The Howard Journal Vol27 No 2. May 88 ISSN 026.5--5527

Problems of Police-Social Work Interaction: Some American Lessons

M I K E S T E P H E N S Lecturer in Social Administration, Department o f Social Sciences,

Loughborough University

Abstract: There are many examples of relationships between police officers and social workers being hindered by suspicion and hostility. The problem is often located at street andfieldworker levels where divergent operational philosophies, practices, and goals create misunderstandings and perpetuate stereotyped attitudes. However, in Madison, U.S.A., there is a crisis intervention scheme looking after the mentally disturbed, and diverting them from the criminal

justice system, that owes much of its success to close co-operation between the police and the scheme’s social workers. Essentially, that co-operation was achieved by identifying the police role as case-finders and by responding to the operational needs of patrol officers.

Much of the literature on police-social services relations argues (Holdaway 1983; Manning 1977; Thomas 1986) that whereas it is often the case that managers in both professions can work together in the formulation of policy, the problems arise when lower level employees have to implement that policy. As Holdaway (1986) highlights:

At the managerial level it would seem that optimism characterizes the formulation of policy. Pessimism takes over when the assumptions of the police occupational culture are considered as policy is implemented . . . Harmonious joint work seems unl ikely. . . (p. 158)

The problems of policy implementation are essentially twofold. First, there is the problem of policy being formulated ‘on high’, so to speak, without detailed reference to the operational needs of both police officers and social workers. Second, there often exists among street level and fieldwork personnel a mutual suspicion and hostility, which are barriers to successful policy implementation. As Schaffer ( 1980) points out:

Even good relationships at the top of the hierarchy can have little impact on the lower echelons where the difficulties of working together are of far greater importance. (p. 60)

The key to creating more harmonious relationships is to be able to break down mutual suspicion and hostility and to foster a better understanding of the occupational roles of each group. Sleigh (1981) argues that ‘for better understanding to occur there must be radical changes on both

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sides’ (p . 164). However, in most areas attempts to improve police-social worker relations have been rather piecemeal, insufficiently far-reaching, and not at all radical. For instance, Sleigh refers to experiments to increase the level of face-to-face contact between police and social workers at joint lectures and seminars, and also during short placements of police officers at social services departments (pp. 165-8). Useful as lectures and seminars may be, they are intermittent and from the police point of view they d o not reach many officers, and at times these forms of contact tend to be directed at police inspectors. Experiments with placements appear morc promising but few constabularies approach this issue with the commitment of the Devon and Cornwall police. Under John Alderson’s community policing initiatives when he was chief constable of Devon and Cornwall constabulary periodic placements were arranged for police officers and social workers in each other’s agencies. Moore and Brown (1981) argue that these placements helped to break down the various myths that the police and social workers had about each other’s work, and also helped to ‘create a healthy climate in which the concepts of co- operation and co-ordination could grow’ (p. 7 7 ) .

Improved relationships can be achieved and, indeed, would have positive effects in those areas of work where greater co-operation between police and social workers would result in a better service to the public and to clients. The purpose of this paper is to concentrate on the area of mental health, and to show how a more co-operative and understanding set of relations between the police and social workers would result in a more effective service for those disturbed individuals who suffer a mental health crisis or emergency. But why should there be such importance placed upon the development of such relations?

The Need for Inter-Agency Co-operation in the Mental Health Sphere

The policy intention in Britain is to move towards a system of treatment for the mentally ill that is increasingly community-based. Thus, many of the older mental hospitals are scheduled for closure as patients become discharged into the communities where they will receive their treatment. Such a development has implications for both social workers (approved and otherwise) and the police, and for the nature of the services they provide.

Treating mentally ill people in the community implies that they must ,also learn to act appropriately within the community and not to overstep the boundaries of acceptable behaviour. When their behaviour does fall outside these boundaries the police may well become involved. Thomas (1986, pp. 28-9) quotes data showing not only the levels of police use of s . 136 of the Mental Health Act 1983 to remove mentally disordered individuals to a place of safety, but also what appears to be wide variations in the use of s . 136 by different police forces. Typically, police involvement in these kinds of mental health emergencies comes about when an individual becomes significantly disturbed, or suffers a psychiatric

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crisis, in such a way and in such a public manner that the person requires immediate attention. In other words, the police become involved in such crises when the individuals concerned are not being treated within some community-based facility but, on the contrary, are exhibiting disturbed behaviour in public or at their own homes. Thus, the adequacy of mental health community-based facilities, and the quality of the treatment they provide, are crucial in influencing the numbers of people in a particular area who may be expected to benefit from community treatment and, generally, to act within the boundaries of accepted behaviour.

However, in Britain not only do the availability and quality of community-based facilities for the treatment of the mentally ill vary markedly between areas, but also thefuture provision of adequate facilities is far from guaranteed. Given this state of affairs, social workers will be involved with the mentally ill in two main ways. They will help to care for them in such community-based programmes as exist, and they will become increasingly involved in responding to mental health emergencies, many of which will also be known to the police.

The process of deinstitutionalisation and the potential inadequacy of community treatment programmes will bring police and social workers into greater contact (Thomas 1986, p. 42). But, as I have already indicted when referring to the nature of the typical relationships between police and social workers, greater contact may lead to greater conflict. There is a need, therefore, for improved co-operation in the mental health sphere. In many instances, especially s. 136 cases, it is the police who make the initial determination of mental disorder. B.A.S.W. (The British Associa- tion of Social Workers) has in the past expressed its concern about this fact, citing as grounds for anxiety the police’s lack of relevant training in this field (Thomas 1986, p. 27). However, there is some evidence to suggest that the police are as efficient as general medical practitioners in recognising people in need of psychiatric care (Keller and Copeland 1972,

Whatever the police role and the concerns of the social work profession, the major issue must be to ensure that mentally disturbed individuals receive the best possible care. Handling such individuals within the criminal justice process, if only because the police sometimes feel they have no other available alternatives, is almost always inappropriate and may be harmful to the mental health of those detained and processed in this fashion. Moreover, the police themselves do not particularly like having to deal with these cases, it is not considered to be ‘real’ police work. As Teplin (1984) has noted in her American research, ‘ “handling mentals” was not regarded as a good pinch and was largely unrewarded by the [police] department’ (p. 165). Such individuals can not only take up a good deal of police time but also they can fill up police cells, which may be in demand, prior to their removal to hospital or elsewhere. O n this issue of time, the police frequently complain that they are often unable to obtain swiftly a social worker’s presence at the police station to help with a mental health emergency, especially if the police request is made outside normal office hours. Although 24 hour emergency services now exist, the

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p. 220).

police are still critical of the response times of social services departments. The Police Superintendents’ Association have stated:

There is a tendrncy that ‘on call’ social workers having a particular speciality are loath to respond to emergency calls if this is not in their field. This is evident with regard to mentally disturbed people and a tremendous amount of police time is wasted in dealing with these people because the social worker either doesn’t know how to deal with these situations, often has to be persuaded to respond, and frequently takes a long time to get to the station. (Thomas 1986, p. 30)

The poor image of social workers, which is built up in this way in the minds of the police, is not lessened when the reason for a less than swift response is not to do with the personal reluctance of a particular social worker but with the lack of resources available to the social services department. Although in some areas, notably London, local joint procedures have been developed to handle the mentally i l l , the situation generally is still far from satisfactory. Where liaison is poor, or insufficient resources prevent the operation of an effective 24 hour emergency service, the police feel that they are having to handle mentally disturbed people without the necessary support from social workers. In such instances police hostility towards social workers is reinforced.

The need for an effective system of co-operation between the police and social workers in respect of the mentally ill is based, therefore, on two major factors. First, there is the growing problem likely to be associated with deinstitutionalisation and community care. Second, there is the police’s need to have a swift resolution of the problem of handling mentally disturbed people. Neither of these two factors can be satisfactorily resolved unless a joint policy can be effectively implemented. In order for it to be implemented the hostility and suspicion existing between lower level police officers and social fieldworkers must be broken down. The Madison scheme, with its innovative system of liaison between the Madison Police Department (MPD) and the Crisis Intervention Service (CIS), provides important lessons as to how that may be achieved.

The Planning and Implementation of the Madison Scheme

The recognition both of a growing problem with mental health crises in the Madison area, particularly the city centre, and thr role of the police as an important referral agency was vital to the planning of CIS. The problem came about in the mid-1970s as a result of active deinstitu- tionalisation programmes throughout the whole state, which had been operating for a number of years. However, many former patients discharged from hospitals in other areas gravitated towards the city of Madison, in part attracted by its liberal welfare policies. Madison, situated in Dane County, is the state capital of Wisconsin and it has for many years enjoyed a reputation as a liberal city producing progressive policies to cope with welfare problems. The city’s population is 170,000 with another 45,000 students based at the University of Wisconsin, Madison. The total population of Dane County is 300,000. The Madison

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Police Department responsible for policing within the city (the university has its own force as does Dane County) has nearly 300 sworn policc officers and another 80 or so unsworn. Significantly, the M P D was headed at this time by a chief of police, David Couper, who fitted in easily with the liberal and progressive traditions of the city.

One of the agencies primarily responsible for mental health in the area is the Dane County Mental Health Centre (DCMHC) , which is located in Madison. Its staff began to recognise an emergent problem with what the police called ‘street crazies’, people who often exhibited bizarre behaviour during a mental health crisis. Typically, such behaviour was occurring in the city centre area and the police had been receiving increasing numbers of complaints from shopkeepers wanting these people removed. Staff at DCMHC realised that few of these cases were reaching their own social workers and mental health fieldworkers. ’I’he police patrol officers were also dissatisfied with the situation, since they felt they were often having to cope with these people with little help from other agencies. The M P D chief of police, however, was not prepared to handle the problem simply by institutionalising more and more of these disturbed individuals, whether the institution be a hospital or a jail. In keeping with his own personal philosophy and the liberal attitude of many of the city’s programmes, Couper was concerned about the rights and needs of the mentally disturbed as well as the operational needs of his own officers. That concern for the mentally ill was also reflected through a number of local pressure groups and mental health agencies whose views were well known in the city. For its part, DCMHC wanted to capitalise on the police’s initial contact with these crisis episodes and approached the M P D to discuss the development of a suitable programme. There was, as it turned out, a coalition of interests upon which both sides could build.

The police in the U.S.A. and U.K. handle a great many calls for help andjassistance that are not related to crime. This ‘service function’ is well documented (for instance, see Punch 1979). Cesnik, Pierce, and Puls ( 1977) who were involved in the planning and operation of CIS state that:

Police agmcies have traditionally provided the primary and generally the only 24- hour mobile emergency service available in a community. Although the police are best known for their crime management responsibilities, th r fact is that over 80% of their time is spent in non-crime-related activities. . . Such involvement puts the police officer in a key c a w f i n d e r role. (p. 21 1, italics added)

Punch (1979, p. 106) also refers to this police role and argues that the police often ‘perform a “gate-keeping’’ function before the other social services intervene. . .’ (p. 106). Indeed:

. . . the police turn out when a crisis is happening and represent a visible, available, and well known agency which, more than any other mental health institution, has mobility and authority in situations where violence is often an element. (p. 107)

Funded by DCMHC in 1975, C I S nevertheless was set up as a result of joint planning between DCMHC managers and M P D senior officers. I t

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was built upon DCMHC’s need to capitalise on the police’s case-finding role, and the need of the police force to be able to call upon professional help in handling the mentally disturbed. One of the problems of implementing this joint policy was to obtain the co-operation of police patrol officers.

It was immediately recognised in the planning process that:

close attention must be paid to the police officer’s viewpoint if any emergency mental health or crisis intervention service is to capitaliLe on the case-finding potential of the police oficer. (Cesnik, Pierce and Puls 1977, p. 212)

Thus, CIS would have to have:

the capacity to move about outside the usual space and time limitations that both confine and offer security to traditional mental health practice. (Cesnik and Stevenson 1979, p. 38)

In other words, C I S would have to be available 24 hours a day and be prepared and able to go to the scene of any crisis of which the police had notified them. Moreover, it was also clear in these initial discussions between the MPD and DCMHC that the CIS staff would have to respond quickly to police calls. Swift face-to-face contact between patrol officer and CIS fieldworker following referral was considered essential if police suspicions about the reliability of the crisis programme were to be allayed. Equally essential was for the C I S fieldworker to take over responsibility for the disturbed person and immediately to begin an appropriate treatment plan. Finally, it was felt that providing feedback to the patrol officers in\.olved in referrals to CIS about the disturbed person’s progress with the treatment would be appreciated by the police. In involving the police in discussions to set up the crisis programme, DCMHC not only discovered what were the particular concerns of patrol officers, and how the scheme would have to be adapted to satisfy those needs, but also it committed senior officers to trying to ensure the success of the programme. The ability of CIS to meet the operational requirements of street-level patrol officers in respect of handling mentally disturbed people would be the supreme test of whether junior officers also became committed to the success of the programme.

Even before CIS became fully operational, as staff were appointed efforts were made both to explain to patrol officers I the )nature land limitations of CIS, and to build up good relationships between police and CIS ficldworkers. Because of earlier frustrating and unsatisfactory experiences with mental health agencies, many patrol officers had a poor image of mental health professionals and doubted ‘the sincerity of any new mental health program purporting to respond to police needs’ (Cesnik, Pierce and Puls 1977, p. 212). In order to counter such feelings the existing experience of police officers in handling crisis situations outside the mental health field was recognised. Several ofiicers were recruited to help in the training of C I S fieldworkers in areas such as how to approach potentially dangerous individuals or situations; how to avoid violrnce; and how to intervene in potential life-threatening incidences.

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CIS tieldworkers also went on ‘ride-alongs’, spending periods on patrol duty with MPD officers. This allowed CIS staff to become more familiar with the role and attitudes of the patrol officers. Moreover, they could carefully explain to the officers the nature of CIS and they could encourage them to report any dissatisfactions with the scheme when it became operational to a social service co-ordinator (a police officer) if they felt that CIS was not meeting its objectives. According to Cesnik, Pierce and Puls (1979) the relationships built up during this period of training and preparation proved to be very valuable in the programme’s continuing operation (p. 214). I shall now look in more detail at the work of CIS in the field.

CIS in Operation

From the outset CIS staff were determined to respond swiftly to referrals, especially those from the police. Out of 150 new refrrrals each month a third came from the police (Pierce and Cesnik 1978, p. 3) . Most referrals end with CIS fieldworkers being on the scene within 20 to 30 minutes of receiving the call. Occasionally when circumstances do not permit such a swift response the referring patrol officers are contacted by radio and told when to expect the arrival of CIS staff or whether they should transport the disturbed individual directly to a designated mental health agency. O n arrival at the scene CIS staff are given what information the police have about the individual and the surrounding circumstances. The police then leave the person in the care of CIS whose fieldworkers begin an immediate evaluation of the disturbed individual in order to develop a treatment plan. This plan is not based on the automatic assumption that hospitalisation will be necessary. O n the contrary, in fact, for C I S strives to ensure that wherever possible mentally disturbed people are treated in the community. Part of the treatment plan, and a way of capitalising on the crisis itself and using it in a therapeutic manner, may be for C I S workers to involve significant others by taking the disturbed individual to his home, collecting his friends and relatives there, and spending time with the client and the significant others to explore the meaning of the crisis. The idea is to create a milieu in which the clirnt

can live through the crisis and benefit from it. Creating the appropriate milieu might mean calming relatives down, helping them to disengage, and sending them to bed with reassurance that further help is available if i t is needed. It might require helping a depressed and withdrawing person reach out to those in his world who will provide support if they know and understand that they are needed. Crucial in making such interventions meaningful is the promise of intensive involvement by staff members throughout the crisis period. This involvement could mean bringing a physician to the home for a medication consultation. It might require gathering hurt, angry, or estranged family members to begin talking to one another. Very often i t will end with the crisis workrr referring the patient and significant others for ongoing outpatient treatment. When successful, this approach moves the individual through his crisis and increases his sense of his own abilities to cope and be responsible for himself. (Cesnik and Stevenson 1979, p. 38)

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If it proves necessary, CIS staff have the option not only to refer an individual to an outpatients’ clinic but also to a number of other community-based mental health programmes. In fact, C I S is part of a treatment network providing help to those, on the one hand, who may require only light supportive treatment in the form of a drop-in centre, and to those, on the other hand, who may need long-term intensive therapy. This latter service in Madison is provided by a mobile community treatment programme designed to help the chronically mentally ill. This network of services is important not only in providing effective community-based mental health treatment throughout a large range of illness, but also in helping CIS to do its job. When individuals originally referred to CIS are able to progress to treatment facilities that suit their psychiatric needs - if these are required following the initial emergency - they are less likely to reappear as crisis episodes necessitating CIS intervention or as ‘street-crazies’ attracting the attention of the police once again.

Following each police referral patrol officers receive feedback informa- tion from CIS about the result of the crisis intervention with the disturbed individual, and about his treatment plan and progress. This information allows officers to react more appropriately to such an individual still under treatment should they encounter him again during patrol at a later date. Moreover, i t also provides some recognition to police officers that they have provided a worthwhile service not only to the disturbed individual but also to the community.

Although the major part of the work of CIS is responding to referrals and managing and treating the crises of clients, i t also has to maintain good relations with patrol officers and to improve the referral practices of those officers. To achieve these ends CIS staff are involved in in-service training for MPD officers. The CIS fieldworkers also attend police shift briefings twice a month, which allows them to provide up-to-date information on the CIS and to receive any questions or dissatisfactions. Furthermore, the CIS have responded to a MPD request to provide training for front-line patrol officers in emergency mental health principles and techniques. This would allow officers to become more adept at recognising mental illness, and thereby improve referral practices, and it would also allow them to handle disturbed persons more appropriately while waiting the arrival of CIS.

The training programme adopted by CIS was a ‘police patrol model’ in which the officers’ familiar routine of vehicular patrolling was maintained. According to Pierce and Cesnik (1978):

New information, techniques and insights are more effectively assimilated by the officers when they remain in a familiar environment and can retain their significant role behaviors - being active, having mobility, communicating with dispatch. (p. 5)

CIS staff in unmarked cars rode along with police officers in plain clothes responding to mental health emergencies and using the cases themselves as training material. Thus, police officers gained first hand insight into the

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work of CIS; how it responded to calls; how and why it tries to work through the crisis with the disturbed individual and his or her friends and relatives, etc. Officers began to realise there were alternatives to hospitalisation and to recognise the value of community-based treatment. Pierce and Cesnik reported that as a result of the training programme police officers did become more confident in dealing with mental health emergencies and did make more effective use of CIS by making more appropriate referrals (Pierce and Cesnik 1978, p. 10).

The formula adopted by CIS - reliable and swift response, highly professional service, and continuing methods to maintain the confidence of the police and to keep them informed about the programme - ‘has resulted in a relatively stable and cooperative working relationship between the crisis service and law enforcement agencies’ (Cesnik, Pierce and Puls 1977, p. 215).

The Policy Lessons of the CIS Scheme

If similar schemes are to operate successfully in the U.K. the following lessons from the Madison experience may prove useful.

Prior to the operation of a crisis programme thorough and careful preparation must take place to inform the employees of other agencies with which the programme will come into contact of the goals and methods of the scheme.

Referrals to the crisis programme should be serviced swiftly; this means having a mobile, 24 hour, adequately staffed and resourced operation.

The crisis programme should be part of a network of treatment programmes for the mentally ill so that each client can receive continuity of appropriate care in the community whenever possible and desirable.

Particular attention must be paid to the needs of the police if a crisis programme is to capitalise successfully on the case-finding potential of the police.

Crisis staff and police managers should endeavour to find ways to break down the suspicion and the hostility that has often existed between social workers and police constables. This may be achieved not only through the reliable and professional operation of the crisis programme itself, but also through regular in-service training schemes that allow the participants to gain a greater understanding of the nature of both the social worker’s and the police oficer’s role.

Much of the success of CIS depended on inter-agency co-operation and co-ordination. A major criticism of agency interaction involving the police and welfare organisations is that the relationship may be dominated by the police and used by them to gather information, or to develop their techniques of social control (see, for instance Baldwin and Kinsey 1982, pp. 59-103). There is, of course, such a risk. In Madison, however, the development of CIS was not seen as a programme dominated by police interests, but as a programme that provided a better and more effective way of treating mental health emergencies than existed previously. Of course, if CIS had become nothing more than the substitution of social

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workers to ferry the mentally ill to mental hospitals and thus relieve the police of this task, it would not have been a scheme worth defending at all. Moreover, while such schemes depend on meeting some of the operational needs of police officers - swiftly to take over responsibility for the emergency from the police - they do so only to take advantage of the police’s case-finding capacity. However, when the case has been found and referred to the crisis programme, the police’s needs no longer figure in the decisions taken by the crisis staff. Following referral mental health crisis were handled in Madison according to the principles o f crisis intervention and decisions were taken in the client’s best interests. The police played no part in deciding upon treatment, nor in referring clients to other community-based agencies, etc. The police were satisfied that CIS took over responsibility for emergency cases and thereby allowed officers to return to a more valued role, that of crime detection and control.

The functions of the two agencies overlapped at the case-finding and referral stage but became separate thereafter. This important separation of functions, which allows the social workers to be the providers of a professional and specialised social service to disturbed individuals, can only occur if the following conditions are present.

First, the police must agree that the separation ofroles is an appropriate way of handling emergency mental health cases. This touches upon the subject of police accountability, for in Madison the police were clearly seen to be responding to a general expectation within the community that mentally disturbed people, even if they did ‘flare up’ in the city centre, should in the main be handled by mental health agencies, and not the police. In the U.K. we need greater police accountability for a number of reasons. One reason. however, is to ensure that when new schemes similar to CIS are put to the police they will be better received because they are seen as representing the interests of the community. Without sufficient accountability, the police are more strongly placed to ignore such proposals or to operate them in ways that serve their own interests and not those primarily of mentally ill individuals and of the wider community.

Second, the police need to be able to trust the crisis programme to which they refer individuals. Trust is not something that has traditionally characterised relationships between police and social workers, but the Madison scheme does highlight how levels of trust may be built up. When the police judge that they can depend on the service provided by the crisis programme they will use it. Indeed, the operation of the programme itself can be used as a mechanism to reduce suspicion and hostility between the two groups. Whereas Holdaway (1986, pp. 147, 158) is pessimistic about the potential to reduce these feelings among the lower police ranks in particular, I am a little less so.

The issue may finally be summarised in this fashion. Crisis programmes deliver prompt and specialist treatment and, potentially, they may provide a gateway into a network of other treatment programmes if the person requires them. The police are integrated into this network, not in terms of treatment, but in terms of case-finding. Thus, according to Cesnik, Pierce and Puls (1977):

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This integration assures that those experiencing emotional crises in the com- munity will be one important step closer to professional mental health intervention. (p. 215)

With so much unemployment, family stress, poverty, a n d the current inadequate provision of community mental health facilities, not to mention those patients to be discharged from existing mental hospitals, we seem set for many more mental crises happening o n the streets a n d in homes throughout the U.K. We need now to give serious thought to planning effective crisis intervention schemes if we a r e to handle these individuals humanely and effectively.

References

Baldwin, R. and Kinsey, R. (1982) Police Powers and Politics, London: Quartet. Cesnik, B., Pierce, N. and Puls, M. (1977) ‘Law enforcement and crisis

intervention services: a critical relationship’, Suicide and Lfe-Threatening Behavior, 7, 21 1-15.

Cesnik, B. and Stevenson, K. (1979) ‘Operating emergency services’, New Directions for Mental Health Services, 2, 3 7 4 3 .

Holdaway, S. (1983) Inside the British Police: A Force at Work, Oxford: Basil Blackwell.

Holdaway, S. ( 1986) ‘Police and social work relations: problems and possibilities’, British Journal of Social(Work, 16, 137-60.

Keller, M. J. and Copeland, J. R. M. (1972) ‘Compulsory psychiatric admission by the police: a study of the use of s. 136’, Medicine, Science and the Law, 12, 220-4.

Manning, P. (1977) Police Work: The Social Organisation of Policing, Cambridge, Ma.: M.I.T. Press.

Moore, C. and Brown, J. (1981) Community Versus Crime, London: Bedford Square Press.

Pierce, N. and Cesnik, B. (1978) ‘Training police in crisis intervention: the police patrol model’ (paper presented at the 1 1 th Annual meeting of the American Association of Suicidology, New Orleans, April 6-9, 1-1 I ) .

Punch, M. (1979) ‘The secret social service’, in: S. Holdaway (Ed.), The British Police, London: Edward Arnold.

Schaffer, E. B. (1980) Community Policing, London: Croom Helm. Sleigh, B. (1981) ‘Social services and the police’, in: D. W. Pope and N. L. Weiner

Teplin, L. A. (1984) ‘Managing disorder: police handling of the mentally ill’, in:

Thomas, T. (1986) The Police and Social Workers, Aldershot: Gower.

(Eds.), Modern Policing, London: Croom Helm.

L. A. Teplin (Ed.), Mental Health and Criminal Justice, London: Sage.

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