A 100-year life expectancy will exacerbate some of our worst criminal justice practices. It will likely lead to longer sentences, less rehabilitation for those sentenced to prison, and less recidivism reduction for those who are released from prison. In sum, a 100-year life expectancy will likely further entrench our mass incarceration problem, which is a result of an incredibly high incarceration rate as compared to other countries, thereby making us less safe.

This chapter looks at the Department of Child Safety and the criminal justice system. Child Safety often didn’t understand that a young person had a cognitive disability. Sometimes young people with cognitive disability were abused while they were in Child Safety. Young people with cognitive disability often did not get much help when they left Child Safety. Parents with cognitive disability often had their children removed from them by Child Safety. Some young people were abused by police. Young people with cognitive disability who went to prison didn’t get much help. They also found it hard when they left prison.

The interaction between mental illness, some personality disorders, psychological and developmental problems and sexual behaviour is a complex area. This chapter focuses on sexually problematic behaviour displayed by adult patients in mental health inpatient settings. It discusses prevalence, definitions and a potential role for the criminal justice system. A clinical case illustrates potential difficulties and solutions in assessment and management which should be multi-faceted.

Individuals with dementia may encounter the Criminal Justice System (CJS), including the police and courts, in different capacities: as victims, witnesses or perpetrators of crimes (related or not to the diagnosis). The Living Well with Dementia strategy makes the following statement: ‘People with dementia access all services and so need informed understanding and support from all the services they come into contact with, not only from specialist dementia services. Awareness and skills are therefore needed in all sections of the workforce and society (e.g. housing, emergency services, employers, utilities, public sector services, GP receptionists, criminal justice system staff), not just those involved with dementia care.’ WhilE we think it is important to highlight this policy initiative, this chapter does not analyse how it has been implemented within the CJS. We are limiting our discussion to the legal issues relating to four areas: crimes committed against people with dementia; crimes committed by people with dementia; dementia in secure settings; and discharge of restricted patients on conditions that amount to deprivation of liberty.

This chapter provides an overview of clinical practice pertaining to offenders with intellectual disability. It covers the ‘offending journey’ of people with intellectual disability whose behaviour reaches the threshold for criminal justice system involvem’nt. This includes being accused of a crime, interactions with the police, decisions regarding prosecution and the processes involved in court cases. Though much of this account is based on the law in England and Wales, the chapter also reviews key research in this area, examining the risk factors for offending, characteristics of this population, models of treatment and treatment outcomes.

This chapter gives an overview of research on offenders with fetal alcohol spectrum disorders (FASDs). We present a history of FASDs and assessment challenges, and describe the diagnostic process. Then we present the epidemiology of FASDs in young offenders: challenges with estimating the prevalence of FASDs; prevalence of FASDs in the criminal justice system; FASD prevalence in young offenders in comparison with other neurodevelopmental disorders; and the patterns, risk and protective factors of justice system encounters in young offenders with FASDs. We then focus on the relationship between FASDs and the criminal justice system in young offenders. We discuss the path to criminal justice encounters and the vulnerabilities of FASD-impacted individuals during investigative interviews. Finally, we discuss the ability to stand trials in young offenders with neurodevelopmental disorders with a focus on FASDs, the roles that evidence of FASDs plays in judicial proceedings, fitness to stand trial, FASD knowledge and awareness among criminal justice system professionals, and give recommendations for questioning individuals with neurodevelopmental disorders during judicial proceedings.

Using two composite case studies the following chapter outlines the intersection of legal and forensic pathways to justice for persons with developmental disabilities in Ontario, Canada. Their pathways include a number of junctures where decision making by different stakeholders across sectors is required pertaining to legal determinations of either criminal fitness to stand trial and culpability as well as the health care presence of a contributory mental illness or disorder. Despite having similar profiles, people with developmental disabilities can have vastly different access, processes, and outcomes depending upon a number of variables including legal factors such as the severity of the offence and offence history; and extralegal factors including support network, discretion of multiple decision makers, legal resources and jurisdiction. The pathways recognise the importance and need for ensuring equitable and therapeutic justice for such individuals.

Attention-deficit/hyperactivity disorder (ADHD) is associated with a range of adverse outcomes. One of many potential adverse trajectories for those with ADHD is involvement in criminal offending. Meta-analyses have reported increased prevalence rates of ADHD in youth and adult offender populations. The prevalence of comorbid disorders in offender populations is common, but this appears to be increased in those with ADHD, which in turn complicates diagnosis and treatment. This chapter outlines the prevalence of ADHD in offender populations and considers gender and cultural effects. The relationship between ADHD and criminal offending is discussed, including the onset and type of offending, recidivism, progress within institutional establishments, comorbidity and long-term consequences. theoretical frameworks for understanding the association between ADHD and criminal offending are also considered. The chapter also highlights the economic consequences of ADHD within offender populations and more broadly within society. We consider system barriers and practical strategies that may be implemented to identify and meet the needs of offenders with ADHD.

People with a wide range of mental health and neurodevelopmental conditions are found amongst criminal justice populations, and many present with co-occurring disorders. These may include other neurodevelopmental conditions, substance use disorders or physical health conditions. It is now standard practice to use a pathways approach to organise and deliver services, and journeys taken by many people within criminal justice systems lend themselves to this, at least in theory. Basic requirements of this approach include police custody and prison reception screening, providing organised multidisciplinary care and introducing appropriate interventions as part of individual care plans. There is much we still do not know about vulnerable people in prisons, and service provision remains far from optimal. In particular, insufficient specialist provision means that many people with neurodevelopmental conditions are not identified appropriately, and do not have their needs met as they should. Further, in the absence of support, the presentations of some people render them vulnerable to specific aspects of prison life.

As we will see in the chapters to come, there is wide variety among and across different American jurisdictions in the causes and motives of the march toward increased penal severity. Generalization is possible but requires separating the system into two components: the “criminal justice system” and the “criminal legal system.”

Stigma negatively shapes the lives of people who use substances through criminalization processes and criminal justice involvement. This chapter draws from the authors’ lived experiences to explore the harms created by stigma at the intersection of substance use and criminal justice. Stigma produces a social context contributing to high rates of criminal justice involvement among people who use substances through inequitable social conditions, criminalization of substances, and under-resourcing of substance use services. Substance use stigma is reinforced by harmful police practices, painful imprisonment experiences, and insufficient support offered to formerly incarcerated people living in the community. Approaches for reducing substance use stigma involve reforming drug policy to decriminalize substances, improving access to substance use treatment and harm reduction services, and involving people with lived and living experiences of substance use and criminal justice involvement in policymaking and service delivery.