The Namibian

The following opinion piece appeared in the Namibian newspaper on 12th April 2016.  It follows the Namibian Correctional Service re-running training on mental health for their staff after the pilot programme I ran in Namibia during 2015.  It was slightly edited by the newspaper as these things are, here is the full version –

The first step towards solving a problem is recognising that you have a problem in the first place, it is said. Many societies don’t see open discussion about mental health issues or understand the extent to which people with disabilities are affected by their criminal justice systems. Mental illness can still be a taboo subject in some parts of the world and those of us living with mental illnesses, neuro-psychological disorders and intellectual disabilities still find themselves stigmatised, marginalised and criminalised because of their problems. We know that people with mental health problems all over the world are disproportionately represented at all stages of the criminal justice system (CJS) and that this problem is not just about the availability of healthcare.

The United Kingdom may well be a G8, so-called first-world economy but a high proportion of those who are imprisoned there – well over three quarters – are diagnosed with one or more mental disorders and most CJ professionals will remark on the difficulty of ensuring support for them by mental health agencies. All countries need to appreciate the extent to which vulnerable people, already marginalised by their disability, are then doubly stigmatised by police and prison systems. But where they are, CJS agencies need to avoid compounding that and are well placed to do so.

It was the highlight of my career so far to visit Namibia in November 2015 and to train Corrections and Police officers. I learned more than anyone else and it kept striking me again and again: we’re all struggling with the same issues – how do we improve identification of vulnerable people amongst all those we meet? When we do, how do we improve the quality of the response by making reasonable adjustments for disabilities? How can we work best in partnership with whatever mental health and social care services we have available minimise the negative impacts upon mentally ill suspects and prisoners to maximise the chance of rehabilitation and recovery?

We need to breakdown some myths –

  • Most people with a mental health condition in conflict with the law have not offended as a direct result of their condition. Research suggests fewer than 10% of mentally disordered offenders (MDOs) would be found insane – this is a legal, not a medical term: it differentiates MDOs who did not know what they were doing from those who did. That said, it may well be in the broader interests of the public that vulnerable people are not unnecessarily criminalised, except where this protects the public.
  • The second myth is that the ideal response to mentally disordered offenders is hospitalisation for mental health treatment. Psychiatrists and psychologists sometimes talk about ‘therapeutic jurisprudence’ and the importance of social boundaries on acceptable behaviour. In other words, it may be the right response to punish and deter through sentencing and then focus is then on rehabilitation and recovery as with every other convicted criminal.

What does this mean for Namibia’s police and Corrections services? Firstly, those police officers working hard 24/7 to us safe should not view vulnerable people with mental health problems as an inconvenient problem who are solely the responsibility of mental health services. These issues are “core police business” to quote Lord ADEBOWALE’s major UK report (2013) on policing and mental health. There are vulnerable people all over the world alive today because a police officer handled a difficult situation appropriately when someone in crisis was threatening to harm themselves, or less often, others. It means that Police and Corrections officers have a role to play in keeping people safe on remand and after sentencing even where they are SPD prisoners intended to be cared for in a hospital. They can still make a positive difference to safety and wellbeing from the way in which they risk assess, monitor and react to individuals as professionals – senior leaders across the CJS have a responsibility to ensure their organisations are ready for this: a point Namibia has already reached, putting them well ahead of the game in Africa.

Both Namibia and the UK are signatories to the United Nations Convention on the Rights of Persons with Disabilities and one area where mental health and criminal justice agencies share common ground is that they have a lot of contact with vulnerable people and a shared interested in keeping people and society safe. There must be a shared approach to the overlapping areas of responsibility, but there is no reason why improving partnerships in the local context can’t be led by the CJS and the Namibian Correctional Service has done exactly that by reusing the training materials we developed last year to roll out further training to staff in 2016 on this most important of topics: there’s no health at all without mental health.

IMG_0053IMG_0052Awarded the President’s Medal by
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award.

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