Mental Health and Criminal Justice / Santé mentale et justice pénale

Acknowledgements xix
Remerciements xxi

Part I Introductory Synthesis and Analyses 1ère Partie Synthèse et Analyses Introductives
A legal perspective on the worldwide situation of defendants and detainees with mental illness 3
Maartje Krabbe
1 Introduction to this volume 3
1.1 Definitions 4
1.2 Outline of this volume 5
1.2.1 Thematic chapters 5
1.2.2 National chapters 8
1.2.3 Present chapter 8
2 Defendants and detainees with mental illness: the numbers 8
3 Defendants and detainees with mental illness: the causes 11
3.1 Systemic causes 12
3.1.1 How the system deals with mental illness 12
3.1.2 How defendants and detainees deal with the system 15
3.2 Reasons for systemic causes 17
4 Defendants and detainees with mental illness: the problems 19
4.1 Defendant is not able to deal with criminal proceedings 19
4.2 Lack of treatment 20
4.3 Unsuitable environment 21
4.4 Aftercare problems 22
5 Human rights implications 23
5.1 Legal framework 23
5.2 Procedural rights of defendants and detainees with mental illness 25
5.3 The right to mental healthcare 26
5.3.1 General rules on the right to mental healthcare 27
5.3.2 Rules on mental healthcare in prison 27
5.3.3 Rules relevant to specific groups of prisoners 29
5.4 Human rights implications of the effect of the general situation in prisons on detainees with mental illness 30
5.5 Human rights implications of aftercare problems 32
5.6 Conclusion 32
6 Recommendations 33
7 Conclusion 42

Une perspective juridique sur la situation mondiale des prévenus et des détenus atteints de maladie mentale 45
Maartje Krabbe
1 Introduction à ce volume 45
1.1 Définitions 46
1.2 Aperçu du présent volume 47
1.2.1 Les chapitres thématiques 47
1.2.2 Chapitres nationaux 50
1.2.3 Présent chapitre 51
2 Les prévenus et les détenus atteints de maladie mentale : les chiffres 51
3 Les prévenus et les détenus atteints de maladie mentale : les causes 54
3.1 Causes systémiques 54
3.1.1 Comment le système traite la maladie mentale 54
3.1.2 Comment les prévenus et les détenus traitent avec le système 58
3.2 Les raisons des causes systémiques 60
4 Les prévenus et les détenus atteints de maladie mentale : les problèmes 62
4.1 Le défendeur n’est pas en mesure de faire face à la procédure pénale 63
4.2 L’absence de traitement 63
4.3 Environnement inadapté 65
4.4 Problèmes de suivi 66
5 Les implications en matière de droits de l’homme 67
5.1 Cadre juridique 67
5.2 Droits procéduraux des accusés et des détenus atteints de maladie mentale 69
5.3 Le droit aux soins de santé mentale 71
5.3.1 Règles générales sur le droit aux soins de santé mentale 71
5.3.2 Règles relatives aux soins de santé mentale en prison 72
5.3.3 Règles applicables à des groupes spécifiques de détenus 74
5.4 Implications pour les droits de l’homme de l’incidence de la situation générale dans les prisons sur les détenus atteints de maladie mentale 75
5.5 Implications des problèmes de postcure sur les droits de l’homme 77
5.6 Conclusion 78
6 Recommandations 79
7 Conclusion 89

Part II Themes 2ème Partie Thèmes
The effects of the criminal process and deprivation of liberty on mental health 95
Olivera Vulić Kralj
1 Introduction 95
2 Effects of deprivation of liberty 96
3 Challenges prior to imprisonment 97
4 The presence of prisoners with mental and behavioural disorders 98
5 Prisons: theory versus reality 100
6 The jurisprudence of the ECtHR 105
6.1 De Donder and De Clippel v. Belgium 106
6.2 Keenan v. the UK 107
7 Conclusion 107

Mentally disordered in prison? Prevalence, development of symptoms and recidivism 109
Oscar Bloem, Robbert-Jan Verkes & Erik Bulten
1 Introduction 109
2 Prevalence 109
2.1 Psychotic disorders 111
2.2 Depressive disorders 115
2.3 Anxiety disorders 115
2.4 Substance-related disorders 116
2.5 Attention Deficit Hyperactivity Disorders (ADHD) 117
2.6 (Antisocial) Personality disorders 117
2.7 Intellectual dysfunction 118
2.8 Autism Spectrum Disorders (ASD) 118
3 Development of symptoms 119
3.1 Symptom changes in the overall prison population 119
3.2 Symptom change in specific mental disorders 120
3.3 Symptom changes in relation to other prison or personal circumstances 121
4 Recidivism 122
4.1 Mental disorders and recidivism 123
4.2 Other factors that may be related to recidivism 124
5 Conclusion 124
6 Closing remark 125

Onthe treatment of prisoners with psychiatric disturbances: a matter of health or justice? 133
Taro Morinaga & Mana Yamamoto
1 Introduction 133
2 Causes 133
3 Criminal justice versus medical care 135
4 Away towards fair and adequate treatment of offenders with psychiatric disturbances 137
5 Conclusion 139

Defendants with psychiatric disturbances or otherwise limited mental abilities – Fair procedure during pre-trial inquiry and at trial 141
Piet Hein van Kempen
1 Introduction 141
2 Scope of the problem: various statistics 143
3 General bases: adversarial procedure, equality of arms, equality – relevance of systems’ adversariality or inquisitoriality? 146
4 The specific fair procedure rights for defendants with psychiatric disturbances or otherwise limited mental abilities 150
4.1 Guarantees for effective participation by defendants during trial 151
4.2 Safeguards for fairness during police questioning of defendants with limited abilities 157
4.3 No right to terminate the trial and no impediment to fair proceedings by suspension 158
4.4 Preliminary conclusion: task for legislature and legal practice 159
5 The need for protection of the legal position of insufficiently capable defendants 161
5.1 Conclusions on defendants who are unfit to stand trial 161
5.2 Conclusions on defendants with limited capacity for effective participation during trial 162
5.3 Conclusions on defendants with limited capacity during police questioning and preliminary inquiry 163
6 Final remarks 165

Healthcare and human rights requirements as regards detainees with psychiatric disturbances 167
Małgorzata Wąsek-Wiaderek
1 Introduction 167
2 The right to obtain adequate healthcare in prison/detention centre 168
3 The right to liberty of persons of unsound mind – an absolute ban on deprivation of liberty based partly on mental disorder? 175
4 Conclusions 183

Prisoners with psychiatric disturbances in detention and in prison 185
Celso Manata
1 Introduction 185
2 Dilemmas in relation to two different groups of prisoners 185
3 Recent developments 188

Les unités hospitalières spécialement aménagées, un dispositif spécifique de prise en charge des personnes détenues atteintes de troubles mentaux 191
Catherine Pautrat
1 Une forte présence de personnes atteintes de troubles mentaux en prison justifiant une politique de prise en charge adaptée 191
1.1 La prévalence des troubles mentaux en prison 191
1.2 Les principes d’une prise en charge spécifique 192
2 Les UHSA : un dispositif innovant de prise en charge des détenus atteints de troubles mentaux nécessitant une hospitalisation 193
2.1 Un dispositif novateur répondant à des besoins spécifiques 193
2.2 Deux cas d’admission sont prévus 194
2.3 Un dispositif pertinent et efficace 195
3 Conclusion 196

Part III National Reports 3ème Partie Rapports Nationaux
Defendants and prison inmates with mental disabilities in the criminal justice system in Brazil 199
Edmundo Oliveira & Silvio Gemaque
1 Introduction 199
2 Defendants with mental disabilities during the investigation stage and the trial stage: the fair process 200
3 Prisoners with mental disabilities during provisional arrest: needs, problems, possible solutions 201
4 Prison inmates with mental disabilities: needs, problems, possible solutions 203
5 Treatment of prison inmates with mental disabilities: a matter of health or justice responsibility? 206
6 Reintegration of prisoners with mental disabilities to the community: needs, problems, solutions 208
7 Conclusion 210

The criminal justice system, mental health and human rights – The situation of defendants and detainees in Chile 211
Francisca Figueroa San Martín & Francisco Molina Jerez
1 Introduction 211
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 212
3 Detainees with psychiatric disturbances during provisional detention: needs, problems, screening tools 216
4 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 217
5 Treatment of prisoners with psychiatric disturbances: health or justice responsibility? 223
6 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 224
7 Conclusions 225

Defendants and detainees with psychiatric disturbances in Germany 227
Rita Haverkamp & Thomas Galli
1 Introduction 227
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 228
3 Detainees and prisoners with psychiatric disturbances during provisional detention: needs, problems, screening tools 232
3.1 Introduction 232
3.2 Context 233
3.3 Needs 233
3.4 Problems 234
3.5 Screening tools 235
3.6 Conclusion 236
4 Treatment of prisoners with psychiatric disturbances: health or justice responsibility? 236
5 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 241
6 Conclusion 248

Defendants and detainees with psychiatric disturbances in the criminal process and in the prison system in Greece 251
Calliope Spinellis & Athanassios Douzenis
1 Introductory remarks 251
1.1 The law in the books of the year 1950 252
1.2 The 1950 law in action 253
1.3 The new law: main points 256
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 257
3 Detainees with psychiatric disturbances in provisional detention: needs, problems, screening tools 260
4 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 261
5 Treatment of prisoners with psychiatric disturbances: health or justice responsibility? 265
6 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 266
7 Conclusion 268

Defendants and detainees with psychiatric disturbances in the criminal process and in the prison system in Hungary 271
Katalin Ligeti
1 Introduction 271
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 273
2.1 Providing information for defendants with psychiatric disturbances 274
2.2 Acquiring evidence on the mental state 276
3 Detainees with psychiatric disturbances in provisional detention: needs, problems, screening tools 278
3.1 Providing information for defendants with psychiatric disturbances 278
3.2 Assessing and meeting the needs in ‘standard’ places of detention 279
3.3 Temporary involuntary treatment – assessing and meeting the needs in the IMEI 282
4 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 283
4.1 Proportion of prisoners with psychiatric disturbances 283
4.2 Psychiatric disturbances in prison 284
4.2.1 Screening and detecting psychiatric disturbances 284
4.2.2 Special units and mental healthcare for persons with psychiatric disturbances in prisons 286
4.3 Treatment and involuntary treatment at the IMEI 289
5 Treatment of prisoners with psychiatric disturbances: health or justice responsibility? 294
6 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 295
6.1 General remarks 295
6.2 Reintegration in the curative-therapeutic and psychosocial unit 298
6.3 Reintegration at the IMEI 298
7 Conclusion 299

Defendants and detainees with psychiatric disturbances in the criminal process and in the prison system in Ireland 303
Mary Davoren & Mary Rogan
1 Introduction 303
2 Therapeutic security and the provision of mental health beds appropriate for the needs of mentally disordered offenders 304
3 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedures 305
4 Detainees with psychiatric disturbances during provisional detention: needs, problems, screening tools 310
4.1 The ‘special verdict’ or not guilty by reason of insanity 313
5 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 315
6 Special populations within the prison setting 317
7 Treatment of prisoners with psychiatric disturbances: health or justice responsibility? 319
8 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 320
9 Conclusion 321

Defendants and detainees with psychiatric disturbances in the criminal process
and in the prison system – The Japanese situation 323
Taro Morinaga & Mana Yamamoto
1 Introduction 323
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 325
2.1 Investigation and prosecution stage 325
2.2 Adjudication stage 328
3 Detainees with psychiatric disturbances during provisional detention: needs, problems, screening tools 329
4 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 330
5 Treatment of prisoners with psychiatric disturbances: health or justice responsibility? 333
6 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 335
7 Conclusion 337

Prisoners and detainees with mental health disorders in the criminal process and in the prison system in Kazakhstan 339
Azamat Shambilov
1 Introduction 339
2 Prisoners with mental disorders during a pre-trial investigation and in court: fair trial 341
3 Detainees with mental disorders during pre-trial detention: needs, problems, instruments of care 346
4 Convicts with mental disorders in prison: needs, problems, instruments of care 348
5 Treatment of convicts with mental disorders: responsibility for causing harm to health or perverting the course of justice? 352
6 Reintegration of convicts with mental disorders in society: needs, problems, solutions 356
7 Conclusions 357

Defendants and detainees with psychiatric disturbances in the criminal process and in the prison system in the Netherlands 359
Michiel van der Wolf & Paul Mevis
1 Introduction 359
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 360
2.1 Suspension of prosecution due to unfitness 360
2.2 Additional safeguards (related to counsel) to ensure a fair procedure 364
2.3 Recent and future developments 367
3 Detainees with psychiatric disturbances in provisional detention, in prison and in community reintegration: needs, problems, screening tools 371
3.1 Introduction: the Dutch penitentiary system related to forensic care 371
3.2 Developments in forensic care: why it became a Justice responsibility and related challenges 373
3.3 Diversion to the mental health system: non-forensic care 377
3.4 (Forensic) Care for detainees in provisional detention 378
3.5 (Forensic) Care for detainees in prison 380
3.6 (Forensic) Care for detainees reintegrating into the community 382
3.7 Screening 384
4 Conclusion 385

Defendants and detainees with psychiatric disturbances in the criminal process in New Zealand 387
Yvette Tinsley & Warren Young
1 Introduction 387
2 Detainees with psychiatric disturbances in provisional detention 388
2.1 Non-offenders experiencing a mental health crisis 388
2.2 Mentally impaired offenders 391
2.3 Detention for detoxification 391
3 Defendants with psychiatric disturbances and intellectual disabilities during pre-trial inquiry and at trial 392
3.1 Rights and protections when questioned 392
3.2 Fitness to stand trial 394
3.3 Insanity defence 398
4 Responsibility for mentally impaired offenders 399
4.1 The prevalence of mental disorder amongst prisoners 401
4.2 Assessment and treatment of mental impairment 402
5 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 402
6 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 406
6.1 Recent reintegration initiatives specifically for offenders with mental health and addiction needs 407
6.2 The call for ‘therapeutic’ mental health courts 408
7 Conclusion 409

Defendants and detainees with psychiatric disturbances in the criminal process and in the prison system of Poland 411
MałgorzataWąsek-Wiaderek & Paulina Duda
1 Introduction 411
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 412
2.1 Pre-trial stage of the proceedings 412
2.2 Trial stage of the proceedings 415
3 Detainees with psychiatric disturbances in provisional detention: needs, problems, screening tools 418
4 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 421
5 Treatment of prisoners with psychiatric disturbances: health or justice responsibility? 426
6 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 428
7 Conclusion 433

Defendants and detainees with psychiatric disturbances in the criminal process and in the prison system in Portugal 435
Anabela Miranda Rodrigues & Sónia Fidalgo
1 Introduction 435
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 436
3 Detainees with psychiatric disturbances in provisional detention: needs, problems, screening tools 440
4 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 442
5 Treatment of prisoners with psychiatric disturbances: health or justice responsibility? 444
6 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 445
7 Conclusion 447

Defendants and detainees with psychiatric disorders in the Spanish criminal justice system 449
Ana Cerezo
1 Introduction 449
2 Detainees with psychiatric disorders during custody and pre-trial detention 451
3 Prisoners with psychiatric disorders in prison 452
3.1 Psychiatric penitentiary hospitals 452
3.2 The high level of mental disorders among the Spanish prison population 455
4 Treatment of prisoners with psychiatric disorders 457
5 Community reintegration of prisoners with psychiatric disorders 459
6 Conclusions 460
6.1 Changes to the restrictive measure of confinement in a psychiatric prison according to the basis for the measure 460
6.2 Disappearance of psychiatric penitentiary hospitals 462

Defendants and detainees with psychiatric disturbances in the criminal process and in the prison system in the United States of America 465
Emilio C. Viano
1 Introduction 465
2 Defendants with psychiatric disturbances during pre-trial inquiry and at trial: fair procedure 469
2.1 Pre-trial 469
2.1.1 Miranda rights – failed protection? 470
2.2 Trial 473
2.2.1 Competency – Is the defendant able to stand trial? 473
2.2.2 Guarantees and aid to demonstrate incompetency to stand trial 473
2.2.3 If the accused is considered to be mentally incompetent to stand trial – what next? 474
2.2.4 Special procedures 474
3 Detainees with psychiatric disturbances during provisional detention: needs, problems, screening tools 477
3.1 Problems in dealing with detainees who suffer from psychiatric disturbances and are held in provisional detention 477
3.2 Mentally ill detainees and their special needs 480
3.3 Screening tools to detect whether the person suffers from psychiatric disturbances 482
3.4 Special measures that must be taken for a detainee who suffers from psychiatric disturbances 483
4 Prisoners with psychiatric disturbances in prison: needs, problems, screening tools 484
4.1 Problems related to dealing with prisoners who suffer from psychiatric disturbances 484
4.2 Mentally ill prisoners and their special needs 486
4.3 Screening tools to detect whether the person suffers from psychiatric disturbances 487
4.3.1 Different tools for juveniles 487
4.4 Special measures that must be taken for a detainee who suffers from psychiatric disturbances 488
4.5 The prison system and mental treatment of prisoners 489
4.5.1 Preparation for release and support after release 491
4.5.2 Imprisonment as a cause of mental health issues 491
5 Community reintegration of prisoners with psychiatric disturbances: needs, problems, solutions 492
5.1 In what way and to what extent the United States is challenged by such a phenomenon 492
5.2 Treatment of prisoners – health or justice responsibility? 494
5.3 International protection – Aspiration values 496