What are MHTR’s and when might I come across them?

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We often use jargon a lot in services like substance misuse – not because we like it but because there is lots of terminology for processes, treatments and ways of working. MHTR is a new one that you may come across and we’ve put together a simple guide to what they are, how they work and how they help.

What’s an MHTR?

MHTR stands for Mental Health Treatment Requirement. You may come across it if you or a loved find yourself part of the criminal justice system. The Mental Health Treatment Requirement (MHTR) is one of three possible treatment requirements which may be made as part of a Community Order. The MHTR is intended for the sentencing of people who are convicted of an offence which falls below the threshold for a custodial sentence (time in prison) and who have mild to moderate mental health needs.

The MHTR is an opportunity for someone to engage with treatment while still receiving a sentence. It’s a form of diversion within, rather than away from the criminal justice system, but outside custody.

Who will be delivering the MHTR’s in Devon?

In Devon and Torbay MHTRs will be delivered  by Together Drug & Alcohol Service (part of Humankind’s SW service) and the Devon Partnership Trust to provide a joined-up service to individuals who require both mental health and substance/alcohol support. Together Drug & Alcohol Service also offers standalone MHTRs.

Who will be delivering the MHTR’s in Dorset?

In Dorset MHTRs will be delivered by Reach (part of Humankind’s SW service) to provide a joined-up service to individuals who require both mental health and substance/alcohol support. Reach also offers standalone MHTRs.

Why are they needed?

It’s often the case that mental health services are under-resourced and over subscribed. This means long waits to get even basic help. The MHTR can provide access to necessary treatment and support that is often out of reach for those who most need it.

Some academic studies have highlighted the link between mental health and offending. A recent study by the Centre for Mental Health and Criminal Justice Alliance (January 2020) showed that if treatment is enforced in community sentences not only will mental health improve but it also supports reductions in re-offending.

Are there other interventions that can help people in the criminal justice system?

A MHTR is one of three possible treatment requirements along with the Drug Rehabilitation Requirement (DRR) and Alcohol Treatment Requirement (ATR). DRRs, ATRs and MHTRs are when people agree to submit to treatment where there is a clear link between alcohol dependency, drug use or mental health issues and offending behaviour. All three of these Community Sentence Treatment Requirements can form part of a Suspended Sentence Order, which keeps someone out of prison whilst they address their substance use or mental health issues.

DRR’s are intensive vehicles for tackling drug misuse and offending. DRRs involve treatment, testing and court reviews of progress.

ATRs are put in place when a person’s alcohol dependency is identified as contributing to their offending behaviour. The Court may then require the person appearing before them to undertake alcohol treatment through an ATR.

The Benefits of MHTRs

Where mental health is a contributing factor to someone commiting a crime, an MHTR order can be an invaluable tool to help that peson address their mental health and substance misuse needs at the point of sentence and at the same time. Every person works to an individualised plan and interventions.

People who require a treatment or rehabilitation requirement are some of the most vulnerable members of society and often difficult to engage into local health and social services through the normal channels. These court requirements can provide a lifeline to much needed treatment.

Work starts straight away for those on MHTRs, DRRs or ATRs, often on the day of sentencing. Treatment is not a single service trying to help, it’s a whole multi-disciplinary team, who can look at all aspects of someone’s life and personal circumstances with a view to addressing their health needs and supporting them back into their communities.

As people sometimes find themselves in a cycle of offending, MHTRs and other requirements  can disrupt that cycle and help people who may have otherwise gone under the radar with mental health issues. By addressing the underlying causes of offending behaviour and reducing any barriers that are in the way those people accessing support, success rates are higher and people actually turn their lives around.

And lastly but importantly, when we introduce successful ways of treating some of the causes of crime, we reduce offending and that means fewer victims of crime and money saved right through the criminal justice system.

Who is eligible?

The MHTR is intended as a sentencing option for individuals who have low-moderate needs in relation to their mental health.

Additional criteria. They must:

  • Be 18 years +
  • Have pleaded guilty or be found guilty after trial.
  • Have committed an offence that falls within the Community or Suspended Sentence Order range.
  • Consent and agree to engage in assessment, intervention and information sharing protocols.
  • Have mental health needs that can be addressed in a community setting or as an outpatient in a nonsecure environment, but do not warrant use of the Mental Health Act 1983

How do they work in practice?

If a person agrees to an MHTR the support will look something like this:

  • Between 8-12, 1-hour sessions.
  • Be specifically tailored to the needs of the individual, as per the treatment plan that is agreed between them and their MHTR worker.
  • Be developed from evidence based psychological theory and tools, which means that the interventions do make a difference and work because they have been tried and tested by lots of people going through the same thing.
  • Be supported by a Registered Psychologist who will provide supervision to the Mental Health Recovery Workers.

Once treatment is complete the practitioner in charge of an MHTR, will provide a personalised end of therapy letter to the individual, which will cover the progress that has been made, areas that require further work or support (along with suggestions about how this could be achieved) and signposting or introductions to other agencies or opportunities to further help or support should this be required.