How good practice guidance improved the commissioning of psychiatric reports
Researchers in LJMU’s School of Law produced the first and only official guidance for the production of psychiatric reports for sentencing in England and Wales endorsed by Her Majesty’s Court Service. Implementation of the guidance has had a positive impact on communication between health services and local courts and in the training of staff in these organisations.
A report by Lord Bradley in 2009 estimated that between 2 and 20% of all suspects passing through police stations in England and Wales had a mental health disorder. According to the Mental Health Foundation, more than 70% of the prison population in England and Wales has two or more mental health disorders.
Where a court is considering sentencing for a defendant who may have a mental health disorder, they may seek additional expert advice by commissioning a psychiatric report. In 2010, researchers from the LJMU School of Law secured funding from the Ministry of Justice to produce the first official guidance on psychiatric reports for sentencing in England and Wales.
Prior to the existence of the guidance, two common issues were highlighted. Firstly, reports often lacked focus or were ‘all purpose’ reports which didn’t respond to the specific needs of the commissioner. Secondly, psychiatric reports used to be written in a specialist clinical language which was not always accessible to a non-psychiatrist.
The ‘action’ research approach used by the LJMU research team included a review of the current practice and procedures for writing and commissioning psychiatric reports and the development of the initial guidance which was then tested in practice and revised to produce the final guidance.
The involvement of professionals from across the sector was fundamental to the research process and included NHS Trusts, psychiatrists, court staff, members of the judiciary and legal representatives.
The guidance covered the commissioning process; the administration of reports (including a pro forma for letters of instruction to ensure sentencers’ requests for reports gave a clear steer to the psychiatrist); and production of reports (including a report template to ensure an appropriate structure is followed).
The guidance was endorsed by the Ministry of Justice, Her Majesty’s Court Service (HMSC), the Department of Health, the faculty of Forensic Psychiatry at the Royal College of Psychiatrists. HMCS incorporated the guidance into manuals for magistrates and crown court judges. The guidance was also used as the basis for establishing a single point of access to psychiatric services in South London. It is used in training programmes for court liaison teams and in the training of trainee forensic psychiatrists. Clinicians at one of the UK’s largest mental health charities receive the guidance in preparation for their role as expert witnesses.
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