Skip to main content Accessibility help
×
Home

Offenders with mental disorders in prison and the courts: links to rates of civil detentions and the number of psychiatric beds in England – longitudinal data from 1984 to 2016

  • Patrick Keown (a1), Dannielle McKenna (a2), Hannah Murphy (a2) and Iain McKinnon (a3)

Abstract

Background

The Mental Health Act in England and Wales allows for two types of detention in hospital: civil and forensic detentions. An association between the closure of mental illness beds and a rise in civil detentions has been reported.

Aims

To examine changes in the rate of court orders and transfer from prison to hospital for treatment, and explore associations with civil involuntary detentions, psychiatric bed numbers and the prison population.

Method

Secondary analysis of routinely collected data with lagged time series analysis. We focused on two main types of forensic detentions in National Health Service (NHS) hospitals and private units: prison transfers and court treatment orders in England from 1984 to 2016. NHS bed numbers only were available.

Results

There was an association between the number of psychiatric beds and the number of prison transfers. This was strongest at a time lag of 2 years with the change in psychiatric beds occurring first. There was an association between the rate of civil detentions and the rate of court orders. This was strongest at a time lag of 3 years. Linear regression indicated that 135 fewer psychiatric beds were associated with one additional transfer from prison to hospital; and as the rate of civil detentions increased by 72, the rate of court treatment orders fell by one.

Conclusions

The closure of psychiatric beds was associated with an increase in transfers from prison to hospital for treatment. The increase in civil detentions was associated with a reduction in the rate of courts detaining to hospital individuals who had offended.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Offenders with mental disorders in prison and the courts: links to rates of civil detentions and the number of psychiatric beds in England – longitudinal data from 1984 to 2016
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Offenders with mental disorders in prison and the courts: links to rates of civil detentions and the number of psychiatric beds in England – longitudinal data from 1984 to 2016
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Offenders with mental disorders in prison and the courts: links to rates of civil detentions and the number of psychiatric beds in England – longitudinal data from 1984 to 2016
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-ncnd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

Corresponding author

Correspondence: Patrick Keown, Hopewood Park, Waterworks Road, Ryhope, Sunderland SR2 0NB, UK. Email patrick.keown@ntw.nhs.uk

References

Hide All
1Turner, T, Salter, M. Forensic psychiatry and general psychiatry: re-examining the relationship. Psychiatrist 2008; 32: 26.
2Committee B. Report of the Committee on Mentally Abnormal Offenders. TSO, 1975.
3Gunn, J. Management of the Mentally Abnormal Offender: Management of the Mentally Abnormal Offender: Integrated or Parallel. SAGE Publications, 1977.
4Sturge, G. UK Prison Population Statistics. House of Commons Library, 2018(https://researchbriefings.parliament.uk/ResearchBriefing/Summary/SN04334).
5Prison Reform Trust. The Woolf Report: A Summary of the Main Findings and Recommendations of the Inquiry into Prison Disturbances. Prison Reform Trust, 1991.
6Reed, J. Reed report on mentally disordered offenders. Br Med J 1992; 305: 1448.
7Bradley, KJCB. The Bradley Report: Lord Bradley's Review of People with Mental Health Problems or Learning Disabilities in the Criminal Justice System. Department of Health London, 2009.
8Department of Health. Mental Health Act 1983. Chapter 20. HM Stationery Office, 1983.
9Keown, P, Murphy, H, McKenna, D, McKinnon, I. Changes in the use of the Mental Health Act 1983 in England 1984/85 to 2015/16. Br J Psychiatry 2018; 213: 595–9.
10Keown, P, Weich, S, Bhui, KS, Scott, J. Association between provision of mental illness beds and rate of involuntary admissions in the NHS in England 1988–2008: ecological study. BMJ 2011; 343: d3736.
11Department of Health. In-patients formally detained in hospitals under the Mental Health Act 1983 and other legislation, England: summary statistics. Department of Health, 2009 Available from: (http://webarchive.nationalarchives.gov.uk/20120907182256/http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/StatisticalWorkAreas/Statisticalhealthcare/DH_4086494).
12Data and Publications NHS Digital. Inpatients Formally Detained in Hospitals under the Mental Health Act and Patients Subject to Supervised Community Treatment. NHS Digital series/collection, 2016 (https://digital.nhs.uk/data-and-information/publications/statistical/inpatients-formally-detained-in-hospitals-under-the-mental-health-act-1983-and-patients-subject-to-supervised-community-treatment).
13IBM. SPSS Statistics for Windows (Version 24). IBM, 2016.
14Fazel, S, Singh, JP, Doll, H, Grann, M. Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis. BMJ 2012; 345: e4692.
15Care Quality Commission. Mental Health Rehabilitation Inpatient Services. Care Quality Commission, 2018 (https://www.cqc.org.uk/publications/themed-work/briefing-%E2%80%93-mental-health-rehabilitation-inpatient-services).
16Department of Health. The Care Programme Approach for People with Mental Illness Referred to Specialist Psychiatric Services. Department of Health, 1990.
17Ritchie, JH, Dick, D, Lingham, R. The Report of the Inquiry into the Care and Treatment of Christopher Clunis. HM Stationery Office, 1994.
18Department of Health. The NHS Plan: A Plan for Investment, a Plan for Reform. The Stationery Office, 2000.
19Department of Health and Social Care. Independent Review of the Mental Health Act 2017. Department of Health and Social Care, 2018 (https://www.gov.uk/government/groups/independent-review-of-the-mental-health-act).
20Tyrer, P. Has the closure of psychiatric beds gone too far? Yes. BMJ 2011; 343: d7457.
21Leff, J, Trieman, N, Knapp, M, Hallam, A. The TAPS project: a report on 13 years of research, 1985–1998. Psychiatr Bull 2000; 24: 165–8.

Keywords

Type Description Title
WORD
Supplementary materials

Keown et al. supplementary material
Table S1

 Word (20 KB)
20 KB

Offenders with mental disorders in prison and the courts: links to rates of civil detentions and the number of psychiatric beds in England – longitudinal data from 1984 to 2016

  • Patrick Keown (a1), Dannielle McKenna (a2), Hannah Murphy (a2) and Iain McKinnon (a3)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Offenders with mental disorders in prison and the courts: links to rates of civil detentions and the number of psychiatric beds in England – longitudinal data from 1984 to 2016

  • Patrick Keown (a1), Dannielle McKenna (a2), Hannah Murphy (a2) and Iain McKinnon (a3)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *