Liaison and Diversion Services Can Help Vulnerable People in the Criminal Justice System at a Time of Crisis and May Halve Custodial Sentences

New research shows that an NHS England programme aimed at supporting vulnerable people in the criminal justice system may significantly reduce the chances of those with mental and other health needs from receiving custodial sentences.

Researchers conducting the independent evaluation of the national Liaison and Diversion (L&D) scheme found that the likelihood of people receiving a custodial sentence after involvement with L&D services was almost half of that of a control group.

The L&D programme is run primarily in police custody suites and courts in England. Expert health practitioners screen detainees and those appearing before the courts to identify a wide range of vulnerabilities, such as mental health issues and learning disabilities. When these needs are known about, people can be referred to appropriate services for treatment or support, and this information can be taken into account in the criminal justice process.

Researchers from RAND Europe, a not-for-profit research organisation, evaluated L&D services using a novel, interlinked health and criminal justice data set from over 8,000 individuals who used L&D services in 2017. Using data from different public services meant the study could assess the impact of L&D services on Accident & Emergency (A&E) attendances, referrals to mental health or drug and alcohol treatment services, court processes, and other situations.

Nadine Dorries MP, Minister for Patient Safety, Suicide Prevention and Mental Health, states: “This evidence shows Liaison and Diversion services are working and helping the most vulnerable people in the criminal justice system. They are identifying people with problems like substance misuse and mental health issues, referring them into suitable services and diverting them away from the justice system when appropriate.

“The programme is an exemplar of strong partnership working across government departments, arms-length bodies and those delivering services locally and has now achieved 100% coverage across England. This research will be invaluable as we consider potential opportunities to further improve this successful model.”

Minister for Prisons and Probation, Alex Chalk MP, states: “It is absolutely vital that vulnerable offenders get the professional help their conditions often require, and it's clear the Liaison and Diversion Scheme is doing just that. Ensuring these people get the right support at the right time will not only address the underlying causes of their offending but could help prevent future victims too.”

“The study findings show that L&D services successfully engage with a group of people with a broad range of vulnerabilities, often at a time of acute crisis when they are most in need of support,” said Emma Disley, the study's lead author and a research group director at RAND Europe. “Having these L&D services can provide a route to better support or care and may reduce the proportion of offences resulting in custodial sentences and thus increase diversion from the criminal justice system.”

Overall, 88% of people referred to L&D services had at least one vulnerability identified. Almost three-quarters, 71%, of those referred had a mental health need, and just over half, 52%, experienced drug or alcohol misuse.

The six to 12-month period prior to L&D referral is often characterised by a steep increase in contact with Accident & Emergency (A&E) services, specialist mental health services, and declining self-reported health in those attending drug treatment services.

L&D services also appear to directly contribute savings of between £13.1 million and £41.5 million in the criminal justice system through diversion from custody and consequent increases in productivity.

“The major strength of this evaluation is the creation of the extensive, large-scale linked data set combining information from four healthcare sources and two criminal justice sources,” said study co-author and research leader, Katherine Morley. “This unique data set provided insights into people's contact with a range of services both before and after referral to a L&D service which could not have been reliably obtained in other ways.”

The National Institute for Health Research (NIHR) Policy Research Programme funded the research.

Other authors of the report, Outcome Evaluation of the National Model of Liaison and Diversion in England, are Catherine Saunders, Evangelos Gkousis, Shann Hulme, Jack Pollard, Alex Sutherland and Jon Sussex.

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Notes to Editors:

• To request a copy of the report or arrange an interview with one of the researchers on the project, contact Cat McShane on europeanmedia@rand.org or +44 (0) 1223 353 329 x2560.
• RAND Europe is a not-for-profit research organisation whose mission is to help improve policy and decision making through research and analysis.