Mental Health, Autism & Learning Disabilities in the Criminal Courts

Information for magistrates, district judges and court staff

Home Contents Search

ii. Mental Health Treatment Requirement (MHTR)

The MHTR allows offenders with mental health conditions to engage with treatment and support in the community whilst also serving a sentence for their offence. This requirement has a number of benefits such as improving health outcomes, reducing reoffending and cutting the cost of crime. It is also an alternative to a custodial sentence as most prisons are generally ill-equipped to manage prisoners with mental health conditions.

At least 40% of offenders on Community Orders are thought to have a diagnosable mental health condition and yet the MHTR is rarely used. Since its introduction in 2005, the MHTR still represents less than 1% of all requirements issued.

The investment in liaison and diversion services should help to increase the use of the MHTR. Liaison and diversion services will be able to identify defendants with mental health conditions and provide courts with timely information to enable to them to make more informed sentencing decisions.

A MHTR can be appropriate in the following situations:

  • if an offender does not require inpatient care
  • if an offender has been treated in hospital since the offence and their mental health has improved to a point where care in the community is appropriate
  • where the custody threshold has been passed as well as those cases in which it has not
  • the offender’s culpability is substantially mitigated by their mental state at the time of the offence and it is in the public interest to ensure they continue to receive treatment for their mental disorder.

A MHTR can provide access to necessary treatment and support that the offender might otherwise have had difficulty accessing. Offenders with mental health problems might need help to address their condition before they are able to undertake other sentence requirements. Treatment and support could help an offender meet the conditions of their sentence and prevent a breach, and to reintegrate into society and reduce their reoffending. The MHTR can be used alongside other requirements, such as an alcohol treatment requirement, a drug rehabilitation requirement or a required activity requirement. 

MHTRs can only be issued when the offender gives their consent to engage with treatment and mental health services are willing to accept the individual. It would be counterproductive to issue a MHTR if the offender does not give consent or if services are unwilling to work with them. This would be likely lead to a breach.

Treatment could include: psychological therapy, medication or a combination of both.  The MHTR can be for a maximum of three years. If you are considering this option you should consult with your Legal Advisor and seek advice from liaison and diversion services and/or court mental health team. 

© Prison Reform Trust and Rethink Mental Illness. All rights reserved.