Forensic mental health

What is forensic mental health?

‘Forensic’ means related to, or associated with, legal issues. Forensic mental health services provide assessment and treatment of people with a mental illness who have offended, or are at risk of offending.

People in the criminal justice system have significantly higher rates of mental illness than people in the general community. People with a mental illness are also more likely to be detained in custody, sentenced to imprisonment, or to become a victim of crime. Young men are overrepresented in Australia’s prison population and are therefore more likely to be referred to forensic mental health specialists or services.

People may be referred for assessment by the police, courts, prison, other health or mental health services, or justice agencies. Treatment may be provided in the community, in hospital or in prison.

The mental state of those people who have offended, who are alleged to have offended or who are at risk of offending may need to be assessed for a variety of reasons, including:

• whether or not they are capable of making a plea in court
• their state of mind at the time of the offence
• their current need for mental health treatment.

Mental illness

A mental illness is a health problem that significantly affects how a person feels, thinks, behaves and interacts with other people. It is diagnosed according to standardised criteria.

Mental illness is an umbrella term that refers to many different illnesses that affect the mind. Around one in five Australians will experience some form of mental illness – mild, moderate or severe – at some time in their lives. Even when people have the same illness, the impact and affect for each person is different.

Some of the main groups of mental illnesses are:

• mood disorders (such as depression or bipolar disorder)
• anxiety disorders
• personality disorders
• psychotic disorders (such as schizophrenia)
• eating disorders
• trauma-related disorders (such as post-traumatic stress disorder)
• substance use disorders.

Support for people with forensic mental health issues

Forensic mental health clinicians may become involved when:

• prisoners need inpatient treatment
• prisoners require assessment or treatment of a mental illness
• people are accused of crimes, but are considered unfit to plead because of their mental impairment
• people are found not guilty of crimes because of mental impairment
• offenders or alleged offenders are referred by courts or other agencies (for example, the parole board) for assessment
• people are unable to be managed safely in mainstream mental health services
• people living in the community and who have a serious mental illness have offended, or are at high risk of offending.

Forensic mental health referral agencies

People who have offended, allegedly offended, or are at risk of offending may be referred to a forensic mental health service or practitioner by a range of organisations, including:

• police
• courts
• prisons
• community corrections
• other justice and mental health services.

Treatment for people with forensic mental health issues

Forensic mental health services provide recovery-focused treatment with the goal of successful rehabilitation and a safer community. Forensic mental health services provide a range of treatments and interventions from a multidisciplinary team in hospital, prisons and youth justice centres and the community.

Treatments and interventions may include:

• Medication – the most prescribed medications are antidepressants, which can be used for anxiety and depression. Mood stabilisers are used for bipolar disorder, and antipsychotic medicines are used for schizophrenia and psychosis.
• Psychological therapy – there are many different types of psychological interventions which can be provided one-on-one or in a group.
• Offence related programs.
• Drug and alcohol related programs.
• Psychosocial interventions.
• Recovery focused rehabilitation.
• Family and carer support.

Forensic mental health services

There are services available to support offenders who have a mental illness. The Department of Health funds a range of public general and forensic mental health services:

• Forensicare (Victorian Institute of Forensic Mental Health) is the state-wide specialist provider of adult forensic mental health services in Victoria.
• Orygen Youth Health provides specialist youth custodial and community forensic mental health services.
• The Department of Justice and Community Safety funds prison-based mental health services, court-based assessment and diversion programs, and community-based support programs.
• Private forensic psychologists and psychiatrists offer treatment and counselling services.

Where to get help

• In urgent mental health and crisis situations, dial triple zero (000)
• Your GP (doctor)
• Forensicare Tel. (03) 9495 9100
• Orygen Tel. (03) 9966 9100
• Mental health services directory (Victoria)