Search Results

You are looking at 1 - 10 of 102 items for

  • Author or Editor: Sharon Morley x
Clear All Modify Search

Within the domains of criminal justice and mental health care, critical debate concerning ‘care’ versus ‘control’ and ‘therapy’ versus ‘security’ is now commonplace. Indeed, the ‘hybridisation’ of these areas is now a familiar theme.

This unique and topical text provides an array of expert analyses from key contributors in the field that explore the interface between criminal justice and mental health. Using concise yet robust definitions of key terms and concepts, it consolidates scholarly analysis of theory, policy and practice. Readers are provided with practical debates, in addition to the theoretical and ideological concerns surrounding the risk assessment, treatment, control and risk management in a cross-disciplinary context.

Included in this book is recommended further reading and an index of legislation, making it an ideal resource for students at undergraduate and postgraduate level, together with researchers and practitioners in the field.

Restricted access

Actuarialism, broadly, is the use of calculation in the prediction and estimation of behaviours in relation to risk. The categorisation of ‘risky’ populations facilitates the management of these groups.

Actuarial practices have been observed to pervade numerous aspects of the management of offender populations. With its links to the ‘new penology’ (Feeley and Simon, 1992), actuarialism seeks to find resolution of the management of deviant populations and, importantly, the ‘risks’ that they pose. The principles of actuarialism are observable within a variety of criminal justice agencies operating with common interests in offender management. Risk assessments and clinical risk assessments produce categories and diagnoses. Once applied, these aggregated labels prove valuable to the criminal justice process as particular systems, facilities and approaches are delivered in response to risk thresholds.

Actuarial practices are increasingly prevalent in line with the economic imperatives placed on criminal justice agencies. The systematic placement of individuals into groups judged on their perceived risk to self or others fulfils the requirements of schemes that are ‘value for money’ and maintain adequate levels of public protection. In such circumstances, individualised rehabilitative imperatives are at risk of coming secondary to such priorities.

The deployment of an actuarial language has been seen to be the most progressive in areas of offender management. Probation services and those involved in the monitoring and assessment of offenders on community sentences and leaving custody are examples of those directly involved in the application of actuarial practices. However, actuarial practices can also be observed across other professions involved in the maintenance of public protection.

Restricted access

Battered Woman Syndrome (BWS) was first conceptualised in 1977 by Lenore Walker when submitting a research grant application to the United States National Institute of Mental Health (Walker, 1979). The resultant BWS research supported two key concepts – learned helplessness and the cycle theory of violence (Walker, 1979) – which are still used in domestic violence work today.

Learned helplessness theory suggested that human beings who consistently fail to control their environment eventually stop trying to do so (Seligman, 1975). Walker (1979) developed this concept by linking the continual abuse inflicted by a male partner to an unconscious acceptance in the female partner that the situation could not be changed, thus producing feelings of helplessness. She also noted that a previous history of abuse could facilitate this process. The cycle theory of violence indicated that tension built within the relationship, violence erupted at some point and then a period of reconciliation followed, before the tension built again. As the woman never knew when the violence would erupt, she lived in a constant state of anxiety, resulting in a number of psychological symptoms, later defined as a subset of post-traumatic stress disorder (Walker, 2009).

Walker (1979) argued that the presence of these factors could trigger a violent act from a woman towards her male partner due to her expectation of further physical abuse and heightened emotional state. Where this resulted in her partner’s serious injury or death, the courts were asked to consider it an act of self-defence resulting from BWS, even though this was not a recognised psychological condition.

Restricted access

Care in the community is the policy of relocating people with severe mental health problems, formerly styled ‘mental patients’, from mental hospitals to sites in the community. Although it has pre-war antecedents, and the closure of the Victorian lunatic asylum was heralded in 1960 by Health Minister Enoch Powell, the policy was formally adopted by the government only in the 1980s. The promotion of alternatives to authoritarian mental hospitals found widespread support among a disaffected post-war generation. In his seminal work Asylums (Goffman, 1961), US sociologist Erving Goffman captured the public mood with his portrayals of the degradations of asylum regimes. However, community care was soon being derided as a cover for cost-cutting measures. Amid headlines in tabloids (eg the Daily Mail and the Daily Mirror) such as ‘Freed mental patients kill two a month’ (Norris, 1997), a succession of cases involving former mental patients were flagged by the media, notably, the killing by Christopher Clunis of a stranger, Jonathan Zito, on the platform of a tube station. The ‘tube murder case’ was deployed as a symbol of the failings of community care policies (Hallam, 2002). The association between mental illness and violence was widely assumed and a person with mental illness who committed a violent act came to embody a fearful stereotype, even more so where black mentally disordered offenders were concerned.

In a climate increasingly governed by the politics of fear, the incoming Labour government announced sterner and more restrictive measures. ‘Community care has failed’, declared Health Minister Frank Dobson in 1998. Hereafter, concerns over risk took precedence, leading to the introduction of Community Treatment Orders (CTOs).

Restricted access

The Dangerous and Severe Personality Disorder (DSPD) programme was conceived in 1999 with the publication of Managing dangerous people with severe personality disorder (Home Office and Department of Health, 1999). The context for the document was the high-profile trial of Michael Stone in 1998 for the murders of Lin and Josie Russell, which had enflamed the debate about: the rights of the individual to freedom; the need for public protection; and the status of personality disorder within the Mental Health Act 1983. The government’s response was twofold: an attempt to introduce a new Mental Health Act, which led to amending the Mental Health Act in 2007; and the introduction of the DSPD programme.

Commissioning of services began in 2001. This included the establishment of four DSPD units to provide assessment and treatment to men identified as having a dangerous and severe personality disorder, and research into the assessment of treatment of this group. Two of the units were established in high-security hospitals (Broadmoor and Rampton) and two in prisons (Whitemoor and Falkland).

The term ‘dangerous and severe personality disorder’ is an administrative rather than a medical term; however, it was criticised for being a quasi-medical term that had been born in the Home Office (Gunn, 2000). This convergence between the Home Office and the psychiatric profession echoes some similarities to that described by Foucault (1978) in his account of psychiatry, in the 19th century, stepping in to resolve a paradox of: managing dangerousness; personal responsibility; and public protection.

The administrative process of the DSPD programme also came under criticism.

Restricted access

Emotional CPR (eCPR) is a public heath educational programme developed by the National Coalition for Mental Health Recovery (NCMHR) based in Washington, DC in the US. eCPR has similar aims to Mental Health First Aid, in that it trains members of the public to provide immediate care and support to those experiencing emotional and mental distress.

The NCMHR was formed in 2006 by people with lived experience of mental ill-health and has its roots in the mental health consumer/survivor movement of the 1970s. The core purpose of the NCMHR is to ensure that ‘mental health consumers/survivors play a major role in the development and implementation of mental health care and social policies at a state and national level’ (NCMHR, 2013a). This approach shares its underpinning principles with a number of other support approaches: emotional intelligence; suicide prevention; cultural attunement; the learning and experience of the provision of trauma care; and the provision of counselling following disasters (NCMHR, 2013b).

eCPR is designed to teach anyone to assist another person through an emotional crisis and regain a sense of hope and purpose in their lives. The ‘vast and compelling need’ for the general public to learn how to assist anyone experiencing an emotional crisis (NCMHR, 2013b) is underpinned by the belief that the experience of emotional crisis is universal and that sincerely offered, ‘heart-to-heart’ resuscitation provides the best assistance to those in crisis. In the same way that physical CPR sustains the heart until it begins to beat again, so emotional CPR sustains the emotional heart until the distressed individual can cope themselves or receive appropriate professional help.

Restricted access

The Fallon Inquiry, chaired by Peter Fallon QC, is the committee of inquiry into the Personality Disorder Unit (PDU), Ashworth Special Hospital in 1999. It was held in response to allegations made by a former patient of the PDU that: paedophile activity was taking place in the unit; there were financial irregularities; and pornography, drugs and alcohol were freely available to patients. The Inquiry found that there was evidence to support many of the allegations, including the grooming of a young child by a patient with a history of child sexual abuse.

The Fallon Report is the second Ashworth inquiry, the first being led by Louis Blom-Cooper in 1992. The Blom-Cooper Inquiry criticised Ashworth Hospital for being too security-focused, with institutionalised practices that were reminiscent of Goffman’s asylums (Goffman, 1961). The Fallon committee of inquiry reported that in response to the recommendations of the Blom-Cooper Report, Ashworth Hospital had become too liberal. Improvements made to address institutional practices were not tailored to specific client groups, and users with personality disorders were erroneously managed in the same way as those with a diagnosis of mental illness.

The Fallon Report had a significant impact on forensic mental health and penal systems, with new procedures established for child visiting, movement of service users to lower levels of security and the increase of physical and procedural security measures within high security. The Report recommended that the PDU at Ashworth Hospital should be closed. Personality disorder services at Ashworth Hospital were later closed and patients relocated. Other, wider-ranging recommendations that affected both health and penal systems were also made in the Report.

Restricted access

There are important links between mental health, gender and offending. Many people whose actions breach criminal laws have mental illnesses. For example, the World Health Organization (WHO) reports that around one quarter of the 2 million prisoners in Europe suffer from a significant mental disorder, and more suffer from common mental health problems, such as depression and anxiety (WHO, 2013).

Women are far less likely than men to commit crimes or to participate in the criminal justice system. Across the world, around 80% of offenders dealt with by the police are male. Men are also more likely than women offenders to be sentenced to imprisonment, comprising 95% of prisoners (Walmsley, 2012). At the same time, women in prison are far more likely than men to be diagnosed with a mental illness, reported to be up to 80% of women in prison in Europe (WHO, 2013).

While many prisoners have experienced traumatic abuse, relevant both to offending and to the development of mental illnesses, women prisoners are far more likely to have experienced sexual, mental and physical abuse, and around half have also been victims of domestic violence (WHO, 2013). This picture raises fundamental questions for the management of the criminal justice system. Important issues include: how mental illnesses lead to offending; whether there are better ways of managing mental illness in the community; and the extent to which imprisonment itself produces mental illnesses.

The link between mental illness, gender and crime is also, more symbolically, important in criminal law. Criminal law has historically tended to use mental illness as an explanation for violence by women.

Restricted access

In the UK, high-security hospitals are specialist psychiatric services within the National Health Service (NHS), providing care and treatment for individuals who have a mental disorder that is related to the risk of violence towards others. The National Health Service Act 2006 (as amended by the Health and Social Care Act 2012) places a duty on the secretary of state to ensure provision of services for individuals ‘who require treatment under conditions of high security on account of their dangerous, violent or criminal propensities’. Individuals meeting the criteria for admission are transferred for assessment and/or treatment either via the criminal justice system or other NHS services, such as medium-secure units, if they cannot be safely managed in conditions of lesser security. Thus, the purpose of high-security hospitals is to provide high-level, secure psychiatric care and treatment for mentally disordered offenders and those at risk of offending, while ensuring public protection.

Risk assessment, individual formulation and management of violence are key challenges for clinicians in any secure setting (see Logan and Johnstone, 2012). Therapeutic interventions aim to increase patients’ mental health awareness, promote recovery, reduce the risk of recidivism and alleviate symptoms of their mental disorder through multidisciplinary working.

Ashworth, Broadmoor and Rampton Hospitals are the three high-security psychiatric hospitals in England and Wales, with the state hospital, Carstairs, serving Scotland and Northern Ireland, operating under Scottish mental health legislation. The history of the provision of high-security psychiatric care in the UK can be traced back to the cases of James Hadfield in 1800 (see Stevens, 2013) and Daniel M’Naghten in 1843.

Restricted access

Independent Monitoring Boards (IMBs) are groups of independent, unpaid, lay people who have a statutory role in monitoring day-to-day life in their local custodial institution (whether public or contracted out), including ensuring the humane and just treatment of those held in custody. All prisons and immigration removal centres, and some short-term holding facilities at airports, have their own designated IMBs. Each board is usually made up of between 12 and 20 members selected from the local area.

Originally created by Queen Elizabeth I, the activities, responsibilities and composition of IMBs have evolved over time. Under the Prison Act 1898, Boards of Visitors were created for each of the convict prisons. Visiting Committees continued to operate in local prisons until 1971, when they were replaced by Boards of Visitors. For over 100 years, there was a stipulation that each Board of Visitors had to include at least two magistrates, but that requirement has now been abolished. Although, prior to 1992, Boards of Visitors held adjudicatory/disciplinary powers and responsibilities, the function of IMBs is now one of oversight and monitoring. Following the recommendations of the Lloyd Review (Home Office, 2001), they were renamed ‘Independent Monitoring Boards’, which reiterated their role in monitoring and oversight and removed confusion with the role and responsibilities of official Prison Visitors.

IMBs are required to meet at least once a month and, between meetings, at least one IMB member must carry out an inspection visit. These routine visits are usually organised on a rota basis. Subject to security issues, IMB members have unrestricted access to all prisoners and to all parts of the prison, at any time, and may interview any prisoner out of the sight and hearing of officers.

Restricted access