MAPPA

Multi-agency public protection arrangements (MAPPA) were introduced in 2001 to manage offenders involved in serious violent or sexual offences (O'Hagan Reference O'Hagan and Elliott2018). Sections 325–327 of the Criminal Justice Act 2003 explicitly outline which individuals are considered relevant sexual or violent offenders and which persons should cooperate with the responsible authority in managing associated risks. This ‘duty to cooperate’ for relevant agencies also applies to MAPPA, with the exact composition of representation depending on the offence and those at risk. These agencies can include social services and safeguarding teams, education and health organisations and government bodies (National MAPPA Team Reference National MAPPA2024).

MAPPA consists of four categories, which reflect the nature of the offence (i.e. registered sex offenders, violent and other sexual offenders, other dangerous offenders and terrorist or terrorist risk offender), and a further three levels of MAPPA management. The latter value indicates the intensity of agency involvement, which in turn defines whether the lead agency can manage the case through information sharing, or whether multi-agency oversight or senior representation are required (National MAPPA Team Reference National MAPPA2024).

OMiC, POMs and COMs

A variety of individuals and disciplines guide offenders through the support schemes and systems. Under the Offender Management in Custody (OMiC) model, each prisoner has an allocated keyworker who aims to help them work towards rehabilitation (Small Reference Small and Hackett2023). A prison offender manager (POM) is part of a team called the offender management unit (OMU) and assists with case management while the offender is in prison, being replaced by a community offender manager (COM), also known as a probation officer, during pre-release or parole (National MAPPA Team Reference National MAPPA2024).

While in prison, a sentence plan is developed within 10 weeks for sentences over 10 months in duration, and 16 weeks for indeterminate sentences. This is developed according to a personalised risk and needs assessment, aiming to identify strategies that may reduce the risk of reoffending (HM Prison and Probation Service 2021). Sentence plans can be reviewed by both the POM and COM and this will occur when the prisoner is transferred or approaching parole or release, when objectives are met or, conversely, if there are concerns that limited progress is being made (National Offender Management Service 2014). Identification of any additional needs allows for alternative strategies and resources to be considered. Input from external disciplines, such as health professionals, can be requested where such needs are identified.

Gathering the evidence

Those with a sentence eligible for parole should be identified on arrival to prison, or when their sentence is changed, and details centrally registered (Ministry of Justice 2023). The Generic Parole Process Policy Framework lays out a timeline for gathering relevant evidence, including expert reports, which is then reviewed by the Parole Board (Ministry of Justice 2023). A party wishing to call a witness must make a written application to the Board no later than 12 weeks before the oral hearing date (Parole Board Rules 2019 (SI 2019/1038): www.legislation.gov.uk/uksi/2019/1038/contents/made).

It should be noted that, although parole hearings occur for the most part in prison, they can be arranged while an offender is in hospital. This is often the case if a Mental Health Review Tribunal recommends conditional discharge of a patient detained under a section 49 transfer direction of the Mental Health Act 1983 (amended 2007) (Parole Board for England and Wales 2020). It is highly likely in such cases that input from the treating psychiatrist will be sought and therefore familiarity with the process and requirements is crucial in psychiatric practice. The psychiatrist should pay attention to whether they are being instructed as a professional witness, who assists the court in determining the facts of a case (for example in the context of being the treating clinician), or an expert witness, whose duty is to the court to provide an impartial medical opinion. The patient should be clear about the role of the expert witness and reminded that any information disclosed to them may well be fed back to the court.

When referring a case to the Parole Board, the Secretary of State is required to serve a risk management report prepared by a probation officer and current reports on risk factors, reduction in risk, and behaviour in the prison (Parole Board (Amendment) Rules 2023 (SI 2023/397): www.legislation.gov.uk/uksi/2023/397/made). These documents form part of the parole dossier. Although in 2022 the Secretary of State amended the Parole Board Rules so that prison and probation staff were prohibited from reporting their opinion on suitability for release or transfer (Parole Board (Amendment) Rules 2022 (SI 2022/717): www.legislation.gov.uk/uksi/2022/717/contents/made), following a claim by two prisoners (R (Bailey and Morris) v Secretary of State for Justice [2023]), there was a further amendment to the rules so that the authors of these reports may, if they feel able, include their opinion on whether the prisoner is safe to be managed in the community or moved to open conditions, i.e. an open prison (Parole Board (Amendment) Rules 2023 (SI 2023/397)). We will return to the parole dossier below.

The Secretary of State (or a third party authorised by the Secretary of State) may apply to the Board for certain material to be withheld from the prisoner and their representative on the grounds that disclosure would adversely affect national security, the prevention of disorder or crime, or the health and welfare of a person (including the prisoner), and that withholding the material is necessary and proportionate to the circumstances of the case (Parole Board Rules 2019 (SI 2019/1038)).

If there is a victim liaison officer (VLO), they should be notified about the application's progress and the victim provided an opportunity to submit a victim personal statement (VPS) (Ministry of Justice 2022, 2023). Furthermore, the victim can themselves request licence conditions to promote non-contact with the prisoner such as exclusion zones (Ministry of Justice 2022).

Appointing the panel and assessing the evidence

Once a case has been referred to the Board, the chair appoints one or more Board members as the panel (Parole Board Rules 2019 (SI 2019/1038)) to consider the release of a prisoner and this panel must decide whether the prisoner is suitable for release, unsuitable for release or whether the case should be directed to an oral hearing (Fig. 1). The panel may ask any question to satisfy itself about the risk of the prisoner.

FIG 1 The parole process in England and Wales (Ministry of Justice 2023). VLO, victim liaison officer.

A panel considering a request for advice from the Secretary of State about whether a prisoner should move to open conditions must recommend either that they are or are not suitable to move. The final decision ultimately lies with the Secretary of State (Parole Board Rules 2019 (SI 2019/1038)).

The application of a statutory release test essentially requires a judgement on whether a prisoner's release would jeopardise the safety of the public, with subsequent reviews for most prisoners occurring biennially (Ministry of Justice 2022). In accordance with the Crime (Sentences) Act 1997 (amended 2003), the Board must not give a direction to release a life-sentenced prisoner unless it concludes that confinement is no longer required for public protection. Application of this public protection test requires the risk posed to be either a psychological or physical ‘risk of serious harm’, although any risk deemed ‘greater than minimal’ should be considered (Parole Board for England and Wales 2022a: para. 3.7).

Before deciding on the prisoner's ‘suitability for release’ (Parole Board Rules 2019 (SI 2019/1038): Part B, para. 5(l)), there may be other matters to be determined, such as whether an allegation of violence in prison is accepted or whether the prisoner meets the criteria for a psychiatric diagnosis. The latter may be informed by expert evidence. If the Board determines that the prisoner is suitable for release, this is final unless an application is submitted for reconsideration within 21 days of the decision being issued. The prisoner must then be released. In the event of a decision based on reading the papers in the parole dossier that the prisoner is unsuitable for release, the prisoner is entitled within 28 days of receiving the decision to apply for an oral hearing (Parole Board Rules 2019 (SI 2019/1038)).

The process of assessing evidence has been amended as a result of significant recent case law. The Supreme Court judgment on the appeals of Osborn, Booth and Reilly in 2013 (R (Osborn) v Parole Board [2013]) resulted in an increase in the entitlement to oral hearings, the resource implications of which inevitably differ from pure paper-based assessments (Hardwick Reference Hardwick2018). The ruling on Worboys in 2018 (R (DSD and NBV) v The Parole Board of England and Wales [2018]) involved a challenge on the decision to direct release. Guidance has since been provided to Board members to consider alleged offences in addition to those for which prisoners have been convicted (Parole Board for England and Wales 2023c), reflecting principles outlined by the Supreme Court (R (on the application of Pearce and another) v Parole Board of England and Wales [2023]). The Worboys ruling also successfully challenged the prohibition of publicising proceedings, and therefore the release of Parole Board decision summaries is now permitted (Jones Reference Jones2020). These cases are frequently referenced in subsequent rulings and their premise used to guide modern decision-making.

Subject to specific conditions (e.g. alleged error of law, or procedural unfairness), there is a process of appeal against Parole Board decisions (Fig. 2). Reconsideration requests were introduced in 2019, allowing either the prisoner or the Secretary of State to challenge a decision. Later escalations include High Court judicial review, which may refer a case back to the Board but not replace the outcome itself, the Court of Appeal and finally the Supreme Court (Ministry of Justice 2022).

FIG 2 Escalation of disputes with the Parole Board for England and Wales (Ministry of Justice 2022).

Victims can request to attend parole hearings should they wish to do so and hearings can now be held in public in certain cases, previously having only occurred in private (Ministry of Justice 2022). This is a reflection of concerns about transparency and public understanding of decision-making, expanding on the access to written decision summaries (Jones Reference Jones2020).

In instances where a prisoner is charged with a serious further offence (SFO), a referral is sent to the Parole Board in order that the circumstances be reviewed. An SFO is defined as a charge for any offence listed in Schedule 15A of the Criminal Justice Act 2003 (Ministry of Justice 2019), including various violent and sexual offences, allegedly committed within the probation supervision period or within 28 days of the supervision period terminating. In 2022–2023 the incidence of SFOs following release was recorded at 0.7% (Parole Board for England and Wales 2023a).

The psychiatric report

The foundation of a psychiatric report for parole hearings is a good psychiatric assessment, bearing in mind the responsibilities of an independent expert (Rix Reference Rix, Mynors-Wallis and Craven2020, Reference Rix, Eastman and Adshead2023). The core elements should be supplemented by a more in-depth focus on specific areas. The choice of those areas is informed by the contribution they make to enhancing the psychiatrist's capacity to assist the Parole Board in assessing a prisoner's risk and determining whether they can be safely released into the community (Rix Reference Rix, Mynors-Wallis and Craven2020). The psychiatrist should study the wording of the Parole Board's direction for a psychiatric report. Although the terms of the direction may be equivalent to a standard psychiatric assessment (e.g. psychiatric history, current presentation, diagnoses, treatment and mental health needs in the community), the detail of the direction may also require the psychiatrist to consider more specific issues (e.g. whether transfer to hospital is indicated). As well as understanding the specific issues arising in the case, the assessing psychiatrist should consider the Board's approach to decision-making (i.e. the Parole Board Decision-Making Framework; Parole Board for England and Wales 2022b). Key issues to be considered in the psychiatric report are outlined in Table 2.

TABLE 2 Key considerations in preparing a psychiatric report for the Parole Board for England and Wales

a Sources of information accessed with the prisoner's informed consent wherever possible.

Formulation of the prisoner's offending

Being mindful of the general evidence base on the factors known to be associated with the type of offending under consideration, the psychiatrist should strive to develop a case-specific explanatory formulation of the prisoner's offending (Nathan Reference Nathan and Wilson2020, Reference Nathan and Bhandari2024). Using this formulation, the psychiatrist can then offer an informed opinion about the factors that are associated with an increased likelihood of reoffending and, critically, what can be done to mitigate those factors. Psychiatric expertise is likely to have been called on to assist in understanding the ‘psychiatric’ components of the explanatory formulation and the potential management plan. Thus, as well as considering the nature of any psychiatric symptoms or traits (and any associated diagnoses), the assessment should cover the relationship between these features and the potential for reoffending, what interventions have been offered, the response to those interventions, and the prisoner's view about any offers of future support and treatment. For instance, in the case of a patient with an enduring psychotic illness, the psychiatrist should explore the potential relationship between features of the illness and previous offending. In doing so, the psychiatrist should bear in mind that the relationship between psychosis and the potential for offending can be accounted for by different explanatory process (e.g. direct responses to command hallucinations, oversensitivity in light of background paranoia and/or general reduction in frustration tolerance due to ongoing symptoms) (Anderson Reference Anderson and Nathan2022). Alternatively, if the patient experiences features of emotionally unstable personality disorder, exploring previous offences should take account of psychological process disturbances associated with borderline functioning, such as over-sensitivity to rejection, affective instability and/or prevailing negative affect. If the prisoner has previously been released and recalled, then the assessing psychiatrist should explore the reasons for recall, including the relevance of any mental state disturbance and adherence to available treatment.

‘Can be safely released into the community’

To understand how to formulate an opinion in the context of a report for a parole hearing, the psychiatrist needs to unpick the statement ‘can be safely released into the community’. First, they should consider the constituent elements of the ‘community’ that have a bearing on the potential for reoffending and particularly how they anticipate that the prisoner will interact with those elements of the community. They will need to consider whether the management plan includes the type of input indicated for identified ongoing clinical needs. If, for instance, the prisoner has an enduring psychotic illness, it is possible that community mental health services in the area to where the prisoner may be released have agreed in principle to offer ongoing care in the event of release. If not, then the psychiatrist should recommend that a referral is made. As with any psychiatric assessment, it is also necessary to take account of the relevance of wider social and interpersonal conditions to well-being and risk. In the context of a psychiatric report for a parole hearing, particular attention may be paid to the type of accommodation offered following release (e.g. approved premises), the proposed licence conditions and any specialist elements of the community management plan (e.g. offender personality disorder services). If the psychiatrist concludes that hospital treatment is required and that the criteria are met for admission under section 47 of the Mental Health Act, they should explain the type of treatment recommended, bearing in mind the availability of different treatments in hospital. This might include administration of medication under the Mental Health Act and specific psychological therapies.

The second important consideration about the test of whether a prisoner can be safely released into the community is its categorical nature. There is a more fundamental issue of whether a question about the future that is framed in an overtly categorical way can be answered by an expert who strictly adheres to the responsibilities incumbent on an expert witness (not to stray beyond the bounds of their expertise). Although risk assessment tools may help to guide clinical decision-making or to allocate resources (Whiting Reference Whiting, Mallett and Lennox2023), there is not a strong empirical basis supporting their use to make categorical risk estimates (e.g. low/medium/high risk) at a single point in time in an individual case (Scurich Reference Scurich2018). The Parole Board may, however, place reliance on these if they are made available. The expert can deal with this dilemma in different ways. For instance, if the expert is inclined to offer a categorical prediction, then it should be heavily qualified with a caveat about the unreliability of such predictions at a point in time in an individual case. Although we would advise against the quantification of future risk (e.g. in terms of a percentage), if the expert believes there is a case for doing so, then any numerical estimate of risk should be accompanied by an explanation of how this figure has been derived and its meaning for an individual case. Alternatively, the expert could articulate the risk and protective factors for recidivism and the steps that can be taken to mitigate the former and amplify the latter but stop short of opining on the ultimate question of whether the prisoner can or cannot be managed in the community. It can be particularly helpful if the report writer studies and comments on the risk management plan for release and highlights any gaps, and how these gaps may be addressed.

As well as undertaking an assessment interview and reviewing the available documents, the psychiatric opinion can be additionally informed by speaking to key individuals. With the patient's consent, it may assist to liaise with the community and prison offender managers and, if they have been involved, the prison mental health team. It is imperative that, when obtaining informed consent at the outset, the psychiatrist clearly explains the purpose of their involvement with particular regard to risk assessment and decision-making by the parole board. Although the psychiatrist should endeavour to obtain the patient's consent, if the patient refuses to agree to the psychiatrist contacting a person or accessing information critical to understanding risk and reaching an opinion about risk management, then the issue should be raised with the Parole Board case manager. The panel chair has the authority to direct access or contact.

The parole hearing

Having completed their report, the psychiatrist may be required to attend the parole hearing. The hearing starts with the chairperson explaining the nature of the referral, the role of the panel and its independence, and checks that all parties have the same dossier with all reports. The prisoner or their legal representative states their application. Mostly it is for release, but sometimes if there is still outstanding offending behaviour work or other issues, they may invite the panel to conduct a risk assessment, or in the case of a life-sentenced prisoner, consider transfer to an open prison. The order of witnesses, including the psychiatric witness, is agreed. The hearing is recorded. Usually, witnesses are not asked for their opinions about release or transfer until they give their evidence, but they may be asked at the start if they have not given a view or there has been a significant change.