Diversion of Mentally Ill Offenders from the Criminal Justice System in Ireland: Comparison with England and Wales.

AIM: It is generally accepted that certain people who are mentally ill and have contact with the criminal justice system should be diverted to psychiatric care rather than imprisoned. We sought to comment on priorities relating to the development of diversion services in Ireland through comparison with developments in a neighbouring jurisdiction. METHODS: A comparative review was undertaken in relation to the provision for psychiatric diversion across the offender pathway in Ireland and England and Wales. This included legal and service related considerations. RESULTS: In both jurisdictions, services show significant geographical variability. While developments in England and Wales have focussed on the broader offender pathway, diversion services in Ireland are chiefly linked to imprisonment. There is little or no specialist psychiatric expertise available to Gardai in Ireland. Prison In-reach and Court Liaison Services (PICLS) are developing in Ireland but expertise and resourcing are variable geographically. There is a lack of Intensive Care Regional Units (ICRU) in Ireland, in sharp contrast with the availability of Intensive Care and Low Secure Units in England and Wales. There is limited scope to divert to hospital at sentencing stage in the absence of a "hospital order" provision in Irish legislation. CONCLUSIONS: Three areas in the development of Irish diversion services should be prioritised. Firstly, the provision of advice and assistance to Gardai at arrest, custody and initial court hearing stages. Secondly, legislative reform to remove barriers to diverting remand prisoners and facilitating hospital disposal on sentencing. Thirdly, an urgent need to develop of ICRU's (Intensive Care Regional Units) to facilitate provision of appropriate care by local mental health services.