In any society, problems abound whose histories contain all the hallmarks of a chronic condition; chronic because underlying causes were not searched out or, if they were, there was a failure adequately to tackle them. That failure may have stemmed from a view that the problem was small enough to live with, could be isolated, or was simply too difficult to contemplate. In varying degrees, it has been the lot of the mentally disturbed to suffer in this way.

Attitudes may be improving. Certainly there is no lack of attention drawn to the question of how and where to deliver proper levels of care. Increasingly, government policy points to this being in the community rather than in large Victorian psychiatric hospitals. The policy of care in the community has philosophical implications for society's response to mentally disordered people who commit offences. Perhaps more particularly, it may have - or indeed be having - important practical implications for the prison service. Medical journals are no strangers to articles purporting to show a causal link between the implementation of the care in the community policy and the number of mentally disordered offenders in prison.

The absence of hard proof of such a link does nothing to diminish the proper anxiety about the number of mentally disturbed people the courts sent to prison, and the provision which the prison service has thus far been able to provide. There will be few who quarrel with either strand of the government's policy, which first looks to the diversion of such people from the criminal justice system (Home Office, 1990<z); and, where custody is deemed to be in the public interest, expects an appropriate level of support to be provided for them from within the prison system. There is much scope for the development of responses to both.

Many openings short of custody exist for dealing with mentally disordered offenders. The police may apply a caution and may themselves - perhaps in conjunction with the social services - arrange admission to hospital or help in the community. The courts have available a wide range of non-custodial disposals. They can remand on bail with a condition of residence at a psychiatric hospital or bail hostel. They can remand direct to hospital for psychiatric reports.