How effective are liaison and diversion schemes?

Work with offenders looks at a new evaluation of the national model

The RAND Corporation has just published its Outcome evaluation of the national model for liaison and diversion. As most readers will know, Liaison and Diversion (L&D) services are designed to support people with mental health problems, a learning disability, substance misuse problems and other vulnerabilities including unstable accommodation and risk of self-harm or domestic abuse.

What are liaison and diversion services?

L&D services have operated in police custody suites in some form for over 25 years, but their nature and quality varied between locations and there were many areas of the country where no L&D services were available.

However in 2011 and 2013, the Department of Health developed a national L&D model which was launched the following year, piloted at ten trial sites initially. The pilots were successful and the model was rolled out across the country in 2017 and 2018. The National Model for L&D provides 24-hour, seven days per week services for people of all ages in the adult and youth justice pathways, covering a range of health issues and ‘vulnerabilities’ including mental health, physical health and learning disabilities.

There are four main goals for these L&D services:

1. Improve access to healthcare and support services for vulnerable individuals and a reduction in health inequalities.
2. Reduce reoffending or escalation of offending behaviours.
3. Divert individuals, where appropriate, out of the youth and criminal justice systems into health, social care or other supportive services.
4. Deliver efficiencies within the youth and criminal justice systems.

The evaluation

RAND’s evaluation of the National Model for L&D was conducted at 27 sites in England. Interestingly, it employed a novel, linked data set combining national level administrative data from both the healthcare and criminal justice sectors. The data set combined information from four separate healthcare sources (Hospital Episode Statistics Accident & Emergency, Mental Health Services Datasets, Improving Access to Psychological Therapies database, National Drug Treatment Monitoring System) and two separate criminal justice sources (Police National Computer, Her Majesty’s Courts and Tribunals Service).

This evaluation examined the impact of the National Model for L&D on health service utilisation, reconviction, diversion from the criminal justice system and timeliness of court processes, as well as the economic effects of identified impacts. Outcomes included:

• Accident & Emergency attendances
• Referrals and attendances at specialist mental health services
• Referrals and attendances at Improving Access to Psychological Therapies services
• Referrals and attendances at drug and alcohol treatment services, and data on quality of life and other wellbeing measures
• Offending, including offence type and outcome
• Court processes, including duration and number of hearings.

Analyses conducted across the data sources consistently showed that L&D services are successfully engaging with a group of service users with a broad range of vulnerabilities, often at a time of acute crisis when they are most in need of support. The strongest effect appeared to be an increase in diversion from custodial sentences, although L&D services may also increase referrals to mental health and drug and alcohol treatment services.

However, it is interesting to note that there was no evidence of an impact on offending, but also no evidence that outcomes became worse due to L&D referral.

Findings

The main findings from the research were:

• L&D services succeeded in engaging people with a broad range of vulnerabilities.
• L&D services appear to intervene at a point of crisis.
• L&D services appear to increase diversion from custodial sentences.
• The interventions offered, and their uptake, varies by individual and by L&D site, and range from advice and brief interventions, to primary care referral, to detention for psychiatric assessment.
• Following L&D referral, there is a short-term increase in referral to mental health services.
• Drug and alcohol treatment referral and attendance may increase following L&D referral.
• Referral to L&D services does not appear to reduce offending.
• Court processes are not significantly affected by L&D services.

Finally, the evaluation conducted a cost benefit analysis and found that the L&D programme contributes to savings in the criminal justice system of between £13.1 million and £41.5 million through diversion from custody and consequent increases in productivity.