Forensic Mental Health Services and Diversion
Forensic mental health services in England and Wales provide care for mentally disordered offenders across hospital, community, and criminal justice settings. These services are among the specialised services commissioned by NHS England, with increasing delegation of commissioning responsibility to NHS-Led Provider Collaboratives such as [[organisations/reach-out-provider-collaborative|Reach Out]] in the West Midlands and the North London Forensic Collaborative.[^c6] This wiki documents the development of such services in and around Birmingham, including the work of nurse researcher [[Stuart Wix]], the governance of [[Birmingham and Solihull Mental Health NHS Foundation Trust]] (BSMHFT), and the evidence base for [[Diversion Schemes for Mentally Disordered Offenders|diverting mentally disordered offenders]] from the criminal justice system into treatment.
The number of people accessing NHS-funded secondary mental health services in England increased by 24% between 2019/20 and 2022/24, reflecting growing demand across the system.[^c7] Birmingham and Solihull Mental Health NHS Foundation Trust is one of the largest mental health trusts in the West Midlands, providing services across Birmingham and Solihull.[^c1] Further detail on governance, policies, and services is on the [[organisations/bsmhft|BSMHFT page]].
Significant developments in policy and service organisation have occurred since 2025. The Mental Health Act 2025 has passed into law and its reforms are being phased in over the coming decade, beginning with provisions affecting restricted patients that came into force in February 2026.[^c9] The government allocated £75 million in 2025/26 to support integrated care boards and NHS-led Provider Collaboratives in reducing out-of-area forensic and inpatient placements.[^c10] The West Midlands is simultaneously expanding community forensic provision through the Reach Out collaborative, including a £30 million tender for 45 secure beds.[^c10]
NHS England allocated £30 million for six pilot projects based on the [[Trieste Model]] of community mental health care, of which BSMHFT's Golden Hillock Neighbourhood Mental Health Centre in East Birmingham is one.[^c12] The pilot serves one of the 10% most deprived wards in England, where 90% of the population are from Black, Asian and minority ethnic backgrounds.[^c11] If successful, the model is intended to become the standard of community mental health care across England.
A significant strand of forensic mental health research in Birmingham has focused on the Diversion at the Point of Arrest (DAPA) scheme, introduced in South Birmingham in 1992.[^c3] Over a four-year period, the scheme recorded nearly 500 contacts, with community psychiatric nurses providing round-the-clock assessment in police stations.[^c4] This work has been cited in subsequent academic literature as an exemplar of police station diversion.
[[Forensic Community Psychiatric Services and Nursing|Forensic community mental health nurses]] play a pivotal role in statutory community aftercare for mentally disordered offenders, and research from Birmingham contributed to the evidence base for this model of care.[^c2]