Thursday 18 March

Tasmania’s Magistrates Tasmania’s Magistrates Court Mental Health Court Mental Health

Diversion ListDiversion List

Chief Magistrate Michael HillChief Magistrate Michael Hill

OverviewOverview

1.1. OriginsOrigins

2.2. ProcedureProcedure

3.3. Key playersKey players

4.4. Evaluation ResultsEvaluation Results

5.5. Offender InterviewsOffender Interviews

6.6. Case studiesCase studies

How the List startedHow the List started

Bottom-up ApproachBottom-up Approach Court-led: collaboration b/w dedicated Court-led: collaboration b/w dedicated

magistrate, FMHCLO police prosecutors and magistrate, FMHCLO police prosecutors and legal practitionerslegal practitioners

Re-arrangement of Court lists to divert Re-arrangement of Court lists to divert defendants with mental illness into specialist defendants with mental illness into specialist sittingssittings

ProcedureProcedure Referral: A person can refer themselves into the program or Referral: A person can refer themselves into the program or

be referred into it by their Solicitor, TasPolice (including be referred into it by their Solicitor, TasPolice (including Prosecutions), Magistrates, Mental Health Case Managers, Prosecutions), Magistrates, Mental Health Case Managers, Other Service Providers, or Anyone with a genuine interest in Other Service Providers, or Anyone with a genuine interest in the welfare of the person.the welfare of the person.

Assessment: In order to determine whether a person is Assessment: In order to determine whether a person is suitable for the program they must first undergo an suitable for the program they must first undergo an assessment interview by a Forensic Mental Health Court assessment interview by a Forensic Mental Health Court Liaison Officer.Liaison Officer.

Court Diversion: Once assessed as eligible and suitable by Court Diversion: Once assessed as eligible and suitable by the FMHCLO, the person will appear before the Magistrate the FMHCLO, the person will appear before the Magistrate presiding over the List. The Magistrate will, on the basis of presiding over the List. The Magistrate will, on the basis of information provided to the Court by the FMHCLO, police and information provided to the Court by the FMHCLO, police and defence lawyer, decide whether to accept a person on to the defence lawyer, decide whether to accept a person on to the program and tailor an order—usually a bail order—best program and tailor an order—usually a bail order—best suited to addressing the person’s mental health needs.suited to addressing the person’s mental health needs.

Procedure (cont.)Procedure (cont.) Court Review: During a person’s diversion program, a series Court Review: During a person’s diversion program, a series

of court reviews will take place, which the person will be of court reviews will take place, which the person will be required to attend unless excused by the Magistrate. This is a required to attend unless excused by the Magistrate. This is a relatively informal process that provides an opportunity for relatively informal process that provides an opportunity for direct interaction with the Magistrates.direct interaction with the Magistrates.

Sentencing: At one of the reviews a final date will be given Sentencing: At one of the reviews a final date will be given for the person to return to Court for finalisation of their for the person to return to Court for finalisation of their matters. A Magistrate may take into account the person’s matters. A Magistrate may take into account the person’s success or otherwise in the diversion program when success or otherwise in the diversion program when considering a final sentence.considering a final sentence.

Consent: Participation in the program is at all times Consent: Participation in the program is at all times

voluntary voluntary and any assessment will only occur after the and any assessment will only occur after the potential participant or their legal guardian has provided potential participant or their legal guardian has provided written consent.written consent.

Key PlayersKey Players

MagistratesMagistrates Forensic Mental Health Court Liaison Forensic Mental Health Court Liaison

OfficersOfficers ProsecutionProsecution Legal AidLegal Aid Private Legal PractitionersPrivate Legal Practitioners

MagistratesMagistrates

EncouragementEncouragement Support Support SympathySympathy ListeningListening PraisingPraising

On Magistrates: Offender On Magistrates: Offender InterviewsInterviews

‘‘They could tell that I was really worked up and They could tell that I was really worked up and they accommodated it…they got my partner to they accommodated it…they got my partner to come over and sit next to me on the big round come over and sit next to me on the big round desk…they were very aware of how I was feeling I desk…they were very aware of how I was feeling I think.’think.’

‘‘The magistrate, he was terrific. He was really The magistrate, he was terrific. He was really good. He was understanding of me (sic) mental good. He was understanding of me (sic) mental illness and how I’d become to get mentally ill and illness and how I’d become to get mentally ill and he was very supportive actually.’he was very supportive actually.’

‘‘He referred to things so that (my daughter) He referred to things so that (my daughter) understood why she was there. And when you are understood why she was there. And when you are on medication you get a bit hazy about things that on medication you get a bit hazy about things that have happened, so it was good that he mentioned have happened, so it was good that he mentioned things like that.’things like that.’

Forensic Mental Health Court Forensic Mental Health Court Liaison OfficersLiaison Officers

Conduct assessments Conduct assessments Refer participants to appropriate service Refer participants to appropriate service

providersproviders Monitor level of engagement/complianceMonitor level of engagement/compliance Make recommendations about changes Make recommendations about changes

to treatment regimes and/or bail to treatment regimes and/or bail conditionsconditions

Liaise with prosecution and defence to Liaise with prosecution and defence to determine progression of the case and determine progression of the case and date of finalisationdate of finalisation

On FMHCLOs - Offender On FMHCLOs - Offender InterviewsInterviews

‘‘The FMHCLO are, in my view, the ones doing The FMHCLO are, in my view, the ones doing all the work.’all the work.’

‘‘She was very compassionate.’She was very compassionate.’ ‘‘Yeah, she’s terrific. Yeah she’s really good Yeah, she’s terrific. Yeah she’s really good

with the people that she deals with…I watch with the people that she deals with…I watch her and she’s really, umm how would you put her and she’s really, umm how would you put it, she tries, she tries hard.’it, she tries, she tries hard.’

‘‘She would always…follow up on anything She would always…follow up on anything that was discussed and…she would ring up that was discussed and…she would ring up and explain stuff to me before and after and explain stuff to me before and after meeting with the lawyer. She was really meeting with the lawyer. She was really good.’good.’

Police ProsecutionsPolice Prosecutions Dedicated police prosecutor allows the Dedicated police prosecutor allows the

prosecutor to develop a relationship with prosecutor to develop a relationship with the FMHCLO and the defence counsel the FMHCLO and the defence counsel

Everyone ‘…is on the same wave length.’ Everyone ‘…is on the same wave length.’ ‘‘I certainly see it as something that is far I certainly see it as something that is far

more just and appropriate. So if a person more just and appropriate. So if a person has a mental illness and their mental has a mental illness and their mental illness has had a significant impact on the illness has had a significant impact on the offence or offending behaviour, then that’s offence or offending behaviour, then that’s the thing that needs to be targeted – their the thing that needs to be targeted – their health. So if Health and Justice can come health. So if Health and Justice can come together and work together well on that, I together and work together well on that, I think that’s fabulous.’think that’s fabulous.’

Legal PractitionersLegal Practitioners

Legal aid employee / private Legal aid employee / private practitionerpractitioner

Still speaks on behalf of the defendant Still speaks on behalf of the defendant in many circumstancesin many circumstances

Enters pleas in mitigation when matter Enters pleas in mitigation when matter is being finalised. is being finalised.

Acts as an interpreter to ensure that D Acts as an interpreter to ensure that D is aware of what is being decided, D’s is aware of what is being decided, D’s obligations and bail conditionsobligations and bail conditions

On Legal Practitioners – Offender On Legal Practitioners – Offender InterviewsInterviews

‘‘I can understand about 70% of (what is said I can understand about 70% of (what is said in court), but when they go through this in court), but when they go through this paragraph and that paragraph, I’ve got no paragraph and that paragraph, I’ve got no idea, but after court the lawyer comes out idea, but after court the lawyer comes out and he sort of explains it to me in layman’s and he sort of explains it to me in layman’s terms.’terms.’

‘‘The solicitor was real good; they worked The solicitor was real good; they worked well with the mental health team.’well with the mental health team.’

‘‘She (explained what was being discussed) She (explained what was being discussed) that day when I went to court and I couldn’t that day when I went to court and I couldn’t understand what the judge was saying. She understand what the judge was saying. She got up and talked for me’got up and talked for me’

Collaboration & CooperationCollaboration & Cooperation In the initial period between referral and In the initial period between referral and

appearance informal discussions take appearance informal discussions take place between the FMHCLO, prosecutors place between the FMHCLO, prosecutors and defence counsel.and defence counsel.

Once the FMHCLO’s recommendation of Once the FMHCLO’s recommendation of eligibility/suitability confirmed by the eligibility/suitability confirmed by the Magistrate, and the appropriate order Magistrate, and the appropriate order made, the quality and integrity of the made, the quality and integrity of the health interventions are maintained by the health interventions are maintained by the role of the FMHCLO. role of the FMHCLO.

Monthly case management meetings Monthly case management meetings between the FMHCLO, prosecution and between the FMHCLO, prosecution and lawyers to review progress.lawyers to review progress.

Selected Results - May 07- Dec 09Selected Results - May 07- Dec 09Acceptance/CompletionAcceptance/Completion 154 referrals154 referrals 126 participants accepted onto/completed MHDL: 126 participants accepted onto/completed MHDL:

16 active cases and 110 completed16 active cases and 110 completed 28 non-completions – reasons for non-completion 28 non-completions – reasons for non-completion

- no mental illness or otherwise unsuitable, - no mental illness or otherwise unsuitable, program non-compliance or withdrawal of program non-compliance or withdrawal of consent - referred back to the general listconsent - referred back to the general list

Of the 126 participantsOf the 126 participants56% - 1-2 criminal charges56% - 1-2 criminal charges44% - 3 or more criminal charges44% - 3 or more criminal charges

Results continuedResults continued

Referrals received from:Referrals received from:

43% lawyers43% lawyers

33% FMHS/MHS staff33% FMHS/MHS staff

18% Magistrates18% Magistrates

1% Police1% Police

5% Other5% Other

Results continuedResults continuedRepresentationRepresentation

64% 64% Legal AidLegal Aid27% 27% Private lawyerPrivate lawyer9% 9% UnrepresentedUnrepresented

FinalisationsFinalisations 110 of the 126 completed (May 07 – Dec 110 of the 126 completed (May 07 – Dec

09) – 135 sentences recorded:09) – 135 sentences recorded: 74 (55%) Conditional release order – 16 with conviction 74 (55%) Conditional release order – 16 with conviction

recorded & 58 without conviction recorded recorded & 58 without conviction recorded 16 (12%) Charges dismissed16 (12%) Charges dismissed 13 (9%) Tender No evidence13 (9%) Tender No evidence 12 (9%) Suspended sentence 12 (9%) Suspended sentence 20 (15%) Other including license disqual., community 20 (15%) Other including license disqual., community

service order, recognisanceservice order, recognisance

Results continuedResults continued

AppearancesAppearances

The average number of appearances The average number of appearances prior to finalisation was 2.8:prior to finalisation was 2.8: 79 of the 110 finalised cases being disposed of 79 of the 110 finalised cases being disposed of

in 1-3 hearings, andin 1-3 hearings, and 27 cases involving 4-5 hearings before 27 cases involving 4-5 hearings before

disposition.disposition.

Results continuedResults continued

Diagnosis of participants:Diagnosis of participants:44% schizophrenia44% schizophrenia15% bi-polar disorder15% bi-polar disorder9% depression9% depression8% post traumatic stress disorder8% post traumatic stress disorder6% personality disorder6% personality disorder6% psychosis not otherwise specified6% psychosis not otherwise specified3% obsessive-compulsive disorder3% obsessive-compulsive disorder9% other9% other

Results continuedResults continued

Treatment provider:Treatment provider:

67% Forensic Mental Health 67% Forensic Mental Health Services/ Mental Health ServicesServices/ Mental Health Services

12% Private psychiatrists12% Private psychiatrists

11% Private psychologists11% Private psychologists

8% GPs8% GPs

2% Other2% Other

Evaluation (May 2009) -Evaluation (May 2009) -

Early Recidivism DataEarly Recidivism Data Results show a reduction in the number of MHDL Results show a reduction in the number of MHDL

participants who offended post-program compared to participants who offended post-program compared to pre-program as well as a reduction in the actual pre-program as well as a reduction in the actual number of incidents charged against these offenders.number of incidents charged against these offenders.

From a sample* of 52 MHDL participants who From a sample* of 52 MHDL participants who completed their program:completed their program: 82.7% were found to have committed an offence in the six 82.7% were found to have committed an offence in the six

months months priorprior to their participation, compared with just 7.7% to their participation, compared with just 7.7% in the six months in the six months afterafter participation. participation.

78.8% of these participants had reduced their offending level 78.8% of these participants had reduced their offending level post-participation (i.e. they recorded fewer incidents)post-participation (i.e. they recorded fewer incidents)

5.8% exhibited an increase in the number of offences they 5.8% exhibited an increase in the number of offences they committed post-participation. committed post-participation.

* Small sample size prevents the statistical significance of the data being calculated* Small sample size prevents the statistical significance of the data being calculated

Comparison of number of offences committed pre- and Comparison of number of offences committed pre- and post- participation by participants who have post- participation by participants who have successfully completed the MHDL.successfully completed the MHDL.

Number of offences committed (prior and post participation)

17.325

19.2

38.5

92.3

3.9 1.9 1.9

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10

20

30

40

50

60

70

80

90

100

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Number of Offences

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Prior

Post

Evaluation - Case Study - “Aaron”Evaluation - Case Study - “Aaron” 43 y.o. male diagnosed with delusional disorder43 y.o. male diagnosed with delusional disorder Firearm & property offences + one count of Firearm & property offences + one count of

stalkingstalking Before participating on the List Aaron kept his Before participating on the List Aaron kept his

mental health issues “all bottled up”mental health issues “all bottled up” He understands about 70% of what goes on in He understands about 70% of what goes on in

the courtroom and the rest is explained to him the courtroom and the rest is explained to him afterwardsafterwards

Finds that having the Mag. talk to him directly Finds that having the Mag. talk to him directly and give him encouragement helps him feel and give him encouragement helps him feel more relaxedmore relaxed

Has been able to continue his work and has Has been able to continue his work and has started to re-engage in social activitiesstarted to re-engage in social activities

Evaluation - Case Study – “Isabel”Evaluation - Case Study – “Isabel” 45 y.o. mother of four with bi-polar disorder45 y.o. mother of four with bi-polar disorder When unmanaged her BPD causes her to be abusive to When unmanaged her BPD causes her to be abusive to

others, esp. her familyothers, esp. her family Charged with breaching restraint orders taken out by Charged with breaching restraint orders taken out by

mother & childrenmother & children Repeat appearances in normal court lists caused pain & Repeat appearances in normal court lists caused pain &

anguish that could have been avoided if she was anguish that could have been avoided if she was referred to the List earlierreferred to the List earlier

Since being on the List Isabel has received proper care Since being on the List Isabel has received proper care and follow–up – her medication has been re-assessed & and follow–up – her medication has been re-assessed & changed, her memory has improved and she is changed, her memory has improved and she is motivated to get out of bedmotivated to get out of bed

Has started to repair relationships with her children and Has started to repair relationships with her children and other family membersother family members

Being in the MHDL meant she felt more at ease in court Being in the MHDL meant she felt more at ease in court and was not worried about what the Mag. was going to and was not worried about what the Mag. was going to say to hersay to her

Evaluation - Case Study – “Caroline”Evaluation - Case Study – “Caroline” Diagnosed with psychosis - sees a private psychologist for this. Diagnosed with psychosis - sees a private psychologist for this.

At the time of offence, she was particularly unwell and At the time of offence, she was particularly unwell and subsequently spent a considerable amount of time in hospital.subsequently spent a considerable amount of time in hospital.

Charged with one count of stealing; has no prior convictions or Charged with one count of stealing; has no prior convictions or chargescharges

Extremely embarrassed about her charge and court Extremely embarrassed about her charge and court appearances appearances

Only required to make one appearance on the ListOnly required to make one appearance on the List Caroline sees 2 benefits of participating on the MHDL: Caroline sees 2 benefits of participating on the MHDL:

1.1. She had no conviction recorded (the prosecution tendered no She had no conviction recorded (the prosecution tendered no evidence and the matter was dropped). This enabled Caroline evidence and the matter was dropped). This enabled Caroline to continue with the various voluntary social /community to continue with the various voluntary social /community roles.roles.

2.2. She needed to seek treatment in a more ‘diligent’ manner. If She needed to seek treatment in a more ‘diligent’ manner. If she did not participate in the MHDL she would not have she did not participate in the MHDL she would not have admitted the incident to anyone else, including psychologist, admitted the incident to anyone else, including psychologist, and would have instead just pretended that it did not happen.and would have instead just pretended that it did not happen.

Case Study – “Annie”Case Study – “Annie” A 45 y.o. homeless woman (generally slept in bus shelters), who had been A 45 y.o. homeless woman (generally slept in bus shelters), who had been

wandering the streets of Hobart for about 3 - 4 years. Over that period of wandering the streets of Hobart for about 3 - 4 years. Over that period of time appeared many times in Court on very minor offences, e.g. disorderly, time appeared many times in Court on very minor offences, e.g. disorderly, swear at police, resist and minor shoplifting. When her pension cheque came swear at police, resist and minor shoplifting. When her pension cheque came in she spent a night or two in cheap lodgings, the rest of the time she was on in she spent a night or two in cheap lodgings, the rest of the time she was on the streets. the streets.

Appeared before a Mag. on very minor charges and it was clear she did not Appeared before a Mag. on very minor charges and it was clear she did not know where she was or who she was, so the FMHCLO was called and she was know where she was or who she was, so the FMHCLO was called and she was immediately diverted to MHDL.immediately diverted to MHDL.

Appeared on the MHDL about 3 to 4 times. Turned out she was a well-Appeared on the MHDL about 3 to 4 times. Turned out she was a well-educated woman whose marriage had broken down. She suffered emotionally educated woman whose marriage had broken down. She suffered emotionally and mentally and her children could not assist her. She had been seen by and mentally and her children could not assist her. She had been seen by doctors and diagnoses made and some medication given - turns out they doctors and diagnoses made and some medication given - turns out they were all inappropriate.were all inappropriate.

After MHDL assessment she was referred to a psychiatrist who properly After MHDL assessment she was referred to a psychiatrist who properly diagnosed and medicated her for the first time for many years. She was given diagnosed and medicated her for the first time for many years. She was given housing and other assistance.housing and other assistance.

When she last appeared in MHDL, she was well-dressed and groomed and When she last appeared in MHDL, she was well-dressed and groomed and very articulate. She thanked all who had helped her over the previous few very articulate. She thanked all who had helped her over the previous few months and acknowledged that for the first time in years she knew who she months and acknowledged that for the first time in years she knew who she was and felt like a member of the community. She was in good was and felt like a member of the community. She was in good accommodation on her own. accommodation on her own.

This was about 9 months ago. She has not re-offended since. This was about 9 months ago. She has not re-offended since.

The FutureThe Future

Extension of the List to other court Extension of the List to other court registriesregistries

Rotation of Magistrates through the Rotation of Magistrates through the ListList

Higher level of data collectionHigher level of data collection Continued monitoring of the resource Continued monitoring of the resource

impactimpact Re-consider eligibility criteria.Re-consider eligibility criteria.

Thank you for your interest today.Thank you for your interest today.

http://www.magistratescourt.tas.gov.au/divisihttp://www.magistratescourt.tas.gov.au/divisions/criminal__and__general/mental_health_dions/criminal__and__general/mental_health_diversionversion