Manchester Offenders: Diversion Engagement and Liaison (MO:DEL)

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Manchester Offenders Diversion
Engagementand Liaison (MODEL)
Chris Martin Butler Trust Workshop September 2013

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WHO ARE WE?

• NHS funded mental health team
• Work across CJS
• Focus is improving health and social care
  outcomes
• Service developed from Pilot project, Bradley
  Report recommendations

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MODEL

• Manchester - Cover city of Manchester
• Offenders - In contact with CJS
• Diversion Police diversion, Diversion panels,
  Magistrates Court diversion
• Engagement - Case management (brief intervention)
• Liaison - Advice, navigation, access

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Who can ACCESS MODEL?

• Residents of Manchester, including NFA who
  consider themselves Manchester residents
• 16
• Currently involved in CJS
• Diagnosed or probable diagnosis of mental
  disorder
• Complex co-morbidities e.g. personality disorder,
  homelessness, substance misuse
• History of exclusion from services/poor engagement

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Aims of the Service

• Provide inclusive service to client group,
  targeting those who would otherwise be excluded
• Work within Recovery Model to support and
  encourage clients back into mainstream services
• Reduce criminal activity by addressing underlying
  mental health issues
• Improve clients mental health
• Assess and reduce risk to self and others
• Support clients to make significant lifestyle
  changes breaking the cycle of offending behaviour

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MODEL Team Structure

• Clinical Lead
• Administrator
• Mental Health Nurses
• Mental Health Social Worker
• Consultant Psychiatrist (x 0.1)
• Adjunct recovery service (personal recovery) led
  by Probation Officer

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Vision Philosophy

• To promote equality of access to the Health and
  Social Care Services to which mentally disordered
  offenders are entitled.
• We promote equivalence by providing equitable
  access to Health and Social Care Agencies,
  working within a socially inclusive framework.
  We facilitate multi-agency working to bridge the
  gaps between Mental Health, Criminal Justice and
  Social Care Agencies.
• We are flexible to meeting the multiple needs of
  the service user, balancing the recovery goals of
  the individual and the need to reduce risk to
  self and others. We apply best evidenced
  practice sharing a culture of lifelong learning,
  education and research.

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What we do

• Mental health assessment and intervention
• Risk assessment
• Case management - up to 6 months
• Facilitate access to mainstream mental health
  services
• Mental health screening at Court
• Engagement Services in Police Custody Cells
• Facilitating Mental Health Activity Requirement
  for Probation Service
• Engage with Targetted Services Court

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CASE STUDY - DIVERSION

• Client A 38 yr old female
• Arrested for Public Order Act Offence
• Concerns around mental health, safeguarding of
  children
• Arrest/assessment made more difficult by language
  barrier
• Arranged assessment/interpreter
• Charge held until assessment had been completed
• Longer term referrals completed, Criminal Justice
  action ceased

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Case Study ENGAGEMENT/RECOVERY

• Client B - 48 year old male
• Referred by drugs worker.
• Referral reason - low mood, hearing voices, panic
  attacks and memory loss. Client A had additional
  substance misuse needs and was on a Methadone
  prescription
• Following assessment, client was referred to
• Bereavement Counselling
• CMHT
• HOPE

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Clients areas of need

• Social isolation/institutionalised (7 years
  prison)
• Long history of substance misuse (heroin)
• Difficulty in engaging with healthcare
  professionals i.e. G.P
• Unresolved bereavement and grief (mother)
• Supporting responsibilities with caring for pets
  (budgie)
• Low Mood/Depression
• Hearing Voices
• Dental problems (contributing factor to clients
  low self esteem)

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Intervention

• The focus was on encouraging Client B to attend
  appointments, build a daily structure, develop
  caring responsibilities, build a social network
  and to improve clients health
• Supported client when attending GP, Dentist to
  obtain dentures and other additional appointments
• Supported client to maintain caring
  responsibility for pet by regularly visiting vet
• Supported client when attending his appointments
  at with drug services, and liaised with drugs
  worker
• Encouraged involvement with HOPE recovery service
  to improve social skills and to reduce social
  isolation
• During the intervention, Client B was referred
  and accepted to CMHT for longer term care
  coordination