisons

Police Officers are responding to an increasing number of mental health-related incidents. The PSNI has warned that keeping pace with the level of demand is becoming increasingly challenging, particularly as their resourcing position has deteriorated in recent years. During the period of 1 January 2023 to 14 April 2023, the PSNI spent approximately 4,550 hours in hospitals with people in mental health crisis. Further work is currently ongoing to capture more data providing a fuller picture of the level of demand in this space.

In addition, the number of people in Northern Ireland’s prisons is increasing. Remand receptions increased by 17% in 2022/23, up from 2,722 in 2021/22 to 3,171 during 2022/23. This includes individuals charged with an offence where a Judge decides they should be detained in custody pending trial. Access to rehabilitation services is often limited for these prisoners as they have not been convicted of any offence. This is a particular issue for those later convicted and released due to ‘time served’ as they typically cannot access support. Barriers to accessing mental health services on completion of a short sentence can also hinder a person’s rehabilitation and resettlement into the community.

Are there any new solutions to the issues?

A growing area of focus is finding opportunities for greater collaborative working between health and justice for people in prisons.

Humberside Police developed an operational model known as ‘Right Care Right Person’ (RCRP) in 2020. This seeks to direct people with health-related issues to the most appropriate service instead of Police acting as the default first responder in certain cases. Before the introduction of RCRP, Humberside Police were deployed to an average of 1,566 incidents per month relating to issues such as concerns for welfare, mental health incidents or missing persons. As a result of implementing RCRP over a three-year period, Humberside Police saw average incidents per month reduce by 508 deployments, equating to 1,132 officer hours, allowing resources to be dedicated elsewhere.

This model is currently in the process of being implemented in Police Forces across England and Wales. However, charities have expressed concerns that NHS mental health crisis services have not been properly funded to be able to deal with added demand in some parts of England. The PSNI is exploring the rollout of the model over the next 12-18 months in Northern Ireland.

Trauma-informed approaches also offer further potential in this area. Developments have been motivated by evidence that traumatic experiences, particularly adverse childhood experiences, can increase the likelihood of people coming into contact with the criminal justice system. The Scottish Government published a trauma-informed framework for working with victims and witnesses in the justice system in 2023. In February 2024, a report from the Safeguarding Board and Queen’s University recommended that a Northern Ireland trauma-informed strategy, resource hub and training framework be established.

England and Wales also introduced the Offenders (Day of Release from Detention) Act 2023 which provides that offenders can only be released on working days that are not followed by a weekend or Bank Holiday. The idea behind this was to mitigate the risk of vulnerable prison-leavers, who may have a mental health or drug issue, from being released on a Friday and not having enough time to access vital services, like healthcare, and accommodation before services close at weekends.

Read the full paper to find out more. Go to NI Direct for information on mental health services and support available.