Lord Bradley’s review of mental health and learning disabilities in the criminal justice system was published last month. Fourteen months in the making, the report that emerged did not disappoint.

It acknowledged that too many people with a wide range of mental health problems are being imprisoned in this country. And it set out a comprehensive and ambitious plan to change the way these people are treated by the health, social care and criminal justice services.

The keystone of the report was the plan for criminal justice mental health teams to be set up in every locality in England. These would be a vast improvement on the patchy provision of diversion schemes we currently rely on. To achieve this, Lord Bradley recommended that the Department of Health mandates these teams in the next NHS operating framework.

Lord Bradley also called for all prison hospital transfers to be completed within 14 days. It is unacceptable that many prisoners wait for months to go to hospital when they are acutely unwell. But to achieve this change we are going to have to explore better ways of using medium secure, low secure and step-down forensic facilities to overcome the long waits for beds and to tackle the long stays many patients are experiencing in hospital.

Call to action

The report makes many other recommendations for improvements in the way people with mental health problems and people with learning disabilities are managed in the criminal justice system. These include a call for the teams to identify individuals with mental health problems in police stations and empower the teams to divert these people to more appropriate places of treatment. This is absolutely vital. Opportunities to identify such individuals are being missed daily and even when they are identified, the diversion teams often either lack the power to admit people for treatment or they do not ensure referrals to community teams are followed up and contact is sustained.

If Lord Bradley’s report is implemented in full, it could make a substantial difference to many thousands of marginalised and disadvantaged people’s lives. Not to mention that where diversion is done appropriately, it can also cut costs in the criminal justice system, such as by avoiding the unnecessary use of remand for long periods, and reduce rates of reoffending.

The key issue we face in 2009 is whether it can be put into action in the midst of recession, with major squeezes in public spending looming. The simple answer to that should be, can we afford not to?

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