Psychiatric recommendations to the courts

In preparing a report for court, the task of the psychiatrist is to explain the possible contribution of substance misuse to a particular offence, set in the context of the life history and psychiatric and offending history of the individual. The contribution of the medical report to the sentencing process is to comment on culpability or responsibility, indicate whether treatment could usefully prevent reoffending, and help the court to protect society. (1.6> The issue of responsibility may be addressed by considering the possible applicability of the relevant psychiatric defences.

The introduction of a psychiatric liaison service for the courts has been shown to offer more rapid assessment and to increase diversion from custody. (17) In cases where a non-custodial disposal is being considered, the court should be informed as to the opportunities for community-based treatments. Drug and alcohol treatment services may be able to provide interventions for the sentenced offender, either on a voluntary basis or as a condition of probationary supervision. An order for conditional treatment can specify where the offender resides and for treatment to be provided in hospital or as an outpatient, but the nature of the treatment cannot be specified. There has been little evaluation of conditional treatments in England, but studies from the United States suggest therapeutic benefit. (18>

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