PILOT PROJECT
PILOT PROJECT IN PORTUGAL
Goals
To promote an effective articulation between probation services and mental health services in the implementation of non-custodial sentences and measures in the community, in order to:
– Promote effective access to local mental health services for probationers in need of mental health care;
– Promote a shared and concerted intervention between probation services and mental health services.
Context
The medical/psychiatric treatment and attendance at psychiatric/psychological appointments are often determined as part of the implementation of sentences and measures in the community, particularly in the context of suspended sentences and conditional release/parole. This is the case, namely, for road traffic offences, sex offences, domestic violence, theft and drug-related offences.
As responsible for the implementation of sanctions and measures in the community, it’s the probation service who refers probationers to mental health services. Often, medical-psychiatric treatment or psychiatric/psychological appointments are determined by the court, following a proposal to that effect made by the probation officer.
Although the determination of treatment or appointments depends on the consent of the sentenced persons, the fact is that they are often not motivated for this treatment, which has repercussions either in the attendance at appointments or in the adherence to the proposed medical treatment. Other times, they do not even have the socio-economic conditions to proceed as determined by the judicial decision. In these situations, social reintegration is seriously compromised and the path that opens up is, consequently, that of a return to prison or the enforcement of the prison sentence. The path that opens up is ultimately the one that was intended to be avoided.
These situations are also caused by the insufficient knowledge of the probation services of the responses of the mental health services, as well as the insufficient knowledge on the part of these services of the particularities of those who, simultaneously, need mental health care and are serving a sentence or measure in the community.
The recent entry into force of the new regime establishing general principles and rules for the organization and functioning of mental health services, established in Decree-Law 113/2021, of December 14, in line with what is understood to be the provision of mental health care today, makes this the right time to promote the articulation of these services with the probation services.
On the one hand, the new regime determines that the provision of mental health care should focus on the specific needs and conditions of the persons who need it and be promoted primarily at the community level, that the organization and operation of mental health services should be geared to the full recovery of persons and that the implementation of mental health policy should ensure the involvement of all public services of the governmental areas with direct or indirect intervention in the area of mental health, including justice, operating in a model of multilevel intervention. On the other hand, the local mental health services are reorganized in order to be provided with multidisciplinary teams which include professionals from the areas of psychiatry, nursing, psychology, social work, occupational therapy and psychomotricity; it is the responsibility of the community mental health teams to ensure, on a continuous basis, all the necessary functions at a specialized and differentiated level of care, including assessment of needs, diagnosis, appointments, therapeutic interventions, home visits and rehabilitation interventions.
Methodology
- Development of a model of articulation between a local mental health community team and the probation service team responsible for the same geographical area.
- Selection of probationers under suspended sentence and conditional release/parole required to undergo medical-psychiatric treatment or attend psychiatric/psychological appointments.
- Joint training of the professionals from both services involved in the pilot project, for mutual knowledge of their competences, procedures and specificities of the target population.
- Definition of procedures for referring the probationers to the local mental health service (referral by the probation team to the community mental health team) and for follow-up according to a concerted and shared intervention model.
- Implementation and evaluation of the new procedures.
- Elaboration of a good practices guide aimed at facilitating dissemination of the methodology.
Partners
Directorate-General for Reintegration and Prison Service and Probation Team of Dão-Lafões, Viseu (Ministry of Justice)
National Coordination of Mental Health Policies (Ministry of Health)
Community Mental Health Team of Dão-Lafões (Hospital Center Tondela-Viseu)
Implementation period
May to November 2022
Results
A Best Practices Guide was developed with the aim of documenting the methodology adopted by the teams in Dão-Lafões and, as community mental health teams are being created, disseminate it to other areas of the country.
The Best Practices Guide is available here.
The results of the pilot-project were presented at the Webinar "Non-custodial sentences and measures Best practices between probation services and mental health services", on March 15, 2023.
Monitoring and Evaluation
A comprehensive evaluation of the implementation and outcomes of the pilot project was entrusted to an external evaluator.
